Your postpartum checkups

What is a postpartum checkup and why is it important?

A postpartum checkup is a medical checkup you get after having a baby to make sure you’re recovering well from labor and birth. Go to your postpartum checkups, even if you’re feeling fine. They’re an important part of your overall pregnancy care. Postpartum care is important because new moms are at risk of serious and sometimes life-threatening health complications in the days and weeks after giving birth. Too many new moms have or even die from health problems that may be prevented by getting postpartum care.  

Postpartum checkups are important for any new mom. They’re especially important for moms who have a loss, including:

• Miscarriage. This is when a baby dies in the womb before 20 weeks of pregnancy.
• Stillbirth. This is when a baby dies in the womb after 20 weeks of pregnancy.
• Neonatal death. This is when a baby dies in the first 28 days of life.

When these things happen, your postpartum checkups may help your health care provider or a genetic counselor learn more about what happened and see if you may be at risk for the same condition in another pregnancy. A genetic counselor is a person who is trained to help you understand about genes, birth defects and other medical conditions that run in families, and how they can affect your health and your baby’s health.

What’s changed in postpartum care guidelines?

The American College of Obstetricians and Gynecologists (also called ACOG) has released new guidelines calling for changes to improve postpartum care for women. In the past, ACOG recommended that most women have a postpartum checkup 4 to 6 weeks after giving birth. ACOG now says that postpartum care should be an ongoing process, rather than a one-time checkup. ACOG now recommends that all women:

• Have contact with their health care provider within 3 weeks of giving birth
• Get ongoing medical care during the postpartum period, as needed
• Have a complete postpartum checkup no later than 12 weeks after giving birth

Many of the discomforts and body changes women have in the weeks after giving birth are normal. But sometimes they’re warning signs or symptoms of a health problem that needs treatment. Seeing your provider sooner and more often can help you and your provider spot these signs and symptoms and may help prevent serious medical problems. Your postpartum care should meet your personal needs so you get the best medical care and support.

What is a postpartum care plan?

A postpartum care plan is a plan that you and your health care provider make together. It helps you prepare for your medical care after giving birth. Don’t wait until after you have your baby to make your plan. Make it during pregnancy at one of your prenatal care checkups.

To make your plan, talk to your provider before you give birth about:

• Contact information for your health care provider. How do you get in touch with your provider after your baby’s born if you’re worried or have questions?
• Your postpartum checkups. Based on the new guidelines, ACOG recommends contacting your provider within 3 weeks of giving birth and a complete checkup within 12 weeks of giving birth. Talk with your provider to make sure this timing is right for you. Find out if your health insurance plan covers all your postpartum checkups. Look at the company’s website or call the number on your insurance card.
•  Your reproductive life plan, including birth control. A reproductive life plan helps you think about if and when you want to have more children. For most women, it's best to wait at least 18 months (1½ years) between giving birth and getting pregnant again. Too little time between pregnancies increases your risk of premature birth (before 37 weeks of pregnancy). Talk to your provider about birth control so you don’t get pregnant again too soon. Ask your provider before you give birth about getting an intrauterine device (also called IUD) or implant right after you have your baby. IUDs and implants are the most effective kinds of birth control.
• Health conditions or pregnancy complications that need treatment after you have your baby. Your provider can help you manage these conditions. You may need extra postpartum checkups to make sure you’re healthy. Your provider may want to refer you to other providers who specialize in treating certain conditions.
• Feeding your baby. Are you planning to breastfeed your baby or feed your baby formula? If you’re planning to breastfeed and you’re going back to work or school after your baby’s born, what’s your plan for feeding? Your provider can help you find a lactation consultant to help with breastfeeding. A lactation consultant is a person trained to help women breastfeed.
• Common physical and emotional changes after pregnancy. What can you expect after giving birth? What’s normal and how do you know when something’s more serious? What are signs and symptoms of serious health conditions to look for after giving birth?
• Postpartum depression (also called PPD) and other mental health conditions after pregnancy. Postpartum depression is a kind of depression that some women get after having a baby. It’s strong feelings of sadness, anxiety (worry) and tiredness that last for a long time after giving birth. PPD is a medical condition that needs treatment to get better. Talk to your provider about looking out for signs and symptoms of PPD.

What happens at a postpartum checkup?

At your postpartum checkup, your provider makes sure you’re recovering well after giving birth and adjusting to life as a mom. Here’s what to expect:

Physical exam

• Your provider checks your blood pressure, weight, breasts and belly. If you had a cesarean birth (also called c-section), your provider may want to see you about 2 weeks after you give birth so she can check on your c-section incision (cut). A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. Most c-section incisions heal without any problems, but they can get infected.
• You get a pelvic exam. Your provider checks your vagina (birth canal), uterus (womb) and cervix. The cervix is the opening to the uterus that sits at the top of the vagina. If you had an episiotomy or a tear during birth, your provider checks to see that it’s healed. An episiotomy is a cut made at the opening of the vagina to help let the baby out. Your provider can tell you when it’s safe to have sex again.
• Your provider checks on any health conditions, like diabetes and high blood pressure, you had during pregnancy. For example, if you had gestational diabetes, your provider may give you a blood glucose test to check your blood sugar. Gestational diabetes is a kind of diabetes that some women get during pregnancy. If you’re breastfeeding, ask your provider to make sure any medicine you take is safe for your baby. You may need to stop taking a medicine or switch to one that’s safer during breastfeeding. Don’t stop taking any medicine without talking to your provider first.
• Your provider makes sure your vaccinations are up to date, including vaccinations for flu and pertussis. By getting vaccinated, you can help keep from getting sick and passing an illness to your baby.

Birth control. If you didn’t talk about birth control with your provider before you had your baby, talk about it at your postpartum visit. Talk to your provider about birth control options and how they fit with your plans about having more children. Ask about using an IUD or implant to help keep you from getting pregnant again too soon.

Problems you had during pregnancy, labor and birth that may affect your health after pregnancy. This is the time to talk about how you may be able to prevent problems in future pregnancies, even if you’re not thinking about having another baby now. For example, if you had a premature birth, you’re at increased risk of having a premature birth in another pregnancy. Talk to your provider about what you can do to reduce risk of premature birth and other complications in your next pregnancy. Even if you don’t plan to have more children, ask your provider if any problems you had during pregnancy may affect your health in the future. For example, if you had a premature birth, gestational diabetes, gestational hypertension (high blood pressure) or a condition called preeclampsia, you may be at increased risk of cardiovascular disease (also called heart disease) later in life. Heart disease affects the heart and blood vessels and can lead to serious problems, like heart attack or stroke. It’s also a leading cause of pregnancy-related death.

Feelings about being a new mom. Tell your provider about how things are going. It’s OK to tell her how you feel. It’s normal to feel tired and stressed in the weeks after birth. You may have questions about breastfeeding and caring for your baby. Tell your provider if you have feelings of sadness or worry that last for a long time. If you have postpartum depression, it can make it hard for you to take care of yourself and your baby. It’s a medical condition that needs treatment to get better.

What is a postpartum care team?

You may need postpartum care from providers other than your prenatal care provider. For example, if you have chronic health conditions, you may need to see other providers after pregnancy to treat those conditions. These providers are part of your postpartum care team. A postpartum care team is a group health care providers and other postpartum care experts who help you get medical care and support after you give birth.

A chronic health condition is one that lasts for a long time or that happens again and again over a long period of time. Chronic health conditions include:

• High blood pressure. Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. If the pressure in your arteries becomes too high, you have high blood pressure (also called hypertension). High blood pressure can put extra stress on your heart and kidneys. This can lead to heart, disease, kidney disease and stroke.
• Obesity. If you’re obese, you have an excess amount of body fat and your body mass index (also called BMI) is 30.0 or higher before pregnancy. BMI is a measure of body fat based on your height and weight. To find out your BMI, go to www.cdc.gov/bmi.
• Preexisting diabetes. This is a medical condition in which your body has too much sugar (called glucose) in your blood. Preexisting diabetes (called type 1 or type 2 diabetes) means you had diabetes before you got pregnant. Diabetes can damage organs in your body, including blood vessels, nerves, eyes and kidneys.
• Thyroid conditions. The thyroid is a gland in your neck that makes hormones that help your body store and use energy from food. If it makes too little or too much of these hormones, you can have health problems.
• Kidney disease. Your kidneys filter your blood, removing waste and extra water. They also keep your body’s chemicals balanced, help control your blood pressure and make hormones. If you have chronic kidney disease (also called CKD), your kidneys are damaged and can’t filter blood like they should. This can cause waste to build up in your body. Untreated kidney disease can lead to kidney failure.
• Mood disorders. A mood disorder is a mental health condition that affects your emotions. Depression (also called major depression or clinical depression) is an example of a mood disorder. Depression causes feelings of sadness and a loss of interest in things you like to do. It can affect how you feel, think and act and can interfere with your daily life. It’s a medical condition that needs treatment to get better.

Members of your postpartum care team can include:

Your prenatal care provider. This is the provider who takes care of you during pregnancy, labor and birth.

Health care providers who treat women with pregnancy complications or chronic health conditions. For example, you may need to see a maternal-fetal medicine specialist (also called an MFM). MFMs are doctors with special education and training to take care of women who have high-risk pregnancies. Or if you have depression, you may need to see a mental health professional. A mental health professional is a provider who helps people cope with emotional or mental health problems. Mental health providers include social workers, therapists, counselors, psychologists, psychiatrists and psychiatric nurse practitioners.

Your baby’s health care provider. Your baby’s health care provider has medical training to take care of babies and children. Your baby’s provider may be:

• A pediatrician. This is a doctor who has training to take care of babies and children.
• A family practice doctor (also called a family physician). This is a doctor who takes care of every member of the family. A family practice doctor can be your health care provider before, during and after pregnancy, and your baby's provider, too.
• A neonatologist. This is a doctor who takes care of sick newborns, including premature babies (babies born before 37 weeks of pregnancy) and babies with birth defects.
• Pediatric nurse practitioner (also called PNP). This is a registered nurse who has advanced training to take care of babies and children.
• Family nurse practitioner (also called FNP). This is a registered nurse with advanced training to take care of every member of your family.

Breastfeeding help. You and your baby may need time and practice to get comfortable breastfeeding. Don’t be afraid to ask for help! You can get breastfeeding help from: 

• A lactation consultant. You can find a lactation consultant through your health care provider or your hospital. Or contact the International Lactation Consultants Association.
• A breastfeeding peer counselor. This is a woman who breastfed her own children and wants to help and support mothers who breastfeed. She has training to help women breastfeed but not as much as a lactation consultant. You can find a peer counselor through your local WIC nutrition program. Or visit womenshealth.gov/breastfeeding or call the National Breastfeeding Helpline at (800) 994-9662.
• A breastfeeding support group. This is a group of women who help and support each other with breastfeeding. Ask your provider to help you find a group near you. Or go to La Leche League.

Case manager or care coordinator. This is a nurse, social worker or other trained professional who works with members of your postpartum care team to make sure you and your baby get the care, resources and services you need.

Home visitor. This is a nurse, social worker or other trained professional who makes regular visits to your home to help you and your baby. Home visitors can help you learn how to care for your baby and understand your baby’s developmental milestones. These are skills or activities that most children can do at a certain age. Milestones include sitting, walking, talking, having social skills and having thinking skills. A home visitor also can help connect you to community resources and services. The Nurse-Family Partnership and Healthy Start are examples of community health programs that offer free home-visiting services.

Family and friends. Your family and friends can help you care for your baby or older children. Tell them if you need help with meals, chores around the house or a ride to your postpartum checkups. Family and friends can keep an eye out for warning signs of health problems you may have after birth, including signs and symptoms of postpartum depression or other mental health conditions.

Last reviewed: July, 2018