A guide to your six week postpartum checkup
Navigating the early postpartum days can be challenging, and at times, overwhelming. Sleep deprivation, hormonal fluctuations, and major changes to your body only skim the surface of what you may be experiencing. When you add all of this on top of trying to care for a new life, simply brushing your teeth and changing out of your pajamas can feel like a huge accomplishment! You may compare yourself to others and even wonder if your own postpartum experiences are “normal.” You may have questions about your healing such as:
- “Should my incision to still hurt?”
- “Does everyone leak when they sneeze after having a baby?”
- “Am I the only one who is nervous to have sex for the first time postpartum?”
Why is the six week postpartum visit important?
Fortunately, most women will have a six week postpartum checkup with their OB. This is the time to get some of your questions answered. Often, this visit is viewed as a necessity to get the “all clear” to return to activities like exercise and intercourse. It can also be a great opportunity for understanding your birth experience and healing process. Let’s talk about a few topics which you may want to discuss at your six week postpartum checkup. Let’s review why this visit is so important. You may also want to consider a six week postpartum checkup with a pelvic floor PT, too.
Review your labor and birth
Do you have any lingering questions that you did not have a chance to ask at the time of birth? Were there any concerns about your delivery that you want to discuss? Your six week postpartum checkup is a good time to talk about your labor and delivery experience with your provider. You may have played your birth experience over and over in your head. Or, you may not have thought about it at all since your little one entered the world. It is great to have a birth plan prior to delivery, but as you may know, labor does not always follow this plan. Your experience may not be what you had imagined. This can be hard to process emotionally as well as physically. Sometimes, talking through this experience with your provider can be helpful. In addition, you may have questions about what interventions were chosen and why or how later births may be affected. This is the perfect time to get your questions answered. Write them down and bring them to your six week postpartum checkup.
Discuss persistent symptoms
This visit is also the time to discuss any lingering physical symptoms you may have and to check in on your healing process. Your body goes through a number of physical changes during pregnancy and childbirth and can often feel unrecognizable. It is no wonder we have questions about what is normal and what is not. You may have heard of terms like diastasis recti and pelvic organ prolapse on social media or from friends and family. You may be wondering if you are experiencing any of these things. If you have concerns, your six week postpartum checkup is the perfect time to have your doctor perform an assessment. If needed, they may refer you to a pelvic floor physical therapist.
Mental health check in
The postpartum period can bring on a vast array of emotions. Your doctor will most likely inquire about how you have been feeling emotionally and how you are adjusting to the new demands of motherhood. Make sure to discuss any concerns you may be having including increased anxiety, depression, exhaustion or other overwhelming emotions. Sometimes, it can be hard to decipher between the typical “baby blues” or something more, and your doctor can help you navigate these emotions and recommend additional resources if needed.
You may want to ask your doctor if you are due for any standard routine tests such as a pap smear or blood work or if you need any additional follow up postpartum visits. Birth control may also be another topic that you wish to discuss at this time. In addition, you may want to inquire about the length of time your doctor recommends you wait to get pregnant again or if they have any recommendations for future pregnancies.
Do I need a referral for pelvic floor physical therapy?
In the state of Louisiana (where we are located!), a referral from a physician is not required to attend pelvic floor physical therapy. In addition to your OB appointment, we also like to see patients for their first postpartum session between 4-6 weeks after birth. Bonus, if you book with us locally, you are welcome to bring your baby to the session. If you would like additional support prior to the 4 week mark, we offer online sessions. If you aren’t local, check out the American Physical Therapy Association’s physical therapy locator to find one near you. Additionally, your OB can likely point you in the direction of a skilled pelvic floor physical therapist if you are having trouble finding one.
Why is a postpartum pelvic floor physical therapy appointment necessary?
Because your body just went through major changes and a therapist can help your body heal. This appointment is necessary for both vaginal and cesarean births. Did you know a pelvic floor physical therapy appointment postpartum is standard in other countries (including France) in addition to the OB appointment? If you see a pelvic floor PT postpartum, we can address symptoms you may be having such as leakage (urinary or fecal), pelvic pressure, prolonged postpartum bleeding, or any pain that you are experiencing including abdominal, low back, pelvic, and hip pain.
A six week postpartum visit with an OB typically does not include screening or assessment for pelvic floor issues that would warrant a referral to a pelvic health physical therapist. A physical therapist will perform a thorough exam to assess your muscle function and coordination and help guide you through your healing process in order to return to the activities you love safely. A PT will check you for diastasis recti, help you learn exercises to heal it, discuss any issues you had during pregnancy, discuss incontinence issues, painful sex and how to prepare for your first time after baby, kegels (sometimes kegel can make issues “down there” worse) and more.
Top questions to ask at your six week postpartum checkup with a PT
- Can you examine my abdominal wall for diastasis recti? If I have it, how severe is it?
- How is my pelvic floor strength and coordination?
- How has my scar (perineal or cesarean) healed? How is the tissue mobility? Can you show me some exercises to help with massage around the area?
- Do I have a pelvic organ prolapse?
- Is pain normal during my postpartum exam or with intercourse? What can I do about vaginal dryness postpartum?
- What can I do to prepare for sex postpartum?
- What are some concerning symptoms I should be on the look out for?
The bottom line
While babies will have multiple doctor’s appointments over their first year of life, new mothers will most often only have one (or two!). Hopefully, this post will guide you in making the most of your six week postpartum checkup, encourage you to seek answers to your concerns, and pursue the care you need to heal, whether physical or emotional.
P.S. Check out our “What to expect from your body postpartum” series with advice for 0-2 weeks postpartum, 2-4 weeks postpartum and 4-8 weeks postpartum.
Are you currently pregnant or planning to conceive? If so, make sure to download my FREE resource — 5 Myths We’ve Been Told About Pregnant Bodies! I correct common pregnancy myths and give you tons of tips to help you feel strong and healthy for 40 weeks and beyond.
Ashley Holstein PT, DPT is a native of New Orleans and attended Mount Carmel Academy. She obtained her Bachelor’s of Kinesiology from Louisiana State University and went on to receive her Doctorate of Physical Therapy in 2013 from Louisiana State University Health Sciences Center in New Orleans. Originally starting her physical therapy career in orthopedics, she developed a passion for pelvic health physical therapy when pregnant with her daughter and transitioned to this specialty full-time. Ashley is certified in dry needling and is also an adjunct professor with Delgado’s Physical Therapist Assistant program. Ashley enjoys reading, attending festivals, and spending time with her husband, daughter, and two dogs.
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