6 Things To Discuss At Your 6-Week Postpartum Check-up

Updated: Jul 13

Giving birth is incredibly hard on the body, no matter how your labor and delivery went. Despite the intensity, if you birthed in a hospital you'll likely only have one postpartum check-up with your medical provider. This appointment is traditionally around 6 weeks postpartum, and is usually about 10 minutes long.

Postpartum people often tell us that they were disappointed by how quick this appointment is. They expected more support, during a very tough time.


We believe that the 6-week checkup is misunderstood. People expect it to be cohesive postpartum care, when in reality, that's not your OB or hospital midwife's scope.


Included in your 6-week appointment: Checking in on your physical recovery

NOT included in your 6-week appointment: lactation, sleep, nutrition, mental health, family dynamics.... basically all the things that are super hard about postpartum. If you have questions about any of these topics, we encourage you to reach out to a postpartum doula.


Consider the list of discussion topics below, to make the most of your 6-week appointment:


1. Clarify lingering questions from your birth

Even if you're not meeting with the provider who actually attended your birth, they still have access to your medical notes. They can clarify things you might want to understand, now that you're a few weeks removed from the fog. Examples might be: "how many stitches did I get?" "what position did baby come out in?" "what was that medication they gave me when I was 5cm dilated?" etc. etc. PRO TIP: Keep a running list on your phone of these types of questions, so you don't forget any when it comes time for your appointment.


2. Get cleared for sex and exercise..... maybe

It's pretty normal for a provider to "clear" you for sex and exercise at your 6-week appointment, after just asking you a few questions. They don't usually do internal exams, unless you request one, so what's this clearance based off of? Nothing.


We believe this clearance is inappropriate, and a part of rape culture. Only YOU can decide when you want to have sex again - that's not your doctor's decision. Some people are ready before 6 weeks, and some aren't ready for a few more weeks/months.


As for exercise - nobody should be running until minimum 12 weeks postpartum. But it might be time for gentle movement, provided your pelvic floor and abdominal muscles are in a good place (see bullet #3 and #4 below).


3. Discuss your pelvic floor

Being pregnant is really hard on your pelvic floor muscles, and most people experience weakness after birth. Side effects are: pain with sex, back or pelvic pain, incontinence, etc. These are all common in the first few weeks, but not normal long-term. If you're still experiencing any of them by your 6-week appointment, ask your medical provider for a referral to a pelvic floor physical therapist. Here in the Twin Cities we recommend Moms in Motion PT.


PRO TIP #1: don't take "no" for an answer on this one. We often hear of OBs saying that you should just wait it out, but we believe that nobody should live in unnecessary pain. PRO TIP #2: not all insurance companies require referrals for pelvic floor PT - you might be able to just schedule an appointment. Ask your insurance company, or consider paying in cash!


4. Get checked for Diastasis Recti

Diastasis recti is the separation of the abdominal muscles in pregnancy. It can leave you looking like you're 4-5 months pregnant for months, or years, after birth. It's very common, and can be fixed with specific exercises or PT; surgery is not usually needed. BUT traditional ab exercises (crunches, planks, downward dog, leg lifts, etc) make diastasis recti worse, and should be avoided.


Diastasis recti is measured in finger-widths, meaning: how many fingers fit between your separation? You can follow this video to diagnose yourself, or ask your medical provider for help. PRO TIP: Normal exercise should NOT be resumed if you have a gap wider than 2 finger-widths. Focus on closing the gap first.


5. Be honest about your mental health

If you think you might be experiencing postpartum depression, anxiety, rage/anger, PTSD, or any other mental illness, call your provider right away. Postpartum mood disorders are common and they're treatable. Your provider can help you with medication or refer you to a mental health professional who specializes in postpartum. It's really useful to see someone with the postpartum specialty, because postpartum mood disorders are unique. Postpartum depression isn't the same as depression you may have experienced before pregnancy. In the Twin Cities, we recommend: Amber Williams at Wild Tree Wellness.


Perinatal mood disorders are common, but many of us don't recognize we have them - we just think we're failing. Have an open and honest conversation with your care provider about how you're feeling.


6. Ask about birth control options

Your cycle may come back as quickly as 6 weeks postpartum, or possibly not until you're done lactating. Breast/chestfeeding also reduces your chances of getting pregnant. BUT if you're interested in preventing pregnancy, birth control might be part of your postpartum care plan. PRO TIP: research options in advance, so you go into the conversation from a place of knowledge. Check out options on bedsider.org.

 

We hope this list helps you prepare for your appointment!


To learn more about postpartum, register for our Postpartum Workshop!


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