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. In the United States, too many women experience serious and life-threatening health complications in the days and weeks after giving birth. Research shows that almost 40 percent of new moms miss their postpartum checkup. Even if you’re feeling fine, it’s important that you go to all your postpartum checkups. This allows you to share any concerns you have with your care team and allows them to look for warning signs of serious health problems, which can cause long-term health issues and even death, and provide treatment.

If you experienced a miscarriage, stillbirth, or your baby died, a postpartum checkup is especially important. A postpartum checkup may help your health care provider or other member of your care team, such as 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. They now encourage that postpartum care be an ongoing process, rather than a one-time checkup and now recommend that all new moms: 

• Have contact with their health care provider within 3 weeks of giving birth
• Get ongoing medical care throughout the postpartum period, as needed
• Have a complete and full medical 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. It’s best to make a postpartum care plan during pregnancy or at one of your prenatal care checkups. But if you didn’t get a chance to, it’s never too late. Your postpartum care plan should include:

• Contact information for your health care provider. How do you get in touch with your provider if you’re worried or have questions?
• The dates of all your postpartum checkups. Get in touch with your provider within 3 weeks of giving birth and schedule 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.
• Health conditions or pregnancy complications that need treatment after you have your baby. Your provider can help you manage these conditions or may want to refer you to other providers who specialize in treating certain conditions.
• 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. PPD 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.
• 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 preterm birth (birth before 37 weeks of pregnancy). Talk to your provider about the best birth control options for you. If you want to wait more than 18 months before getting pregnant again, talk to your provider about long-term reversible contraception, such as IUDs and implants. These types of birth control last for several years but can be stopped when you’re ready to get pregnant again.

What happens at a postpartum checkup?

Here’s what to expect at your postpartum checkup:

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 to check on your c-section incision (cut to ensure you’re healing well and without any problems.
• You get a pelvic exam. Your provider checks your vagina (birth canal), uterus (womb) and cervix. 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. If your provider prescribes any medication and you’re breastfeeding, be sure to tell your provider at your visit since some medicines can affect your breast milk.  
• 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.

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 preterm birth, you’re at higher risk for having another preterm birth in the future. Talk to your provider about what you can do to reduce risk of preterm 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 later in life.  For example, if you had a preterm 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) in the long-term. Heart disease affects the heart and blood vessels and can lead to serious problems, like heart attack or stroke.

Feelings about being a new mom. Tell your provider about how things are going. 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—these can be signs of PPD.

What is a 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. Members of your postpartum care team can include:

• Your prenatal care provider. 
• Your baby’s health care provider.
• A case manager or coordinator, such as a social worker.
• A doula or other perinatal birth worker.
• Lactation specialist or breastfeeding counselor.
• A licensed mental health counselor or mental health care provider.
• Health care providers who treat women with pregnancy complications or chronic health conditions.

If you have a chronic health condition, you may need to see other providers after pregnancy to treat those conditions. Chronic health conditions include:

• High blood pressure (also called hypertension).  Uncontrolled high blood pressure can lead to heart, disease, kidney disease and stroke.
• Obesity. If you have an excess amount of body fat and your body mass index (also called BMI) was 30.0 or higher before pregnancy, you’re considered to have obesity. 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 (type 1 or type 2 diabetes). Uncontrolled 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. If you have chronic kidney disease (also called CKD), your kidneys 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 and needs treatment to get better. Depression (also called major depression or clinical depression) is an example of a mood disorder. It can cause feelings of sadness, and a loss of interest in things you like to do.

Last reviewed: September, 2023