You’re six weeks postpartum! You may be feeling back to normal, or may still be wondering how you will ever get there. You might be ready to exercise and have sex, or you may be wondering how you will ever manage to do these things again. Regardless, six weeks is the perfect time to be having these thoughts, as you will be checking in with your provider for your six week postpartum visit.
What happens at the six week postpartum checkup? This checkup will start normally with the typical weight and vital signs being taken. There will then be a pelvic exam to make sure the uterus is back to its normal size and that there is no sign of infection. For women who have had incisions due to cesareans or episiotomies, these will be checked as well. Since this appointment can count as your annual well woman exam, your provider will often times do a pap smear. A breast exam will also be done to feel for any abnormal lumps. This is a great time to bring up any discomforts and ask questions about anything that may feel not quite right. Other important matters addressed in this checkup include mental health and birth control. Usually, there will be a screening for postpartum depression and other perinatal mood disorders. The screening can vary in detail from provider to provider, so it is important to remember to speak up if you feel anything is not quite right with your mental state. Perinatal mood disorders are more easily managed when addressed and treated earlier on. Your provider will also start to talk to you about birth control, and see which option you may want to pursue. Some changes may need to take place from methods you previously used. For women wanting to continue taking the pill who are breastfeeding, a progesterone only pill will be prescribed, because the pills with estrogen can lower milk supply. Also, women who were using the diaphragm will need to be fitted for a new one. It is important to pick a birth control method you are comfortable with, which you feel will be most effective with your new pace of life. When can I have sex again? At your six week appointment, your provider will give you the all clear to start having sex again if everything checks out normal. If your lochia (postpartum bleeding) has stopped, this is a great sign that the lining of your uterus has healed. It is important to wait until you are healed before engaging in sex, and know that if you had a tear or episiotomy, it may take a little longer for you to feel ready. Does sex hurt after childbirth? It is common for women to have discomfort the first few times they have sex after having a baby. Often times, a water based lubricant can be helpful in easing this discomfort. For couples using condoms, be sure to avoid oil based lubricants. For longer term issues with pain, there may be a pelvic floor issue. A call to your provider and/or referral to a physical therapist can help with this. Above all... remember this: It is most important when getting back to your normal routine, that you listen to your body and don’t push it further than it wants to go. Remember that the six week recommendation is a guideline, not a must. If anything is particularly bothersome, reach out to your provider at any time.
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