Postpartum Basics: The Six-Week Visit

This appointment takes place at an essentially arbitrary amount of time after giving birth. Six weeks isn't a magic number, -- you're bouncing back from major body changes -- but by this point, the uterus has been allowed to return to its normal size (about as big as a pear), bleeding has resolved, the episiotomy has healed, and if a woman has had a cesarean, that scar has healed as well. If there have been any problems in the interim, such as heavy bleeding that continues after the first month or continued pain and fever, signaling an infection, I should have had heard from the patient. At the six-week appointment, I can pretty much assess the state of a woman's pelvic recovery by the way she walks into the office -- whether her movements are normal or whether, in the rare case, she still has the "saddle sore" look that women have after they've just given birth. I perform a pelvic exam to ensure that everything has healed well and has returned to its pregnancy state. I also do a Pap smear, breast exam and thyroid exam (sometimes thyroid problems develop after a pregnancy), and I initiate a discussion about birth control.

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