young mum and baby

You’re emerging from the newborn fog and it’s time for you and your baby to visit your GP. Here’s how to get the most out of it and what happens.

What you need to know about the six-week check

About six weeks after you give birth, your baby should have a check-up with your GP and you will probably have a postnatal check-up appointment. Yours and your baby’s check-ups might be combined (NHS, 2018a).

Your baby’s six-week appointment is a chance for your GP to give your baby a check-up to make sure they’re well. Your postnatal check-up is to see that you’re on the road to recovery.

Some GP surgeries don’t routinely offer a postnatal check-up. So it’s good to know that you might have to request it if you want one, for example if you have any worries.

Your baby’s six-week check

Your baby will probably get a six to eight week once-over, which might be combined with yours (NHS, 2018a). Your GP has specific things to check for your baby’s six-week appointment.

This check is the same as your baby's newborn physical examination, which they would have had within 72 hours of birth. So you can expect all of the same kinds of tests to come up, such as checks of their eyes and their hips. Extra checks include reflexes – moro, stepping, whether your baby smiles and follows you around, and listening for any heart murmurs.

Your GP might also check with you that your baby is booked in for their injections.

What might be covered at your six-week postnatal check

Your six-week check can vary depending on your GP practice and how long your appointment is. The GP might do a physical examination if they think it’s necessary, e.g. if you tell them about something they’d need to check.

The GP is there to help you, not judge you. So try to remember it’s ok to tell your GP about any worries and concerns you might have.

Unlike when they did your baby’s check, GPs have no set guidelines for what they should check with you during your six-week postnatal check. So you might find it useful to jot down some questions or points in advance  (NHS, 2016a). That way nothing will slip your (probably sleep-deprived) mind.

Partners are welcome to come too. They might just give you that extra bit of support.

The following topics and checks might be covered in your check-up…

How you are

You can discuss how you are feeling, and your mental health and wellbeing. Your GP may consider your risk of postnatal depression and anxiety, including whether you’ve had any mental health concerns before. They might also ask you about your worries or any symptoms you’re getting that might mean you’re not as well as you could be.

They might ask about your lifestyle too. They may ask questions about things like what support you get at home, how well you’re sleeping and about your other children

Vaginal discharge

Your GP will normally ask about your vaginal discharge. They’ll also ask whether you have had a period since the birth. See our article about bleeding after birth for more details on what to expect to see. Thrush is very common too at this time.

Your tummy

Your GP might feel your tummy to make sure your uterus has gone back into its old position.

Checking your wound

If you had an episiotomy or caesarean section, your GP may offer to check your wound (NHS, 2016b).

Pelvic floors and your vagina

Your GP will give you leaflets or tell you how best to do pelvic floor exercises. They may also ask whether you’ve had any sexual problems since the birth, including about any pain or libido issues that are affecting things.

Going to the toilet

Your GP might ask you whether you find you’re weeing, pooing or farting when you didn’t mean to. And whether you wee yourself when you cough or laugh. They may also ask whether you get any pain when you have a poo.

Constipation due to not drinking enough when breastfeeding and bleeding from piles are both very common.

Breast health and feeding

Your GP might ask you about how breastfeeding is going and whether you have any symptoms of anything like mastitis. They might be able to give you details about feeding support if you need any and may examine you if there’s a problem with pain.

Legs

Your GP might ask about any varicose veins, swelling or any symptoms you’re having with your legs that might suggest a blood clot.

Weight

If your BMI is 30 or more, your GP might ask to weigh you. They can also give you some weight loss advice and guidance on how to eat more healthily. They’ll also advise on how to get fit and exercise.

Medical problems

If you had a medical problem when you were pregnant or if a previous issue got worse, your GP might give you a check-up to see how things are going. For example, your GP will normally check your blood pressure if you had problems during pregnancy or right after the birth (Guy’s and St Thomas’ NHS Foundation Trust, 2016). They will also do blood tests if appropriate, e.g. for anaemia.

Contraception

Your GP will ask you what contraception you now plan to use and issue you with a prescription if needed (NHS, 2017b).

Rescheduling a smear test

If your smear test was due while you were pregnant, it can be rearranged for 12 weeks after you gave birth (NHS, 2018b).

Six-week check: things to think about beforehand

How do I really feel?

Plenty of myths surround parenthood and mental health. Whatever the myths say, becoming a parent is a massive life change, and it's totally normal to feel overwhelmed after you give birth. But if your feelings start to impact how you live your life, you might have a mental health problem (Mind, 2016a).

Some sources say around one in five women will experience a mental health problem during pregnancy or in the year after giving birth (MIND, 2016a). Yet a survey by NCT found that half of new mothers experience emotional problems during this time. Interestingly, as many as 60% of these mothers who were experiencing emotional problems felt too worried or ashamed to be able to discuss them (NCT, 2017).  

So if you are experiencing emotional problems, you’re certainly not alone (Mind, 2016b). You could speak to your GP about getting some help and support, and take a look at the support details in the Further information section below. It’s definitely worth discussing any problems as 82% of women in this situation say that treatment really does help (NCT, 2017).

What’s happening down below?

If you’re having trouble stopping yourself from weeing or are pooing or farting unexpectedly, do mention this to your GP. These issues often happen if you’ve had a severe tear (UCLA Health, 2018).

Is sex painful?

If you have discomfort around your perineum (the part between your bum and vagina), your GP should check to make sure it’s healing well.

Dryness may contribute to sex being painful, and oestrogen levels after childbirth are partly to blame (NHS, 2018c).

But probably the most important reason for dryness is that you’re knackered and adapting to your post-birth body, so you’re not sexually aroused enough to produce lubrication. Your GP will examine you but usually lubricating gel will help.

Have I had my MMR vaccination?

If you’re not sure whether you’ve had two doses of MMR, ask your GP. You can have them done by your practice nurse. You should avoid getting pregnant until a month after having an MMR vaccination (NHS, 2018d).

Do I have any other worries?

If you have any other worries, now’s the time to bring them up. Some parents worry about feeding, colic or spots on their baby’s face (this is normal at six weeks as the baby still has some of your hormones in their body). Others might have questions about how to reduce the risk of SIDS.

Just don’t forget that list…

This page was last reviewed in April 2018.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

You might also like to try one of our Mother and Baby Yoga courses, which aim to help improve your physical and emotional wellbeing, as well as feel more confident and positive.

Mind, a leading mental health charity, provides information on a range of mental health topics including postnatal depression and has an infoline for support: 0300 123 3393.

#PNDHour is an online peer support group that runs every Wednesday at 8pm via the Twitter account @PNDandMe. Anyone can join in to discuss topics about antenatal and postnatal depression, such as self-care, medication and seeking help. It’s run by a mum called Rosey who also blogs about her own experiences with antenatal and postnatal depression, as well as raising awareness of perinatal mental illness, at PND and me.

The charity Tommy's has information about mental health in pregnancy as well as a Wellbeing Plan to help parents talk more openly about how they’re feeling.

The Royal College of Psychiatrists has information on mental health in pregnancy

Effective psychotherapeutic treatments can be found in your area. Check out the British Association for Counselling & Psychotherapy the United Kingdom Council for Psychotherapy (UKCP) and the British Psychoanalytic Council (BPC) for a list of recommended therapists.

Wellbeing Scotland or Niamh (in Northern Ireland) are leading providers of mental health information in their regions, for further information on PND.

U.S. National Library of Medicine. (2018) Vaginal delivery – discharge. Available at: https://medlineplus.gov/ency/patientinstructions/000628.htm [last accessed 22nd April 2018].

Guy’s and St Thomas’ NHS Foundation Trust. (2016) Postnatal hypertension (high blood pressure). Available at: https://www.guysandstthomas.nhs.uk/resources/patient-information/maternity/postnatal-hypertension.pdf [last accessed 22nd April 2018].

NCT. (2017) The hidden half. Bringing postnatal mental illness out of hiding. Available at: https://www.nct.org.uk/sites/default/files/related_documents/NCT%20The%20Hidden%20Half%20shortform%5B1%5D_0.pdf [last accessed 22nd April 2018].

NHS. (2016a) Your six-week postnatal check. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/postnatal-check/ [last accessed 22nd April 2018].

NHS. (2016b) Caesarean section. Available at: https://www.nhs.uk/conditions/caesarean-section/recovery/ [last accessed 22nd April 2018].

NHS. (2017a) Episiotomy and perineal tears. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/episiotomy/ [last accessed 22nd April 2018].

NHS. (2017b) When can I use contraception after having a baby? Available at: https://www.nhs.uk/conditions/contraception/when-contraception-after-baby/ [last accessed 22nd April 2018].

NHS. (2018a) Newborn physical examination. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/newborn-physical-exam/ [last accessed 22nd April 2018].

NHS. (2018b) Cervical screening. Available at: https://www.nhs.uk/conditions/cervical-screening/ [last accessed 22 April 2018].

NHS. (2018c) Vagina changes after childbirth. Available at: https://www.nhs.uk/Livewell/vagina-health/Pages/vagina-after-childbirth.aspx [last accessed 22nd April 2018].

NHS. (2018d) MMR vaccine. Available at: https://www.nhs.uk/conditions/vaccinations/mmr-vaccine/ [last accessed 22nd April 2018].

Mind. (2016a) Postnatal depression and perinatal mental health. Available at: https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/#.WtiaSWaZPwc [last accessed 22nd April 2018].

Mind. (2016b) Understanding postnatal depression and perinatal mental health. Available at: https://www.mind.org.uk/media/4852718/understanding-postnatal-depression-2016.pdf [last accessed 22nd April 2018].

UCLA Health. (2018) Childbirth and incontinence. Things you should know. Available at: http://obgyn.ucla.edu/childbirth-and-incontinence [last accessed 22nd April 2018].

 

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