What happens at the 6 week postpartum check up – and what I really needed
I remember my very first 6 week postpartum check up like it was yesterday.
I was so exhausted even my bones were tired. My hair was greasy and well overdue for a cut. I was wearing blue skinny jeans that I only fit back into because I’d been living on whatever I could grab one handed for the past 6 weeks and the baby weight had fallen off me. I remember being congratulated for this, even though it was a sign that I was struggling (what a funny twisted world we live in).
The most unforgettable memory I have though is my anxiety (though at the time I didn’t even know what I was feeling was anxiety). I felt like I was on high alert 24/7. I felt like I couldn’t relax or something bad would happen. Anything that involved getting out of the house with the baby sent me into a spin. So you can only imagine how I felt on this 3 hour round trip to my doctor’s appointment.
My sister-in-law met me at the coffee shop underneath the doctor’s office so she could hold Eamon while I went to my appointment. I remember I’d run over the details in my head a million times in the weeks leading up to the appointment.
What time I’d have to leave.
What time I’d have to start getting ready in order to be able to feed him for at least forty minutes before I left to make sure he’d sleep in the car on the way there.
How early I’d have to leave in case he screamed on the way down and I had to pull over and stop to feed him.
Where on the 1.5 hours of country roads I could stop and feed him.
What time I had to be there in order to leave enough time to feed him again before going into the doctors.
How many tonnes of baby paraphernalia I would need to take for one day out.
I remember I drank two cups of coffee before I left that morning as this was pretty much a standard morning ritual for me back in those days. (LOLs at myself in hindsight – no wonder I was so freaking anxious).
I remember instantly regretting those cups of coffee once I was on the road. The baby was sleeping peacefully and all was going to plan except for the fact that now I desperately needed to pee and there was not a toilet in sight for miles. (But I digress, my lack of pelvic floor strength was not the point of this article though is probably somewhat relevant.)
My doctors appointment was very brief. I was seeing a private obstetrician. At the time I thought he was great. He had been friendly and personable in all of my pregnancy appointments. But being that this was my first time having a baby and my first experience of postpartum, I didn’t know how it was meant to be. I didn’t know what I didn’t know.
He asked me how I was healing. (I’d ended up with an episiotomy). I replied ‘good’ but to be honest I’d done very little exploration of the area. I’d found birth and recovery traumatic and I’d pretty much just blocked thinking about it once the immediate pain of the stitches had faded.
He performed a pap smear (as was his standard practice) after he checked how my stitches had healed. Because there is nothing more delightful 6 weeks after giving birth and recovering from birth injuries than having a speculum shoved up there… is there?
His actual words after this were ‘You’re all good – you can start mowing the grass again now.’ I’m still not sure whether he was referring to my total lack of trimming down there since I’d lost the ability to see said area back in the late second trimester or whether this was some strange euphemism for sex.
I remember leaving that appointment feeling baffled.
That was it? I’m done. I’m all good? This whole baby making journey was over and I’m supposed to be back to normal now?
But I don’t feel normal?
And I don’t FEEL good?!
I’d barely slept in 6 weeks and I couldn’t think straight.
My body still felt weird and foreign.
I felt like I was on high alert ALL THE TIME. Like if i didn’t do all the things myself something bad was going to happen.
And to be bloody honest, I’d not even given a moment’s thought to attempting sex at that point because I barely had the energy to look after myself let alone show affection to anyone else.
Looking back it makes me mad (and a whole lot sad) that this was the kind of care I received at my 6 week postpartum check up as a first time Mum.
It’s like the only thing that was important were the physical changes that had occurred during birth. While my physical body was obviously important, I don’t think there was enough emphasis put on all the other ways I’d changed as well. Especially when you consider that the mental, emotional and spiritual changes DIRECTLY AFFECTED how I was physically feeling.
What I really needed my doctor to ask at my 6 week postpartum checkup
How are you really feeling?
Look, to give my doctor some credit he probably did say ‘How are you?’ as I walked into his office. But was that really supposed to be my opening to explain how I was feeling about the biggest transformation that had ever happened in my life?
How could I explain that I my life no longer felt like my own?
How could I explain that I felt deliriously happy but also anxious, and sad and also so in love all at the same time?
How could I explain that I was able to flip from feeling so epically tired and feeling like I couldn’t cope a minute longer, to on top of of the world in one second flat?
What I wish I’d known when I at my 6 week postpartum check up
Maybe what I really needed was just some recognition of how huge having a baby and becoming a mother was and is. It takes all of you physically, emotionally, mentally, spiritually and while someone probably did tell me this beforehand, I wasn’t really able to know it until I’d experienced it.
I just needed someone to tell me that it was all going to be okay. That I would eventually sleep again. That I would eventually feel at home in my body again. That I would eventually be able to have a whole conversation with my partner again.
I needed to know that it was okay to love my baby with everything I had and still crave time away from him.
I needed someone to tell me that it was okay to feel overwhelmed by the huge task of raising a small human for the foreseeable forever. And that it was normal to feel a little trapped by a small being who was so dependant on me for everything. I needed to know that it wouldn’t last forever.
It’s probably unrealistic of me to expect to get all of this from my doctor, although when I had my second baby my private midwife got a LOT closer to this ideal at the six week check up.
The type of care you really need at 6 weeks postpartum
I thoroughly recommend trying to get some support in all of these areas during the postpartum period.
Mental – A counsellor or someone to talk through your birth experience. Or a circle of friends to share how you’re coping with a newborn.
Emotional – Find someone who helps you feel normal for the emotional rollercoaster that is postpartum. This could just be a friend who you call when you’re bawling at breakfast. Or your husband who holds you without trying to ‘fix anything.’ Or maybe it’s your Mum who just calls every couple of days to see if you need some time to yourself today.
Spiritual – Spirituality is about connection (and personally I believe it starts with our connection to the self. When you’re in the thick of newborn life it can be hard to connect a thought together let alone feel connected spiritually. I think the best support you can get in this area is someone who can give you time and space away from your baby to attend to this part of yourself.
It doesn’t really matter what you do with the time. You could sit in meditation, or do a gentle yoga practice. You might go for a walk through a park or to the beach. You could do some journalling. Hey, it might just be a long hot shower without worrying about being interrupted.
You’ll feel a thousand times more like yourself and able to function physically when you’ve taken care of the inner stuff that get all mixed up after you have a baby.
Physical – I’ve left physical to last, although please don’t interpret that as my belief that this is the least important. While my first experience of the postpartum check up was primarily physical, it certainly DID NOT cover the extent of physical care that I really needed.
He looked externally at my stitches but it took a long time for me to even feel brave enough to re-aquaint myself with the internal injuries that I’d experienced. I wasn’t sure how I was meant to be feeling, but to be honest I felt broken. I felt like I would never be the same again and as a result; my intimate relationship would also never be the same again.
No one ever addressed the strength of my pelvic floor or spoke to me about HOW I needed to repair this area. No one checked my core separation or even spoke about this being an area I needed to think about.
No one took a blood test to check how nutritionally depleted I was (which is super common after having a baby who happily leeches all the good stuff out of you for 9 months).
Physically I needed to see a women’s health physio to address my core and pelvic floor, and potentially a chiro or Osteo as well to address the whole body misalignment I felt from being wrapped around a newborn all day. I needed to see a naturopath or at the least a GP who could check my levels and advise what to do to improve the areas I was deficit.
I also needed a night Nanny so I could actually get a minute’s sleep, but you know… that’s probably dreamin’.
I feel like there are a lot more opportunities for better postpartum care these days but also the whole ‘you don’t know what you don’t know still prevails’. I think we just assume that because we’re giving birth in a hospital we’ll be checked on and followed up on but in my experience that is just not the case.
If I was doing the first-time-mum-thing again tomorrow (and money was no object) I’d hire a private midwife and/ or a doula. I’d have postpartum doula coming to visit in the first six weeks and have pre-booked appointments to see a physio at 6 weeks (and maybe also an Osteo and Chiro as well). Oh and 100% I’d have a massage therapist coming to my house at least once as well.
What was your first experience of the postpartum period like? Did it affect how you felt about motherhood and yourself as a Mum? If you’re really struggling with postnatal anxiety or depression (or just not feeling yourself) please reach out to me or to PANDA to find someone in your area who can help.
If you’re early postnatal and want to get into some really gentle movement that you can do with your baby. Check out this yoga class below.