It is advisable to see the obstetrician a week after delivery. If it was by caesarean section, the doctor checks the excellent retraction of the uterus and the quality of the bleeding or lochia (ruling out infections) and removes the points of the operative wound. If it was a vaginal delivery, the same things are verified, and the evolution of the episiotomy scar or tears (if any) are controlled. The nipples are also examined, the breasts are examined, whether or not you are breastfeeding.
A month after delivery, a new control is carried out to check to go as expected in the puerperium; if all goes well, she is discharged (following discharge, she continues with routine gynaecological visits, as suggested by the doctor).
On this occasion, in addition to weight and blood pressure, the following is evaluated:
The uterus: with a vaginal examination, the doctor checks that the uterus has returned to its usual size and shape. If there is any associated pathology, such as fibroids, they are identified and their size evaluated (they usually increase in size during pregnancy and decrease after delivery).
Healing: if there was a caesarean section, episiotomy or tear suture, the doctor assesses that the stitches have been closed correctly and that the discomfort has passed.
In caesarean, it checks that the suture – from the aesthetic point of view – has healed well and that keloids, hernias, etc., have not formed.
Lochia: losses or lochia after childbirth usually last between 20 to 40 days and vary over time. At first, they are usually more intense and red, then lighter and less abundant as the days go by. They also vary depending on the type of delivery, being milder in cesarean delivery.
In the consultation, the doctor evaluates that the lochia is normal.
The perineum: through vaginal touch –sometimes also using a speculum-the doctor checks that the perineal tone has been recovered and the presence of granulomas, tears, etc., is ruled out.
The moms: if you are breastfeeding, the doctor checks that there are no cracks in the nipple, risk of mastitis or any hardness.
In the case of having suffered gestational diabetes, preeclampsia or problems in the thyroid functioning during pregnancy, extra control will be necessary to verify that these conditions have remitted. In such cases, consultation with an endocrinologist or cardiologist is indicated.
The consultation with the obstetrician is not only about gynaecological aspects. It is also an opportunity to talk about diet, weight, if it is necessary or possible to start a diet, the return to physical activity and sexuality.
It is vital to remove all doubts without shame because if everything is fine, the doctor will discharge you and will be able to resume sexual relations. In this sense, it is not only necessary to find out about the contraceptive methods that can be used at this stage, even if the baby is being exclusively breastfed, but also about the possible inconveniences or difficulties that may arise when resuming relationships. Sexual.Â
It is also essential to talk about how the mother feels emotionally if she has periods of anguish, insomnia, irritability, crying or, in these cases, strong feelings of guilt and inability to take care of the baby because this may require a consultation with a psychologist or psychiatrist.
When to visit the doctor?
It’s important not to wait for consultation. Just visit the doctor after delivery in case of:
- Fever greater than 38ºC
- Unpleasant odour in the lochia during the first ten days
- Sudden and heavy blood loss when lochia was already disappearing
- Pain or discomfort when urinating
- Intense discomfort in the scar of the episiotomy or cesarean section.
- Noticing a lump or hardness accompanied by severe pain in one or both breasts
Other medical consultations after childbirth
A general check-up, taking into account the changes in the body during pregnancy, will help rule out problems. Among the consultations that are recommended beyond the gynaecological control are:
Dentist: if you have not visited the dentist in the previous months, this is an excellent opportunity to do so, mainly since hormonal changes during pregnancy produce changes in saliva -which can favour the appearance of cavities- and inflammation of the gums, which can cause gingivitis.
Dermatologist: to check spots or moles that have darkened during pregnancy or other skin changes such as acne, dryness and stretch marks. A visit to the dermatologist after delivery never hurts.
Ophthalmologist: During pregnancy, certain vision disorders, such as myopia, can worsen. If you had any visual difficulties before pregnancy, it is best to consult an ophthalmologist after delivery.
Phlebologist: varicose veins are another common condition during pregnancy. If you have suffered them, a visit to the phlebologist will help to determine the diagnosis and treat them if necessary.
Nutrition specialist: some mothers take six months and a year to recover their average weight before pregnancy. However, sometimes they may not get it back. They may be even thinner than before.
