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Your Six-Week Postpartum Check-up: A Health Care Guide for New Mothers

Also available in Spanish

You have spent nine months preparing for your baby’s birth. You’ve probably read every book, article, and Web site to make sure you’re eating right, exercising at the right level, and taking the right vitamins and supplements. Your effort has paid off… CONGRATULATIONS.

After giving birth, it’s important for you to keep up the healthy habits you practiced while you were pregnant. Your health care provider is your best resource for making sure you’re on track. To get ready for your six-week postpartum visit, review this planner and bring it with you to your check-up.

  Weight Loss Goal Your Notes

Weight Loss
Returning to pre-pregnancy weight is a common goal. Combining a healthy diet with exercise will help you lose weight safely after delivery. Because dieting after pregnancy decrease bone mineral density, it’s important to get enough calcium and do weight-bearing activities.

Lose weight gradually—4.5 lbs/month maximum after first month post-delivery (unless you had a high pre-pregnancy weight):

  • Be patient.
  • Consume at least 1,800 calories per day (an additional 500 calories/day is recommended if you’re breastfeeding).
  • Drink plenty of fluids (moderate caffeine intake, such as 1 cup of coffee per day, and occasional alcohol consumption are okay).
 
  Nutrition Goals Your Notes

Nutrition
A well-balanced diet is essential for women before, during, and after pregnancy. Most multivitamins and prenatal vitamins don’t supply enough calcium. Also, breastfeeding mothers transfer 250–350 mg of calcium to their baby through breast milk when they’re nursing. Vitamin and mineral supplements can help ensure that you get the nutrients you need.

1,000 mg of calcium daily for adult women (1,300 mg for adolescents):

  • Eat foods such as low-fat and fat-free dairy products and green leafy vegetables (e.g., broccoli, kale, and collards).
  • If food choices don’t supply the recommended calcium, take a calcium supplement (e.g., Calcium Soft Chews, Caltrate®, Os-Cal®, Tums®, or Viactiv® with meals. Note: 400 to 800 IU of vitamin D helps your body absorb calcium).

15 mg of iron daily:

  • Eat foods such as fortified cereals, lean beef, dried fruits, tofu, oysters, and spinach.
  • If the time between pregnancies is short, talk to your health care provider to see if you should take an iron supplement as well.
 
  Exercise Goals Your Notes

Exercise
Regular physical activity after delivery should be a part of every new mother’s daily life. A gradual return to exercise is recommended. Some women may be able to start exercising within days of delivery; others may need to wait four to six weeks. Talk to your health care provider about what exercise schedule and level are right for you.

Strengthen the pelvic floor and abdominal muscles; reduce the risk of urinary stress incontinence (urine leakage):

  • Do Kegel exercises: Contract the pelvic muscles for 10 seconds and then relax them for 10 seconds. Do this for 15 minutes, four times/day.

Keep bones strong, tone and shape your body:

  • Do weight-bearing exercises, (e.g., walking or cycling), which help maintain strong, dense bones.
  • If you’re nursing, breastfeed before exercise to minimize breast discomfort.
 
  Physical Exam Goal Your Notes
Physical Exam
Don’t be embarrassed to discuss with your health care provider all aspects of your physical health, including important conditions that may result from delivery.

Thorough post-delivery health exam:

  • Talk to your health care provider about:
    • Breast condition and breastfeeding
    • Constipation
    • Hemorrhoids
    • Vaginal discharge
    • Urinary incontinence (leakage)
    • Healing below the birth canal
    • Varicose veins
    • Weight loss
    • Exercise
 
  Emotional Adjustment Goal Your Notes
Emotional Adjustment
Many women have emotional changes after delivery. Let your health care provider know if you’ve been feeling overwhelmed, anxious, sad, isolated, nervous, obsessive, incompetent, exhausted, or you can’t sleep. Your provider can help you feel and cope better.

Good health and well-being:

  • Take time for yourself.
  • Get enough rest.
  • Call on family and friends for help.
  • Consider joining a mothers’ or postpartum support group.
  • Call Postpartum Support International at 800-944-4PPD or visit online at www.postpartum.net.
  • Delay going back to work for at least 6 weeks after delivery.
  • Ask your health care provider about:
    • Mood swings and “baby blues”
    • Symptoms of postpartum depression
    • Ways to prevent depression
    • Planning for hormonal shifts (e.g., when you’re weaning your baby or your period starts again)
 
  Sexuality and Contraception Goal Your Notes
Sexuality and Contraception
Lack of interest in sex is common after childbirth and for the first couple of months afterward. Most women experience a gradual return to pre-pregnancy levels of sexual desire, enjoyment, and frequency within a year of giving birth, but every woman has her own timetable. The return to fertility is unpredictable. You may be able to get pregnant before your periods return, even if you’re breastfeeding. For most women who aren’t nursing, ovulation occurs about 45 days postpartum, but it can be earlier. Discuss family planning with your health care provider.

Healthy sexuality:

  • Keep an open dialogue with your partner about your readiness for making love.
  • Make time for cuddling and kissing to re-establish physical closeness.
  • Ask your health care provider about:
    • When to resume sexual intercourse
    • How to minimize discomfort
    • Effects of breastfeeding or hormones on sexual desire

Postpartum contraception:

  • Think about whether or not you’d like to have more children.
  • Before you resume sexual activity, ask your health care provider about:
    • Contraceptive options during breastfeeding and afterward
    • The benefits and risks of all suitable methods
 

Clinical Advisors:
Kelly Boyd, PsyD; Beth Cheney, RN, MSN, CFNP; Anne Davis, MD; Margaret Plumbo, RN, MS, CNM; John Sunyecz, MD, FACOG; Michael Thomas, MD

Writer:
Nancy Monson

This publication was made possible by an unrestricted educational grant from GlaxoSmithKline Consumer Healthcare

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