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Health Matters Fact Sheets

Your 4-6 Week Postpartum Check-up: A Health Care Guide for New Mothers

(Updated July 2008)

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 appropriate level, and taking the necessary 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 4-6 week postpartum visit, review this planner and bring it with you to your check-up.

DIET, NUTRITION, & EXERCISE GOALS

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 can decrease bone mineral density, it’s important to get enough calcium and do weightbearing activities.

GOAL: 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 per 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

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.

GOAL: 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 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®, Oc-Cal®, Tums®, or Viactiv® with meals. Note: 400-800 IU of vitamin D helps your body absorb calcium).

GOAL: daily: 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

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.

GOAL: 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.

GOAL: Keep bones strong; tone and shape your body:

  • Do weight-bearing exercises, (e.g., walking or cycyling), which help maintain strong, dense bones.
  • If you’re nursing, breastfeed before exercising to minimize breast discomfort.
PHYSICAL, EMOTIONAL AND SEXUAL NEEDS GOALS

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.

GOAL: Thorough post 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

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 health care provider can help you feel and cope better.

GOAL: Good health and well 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 Pospartum 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

Lack of interest in sex is common after childbirth and for the first couple of months afterwards. 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 when 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.

GOAL: Healthy sexuality:

  • Keep an open dialogue with your partner about your readiness to make 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

GOAL: Post-delivery 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