Postpartum care starts before you leave the hospital and continues for weeks after

Postpartum care is not a single visit—it is a series of checkups, screenings, and support services that begin in the hospital and extend for at least six weeks after delivery. Your first postpartum visit usually happens before discharge, your second around two weeks after birth, and a full postpartum exam typically occurs at six weeks. What happens at each visit depends on how you delivered, whether you had complications, and what your insurance covers. You need to know what to expect at each stage so you can ask for what you need and catch problems early.

The American College of Obstetricians and Gynecologists now recommends ongoing postpartum care through the first year, not just the traditional six-week checkup. This means your doctor should be monitoring you for postpartum depression, high blood pressure, gestational diabetes that persists, and other conditions that can emerge weeks or months after birth. If your provider does not mention these screenings, you should ask for them by name.

Key Takeaways

  • Postpartum visits include blood pressure checks, wound or incision inspection, mental health screening, and contraception counseling—ask which ones are scheduled before you leave the hospital.
  • Postpartum depression and postpartum anxiety screening should happen at your two-week and six-week visits; if your provider does not ask, bring up your mood and sleep yourself.
  • Physical therapy for pelvic floor recovery is often not offered automatically but may be covered by insurance if your doctor writes a referral.
  • Your insurance may cover lactation support, mental health visits, and physical therapy differently than routine office visits, so confirm coverage before your first appointment.
  • If you had gestational diabetes, preeclampsia, or a complicated delivery, you need specific follow-up tests—ask your discharge paperwork which ones apply to you.

What happens at your hospital discharge visit

Before you leave the hospital, a nurse or doctor should review your discharge paperwork with you. This paperwork lists any complications during delivery, medications you are taking, and what to watch for at home. Ask the staff to walk you through it and explain any medical terms. You should leave with a clear list of warning signs—heavy bleeding, fever, chest pain, thoughts of harming yourself—and a phone number to call if any occur.

At discharge, confirm the date and time of your first postpartum visit. Many practices schedule this for one to two weeks after birth. If no appointment is on your paperwork, call your obstetrician's office before you leave the hospital or within 24 hours of getting home. Do not assume the office will call you. Also ask whether your visit will be in person or by telehealth, because some practices now offer the two-week check as a video visit.

The two-week postpartum visit: what to expect and what to ask

At two weeks, your provider checks your blood pressure, inspects any incisions or tears, and asks about bleeding, pain, and how you are sleeping and feeling emotionally. This is when you should be screened for postpartum depression and postpartum anxiety using a standardized questionnaire—usually the Edinburgh Postnatal Depression Scale or the Patient Health Questionnaire. If your provider does not bring this up, ask directly: "Do you screen for postpartum depression at this visit?" Many providers still do not screen routinely, so you may need to raise it yourself.

Bring a list of any symptoms you have noticed: persistent sadness, intrusive thoughts, panic, difficulty bonding with the baby, or feeling disconnected from reality. These are not character flaws or signs of weakness—they are medical symptoms that respond to treatment. If you are exclusively breastfeeding and struggling, ask for a lactation consultant referral. Some hospitals have them on staff; others refer you to an outside provider. Insurance coverage for lactation support varies, so ask what your plan covers before the referral is sent.

At this visit, also ask about pelvic floor physical therapy if you had a vaginal delivery, especially if you experienced tearing, episiotomy, or forceps use. Many women assume pelvic floor problems are normal after birth, but physical therapy can prevent or treat incontinence and pain during sex. Your obstetrician can write a referral, and most insurance plans cover it with a referral, though you may have a copay.

The six-week postpartum exam: the full checkup

The six-week visit is your comprehensive postpartum exam. Your provider repeats blood pressure and weight checks, does a full pelvic exam to confirm healing, and reviews your mental health again. This is when contraception is discussed in detail—your options depend on whether you are breastfeeding, your medical history, and your preferences. If you want an IUD or implant, this visit is often when it is placed, though some providers do it earlier. Ask about timing when you schedule the appointment so you know what to expect.

If you had gestational diabetes during pregnancy, you should have a fasting blood glucose test or glucose tolerance test at this visit to see whether the diabetes resolved. If you had preeclampsia or high blood pressure during pregnancy, your blood pressure should be monitored and you may need lab work. If you had a cesarean delivery, your incision should be fully healed by six weeks, but ask your provider to confirm there are no signs of infection or separation. If you are still having pain at the incision site, mention it—some women develop scar tissue that needs attention.

Mental health screening and what to do if you screen positive

Postpartum depression and postpartum anxiety affect roughly one in seven new mothers and can begin anytime in the first year after birth. Screening should happen at your two-week and six-week visits, and ideally again at three and six months. Standard screening tools ask about your mood, sleep, concentration, and thoughts of harming yourself or the baby. A positive screen does not mean you are diagnosed with depression—it means your provider should do a more detailed assessment and discuss treatment options.

Treatment options include therapy, medication, or both. Some antidepressants and anti-anxiety medications are safe while breastfeeding; others are not. If your obstetrician is not comfortable prescribing psychiatric medication, ask for a referral to a psychiatrist or perinatal mental health specialist. Many communities have perinatal mental health programs that offer therapy specifically for postpartum mood disorders. If you cannot find one, your primary care doctor can prescribe treatment, or you can search for therapists through the Postpartum Support International helpline (1-800-944-4773) or website.

Physical recovery: incisions, bleeding, and pelvic floor function

Vaginal bleeding typically lasts four to six weeks after birth, starting heavy and gradually lightening. At your visits, your provider asks about the amount and whether you are passing clots. Bleeding that soaks more than one pad per hour, contains clots larger than a golf ball, or worsens after improving can signal postpartum hemorrhage or infection and needs urgent evaluation. Do not wait for your scheduled visit—call your provider or go to the emergency department if this occurs.

If you had a vaginal tear or episiotomy, the area should be healing without opening up, excessive drainage, or foul odor. Pain during sex is common in the first weeks but should improve by six weeks. If it persists, mention it at your six-week visit—it may be scar tissue, infection, or a need for more time. If you had a cesarean delivery, your incision should be closed and the skin should be intact. Some redness or slight swelling is normal, but increasing pain, warmth, drainage, or separation of the incision needs medical attention.

Pelvic floor dysfunction—leaking urine when you cough, sneeze, or exercise, or pain during sex—affects many women after vaginal delivery but is often not discussed unless you bring it up. Physical therapy that focuses on pelvic floor muscles can resolve these problems in most cases. Ask your provider for a referral to a pelvic floor physical therapist, and confirm your insurance covers it before the first appointment.

Contraception counseling and your options

Contraception should be discussed before you leave the hospital or at your two-week visit, not assumed. Your options depend on whether you are breastfeeding. If you are, hormonal methods containing estrogen can reduce milk supply, so progestin-only pills, the implant, the hormonal IUD, or the copper IUD are preferred. If you are not breastfeeding, all methods are available. Long-acting reversible methods like IUDs and implants have the highest effectiveness rates and can be placed at your six-week visit or sometimes earlier.

Ask your provider about each option: how it works, how effective it is, what the side effects are, and whether your insurance covers it. Some methods require a separate visit or referral to a family planning clinic. If your provider does not discuss contraception or dismisses your questions, that is a sign to seek a second opinion or change providers. Contraception is part of postpartum care, not an afterthought.

Insurance coverage and what to ask before your visits

Most insurance plans cover postpartum office visits with no copay under the Affordable Care Act, but coverage for related services—lactation support, mental health visits, physical therapy—varies. Before your first postpartum visit, call your insurance company and ask: What is my copay for postpartum office visits? Are lactation consultants covered, and do I need a referral? Are mental health visits covered, and do I need a referral? Is pelvic floor physical therapy covered, and do I need a referral? What is my copay for each?

Write down the answers and bring them to your appointment. If your provider recommends a service that your insurance does not cover, ask whether there is a lower-cost alternative or whether the provider can appeal the denial. Some providers have relationships with lactation consultants or physical therapists who offer sliding-scale fees for uninsured or underinsured patients.

Frequently Asked Questions

What if I cannot get an appointment with my obstetrician for my postpartum visit?

Call your primary care doctor—many can do postpartum checkups and mental health screening. If neither is available within two weeks, go to an urgent care clinic and ask for a postpartum evaluation. Bring your discharge paperwork so the provider knows your delivery history. If you are having warning signs like fever, heavy bleeding, or thoughts of harming yourself, go to the emergency department instead.

Can I do my postpartum visits by telehealth instead of in person?

The two-week visit can often be done by video, but the six-week exam typically needs to be in person because your provider needs to do a pelvic exam. Ask your provider which visits can be virtual when you schedule. If you have mobility issues or transportation barriers, mention this—some practices can accommodate you with a hybrid approach.

What if I had a complicated delivery or a cesarean section—do I need different follow-up?

Yes. If you had a cesarean, your incision needs inspection at both the two-week and six-week visits. If you had preeclampsia, gestational diabetes, or significant bleeding, your provider should order specific tests at six weeks. Ask your discharge paperwork which complications apply to you and what follow-up is needed, then confirm those appointments are scheduled.

I am breastfeeding and struggling—what kind of help can I get?

Ask your provider for a referral to a lactation consultant at your two-week visit. Consultants can assess latch, milk supply, and pain and teach techniques to improve feeding. Some are covered by insurance with a referral; others charge out of pocket. La Leche League and WIC programs also offer free breastfeeding support in many communities.

When should I see my primary care doctor after giving birth?

Your obstetrician handles postpartum care for the first six weeks. After that, your primary care doctor should take over your routine care and continue monitoring your blood pressure, weight, and mental health. Schedule a visit with your primary care doctor around eight weeks postpartum if you have not already, especially if you had gestational diabetes or preeclampsia during pregnancy.