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Your Postpartum Doctor Appointment

Should You Wait Six Weeks? When to See the Doctor and Why

Verywell / Bailey Mariner

The Postpartum Period

When to see the doctor, why you need to go, what to expect.

• Bring Your Questions

Symptoms to Bring Up

When to call the doctor.

• Skipping It

Your body goes through many changes during pregnancy and childbirth . So, after your baby is born, your body needs time to heal. As you recover, it’s important to make an appointment to see your OB-GYN for postpartum care. Here’s what you need to know about the postpartum visit, including when to see your doctor and what you can expect. 

The time of your life after you have a baby is called the postpartum or postnatal period . It is broken down into three phases.   

• Phase one is the initial recovery during the first six to twelve hours after giving birth.
• The second stage lasts two to six weeks while your body is physically healing, and you are adjusting to life with your newborn.
• The third part is the gradual return of your body to the way it was before your pregnancy. Of course, some things may not entirely go back to the way they were. This time of healing can take up to six months.

Watch Now: The Three Stages of Postpartum Depression

In the past, a postpartum check-up was a one-time visit scheduled between four and six weeks after delivery. However, thoughts on postnatal care have changed in recent years. Health experts now consider postpartum care an ongoing process based on each individual’s needs.

The World Health Organization (WHO) guidelines published in 2013 recommend at least four postnatal interactions after delivery: in the first 24 hours, on the third day, between 7-14 days, and at six weeks.  

In 2018, the American College of Obstetricians and Gynecologists (ACOG) updated its guidelines to reflect an ongoing process.  

After the initial care at birth, the first postpartum contact or visit should be within three weeks. You should stay in contact with your healthcare provider during the first three months, and a complete and thorough postpartum exam should occur no later than twelve weeks.  

After you have a baby, you experience physical and emotional changes .   A visit with your doctor during this time can help prevent complications. If something isn't right, the doctor can catch it and treat it early before it becomes a problem.

This appointment is also time set aside to talk to your doctor about sensitive issues and get answers to questions you may have about bleeding, your sex drive, birth control , the baby blues, postpartum depression , and more.

All pregnant women should receive postpartum care even if the pregnancy ends with a devastating loss . Physical and emotional care and support are even more critical during a very difficult time.

You should see your doctor or talk to your doctor on the phone within three weeks of giving birth. If you have a c-section , complications, or other health issues such as gestational diabetes or high blood pressure , you may see your doctor sooner and keep in touch with the doctor more often as you heal.

At your first contact, you will spend some time talking to your doctor. The doctor may also check your blood pressure or follow up with any other concerns. As your care continues, the health care team can keep in touch with you in a variety of ways. You may go to the office, see a health care provider at home, or talk to the doctor on the phone or by text message.

As postpartum care nears its end, you should have a thorough health and wellness examination before you transition to well-care. Your comprehensive exam can take place as early as four weeks after birth, but no later than 12 weeks, depending on your situation. This visit is a complete check-up of your physical, social, and psychological health.

During this appointment, you will have a full physical exam. The doctor may:

• Check your weight
• Take your blood pressure
• Check your perineum to see how you’re healing
• Check an episiotomy , tear, or c-section wound if you have one
• Check to see if your uterus is shrinking as expected
• Check your breasts and talk about breastfeeding
• Discuss any health issues you have
• Talk to you about the postpartum blues and depression
• Answer questions about your labor and delivery if you have them

You may also have your general gynecological screening if you are due for it. It may include a Pap smear, bloodwork to check for anemia or high blood sugar, and a urine test if you have urinary problems or symptoms of a urinary tract infection.

The doctor will also talk to you about:

• How your body is recovering from childbirth 
• Your emotions and how you feel about motherhood
• Any anxiety or depression that you may be feeling
• Your social support system
• How you are sleeping
• Nutrition and your eating habits 
• How caring for your baby is going
• How bottle-feeding or breastfeeding is going
• If you are considering having more children
• Any concerns about sex
• Birth control
• Managing any health concerns such as high blood pressure, diabetes, or other conditions
• Following up with other health practitioners for any issues you may have
• Continuing to tend to your health through routine care

Bring Your Questions 

You are bound to have questions, especially if you just had your first baby. But, since pregnancy and birth can be very different with each child, experienced moms can have questions, too.

As questions come up, write them down so you can bring them to your appointment. If you don't write them down, you may not remember everything you want to ask once you're sitting in the office. And remember, there are no silly questions. You shouldn't feel uncomfortable or embarrassed about asking your doctor anything. That's one of the reasons they're there, and they want to help. Some of the things you may want to ask about are:

• Your delivery
• The healing process
• Preventing problems now and in the future
• Breast issues such as pain or lumps
• Caring for your newborn
• Returning to work

Those pesky pregnancy symptoms may finally be gone, but the postpartum period has its own set of discomforts. Most of the time, postpartum symptoms are common and expected. However, sometimes they can be a sign of a complication. So, you should discuss all your symptoms with your doctor. The doctor can reassure you of what's normal and help you find relief, but also look into any concerning symptoms. You should talk to your doctor about:  

• The amount and color of any bleeding you are experiencing
• Hemorrhoids
• Constipation
• Leaking urine
• How you're feeling
• If you are sad or under a lot of stress

You do not have to wait for your scheduled postpartum appointment to talk to or see the doctor if you have urgent concerns . You should call the doctor or go to the hospital if you have:

• A fever over 100.4 F
• Bleeding that is getting heavier
• Severe pain
• Swelling in your body, especially your hands or face
• Nausea and vomiting
• A headache that is not going away or getting worse
• Foul-smelling vaginal bleeding or discharge
• Difficulty caring for yourself and your baby
• Feelings of depression
• Painful, burning urination or urinary frequency  

Skipping It 

Not all women get postpartum care. Up to 40% of women do not follow up with a doctor after giving birth.   There are many reasons for this, such as:

• Not knowing about it
• Not knowing who to call
• Being too busy
• Having too many other things to do
• Thinking it isn't necessary
• Feeling good
• Not having anyone to watch the baby
• Having been through it before many times
• Concerns about the cost
• The insurance will not cover it  

While there are things that make can make it difficult or inconvenient to get there, you should make every effort to see the doctor. If you have to bring your baby with you, you can. If you’re concerned about the cost or your insurance, talk to the hospital staff or your health care provider for helpful resources.

Skipping out on postpartum care can have some unintended consequences.   

• You may not realize you have an infection or a postpartum complication.
• You may not heal well. 
• You could get pregnant again quickly.
• You could have undiagnosed postpartum depression.

A Word From Verywell

During pregnancy, prenatal visits are plentiful. But, the attention to an expecting mom's health and wellness seems to fade once the baby is born. Care during the postpartum period can be overlooked at a time when many women need it most.  

The body changes so much during pregnancy, birth, and the postpartum period. It is incredible what the body goes through in less than one year. And, it's true that some women feel wonderful after childbirth. But, for others, the physical and emotional challenges of the fourth trimester can be a struggle. 

The continuation of care after pregnancy is so important. Just as you need ongoing care during pregnancy, labor, and delivery, you need it while you're healing in the days, weeks, and months after your baby is born. Postpartum care should be part of your overall pregnancy care. You and doctor should work together to make sure your health is monitored and managed throughout the entire process. So, talk about it with your doctor while you're pregnant, be sure to make your appointments, and don't skip out on them even if you're feeling good. 

Romano M, Cacciatore A, Giordano R, La Rosa B. Postpartum period: three distinct but continuous phases . Journal of prenatal medicine. 2010 Apr;4(2):22.

World Health Organization. WHO recommendations on postnatal care of the mother and newborn. World Health Organization; 2014.

Care OP. ACOG Committee Opinion No. 736 Optimizing Postpartum Care . American College of Obstetricians and Gynecologists. Obstetrics & Gynecology. 2018;131(5):e140-50.

Fahey JO, Shenassa E. Understanding and meeting the needs of women in the postpartum period: the perinatal maternal health promotion model . Journal of midwifery & women's health. 2013 Nov;58(6):613-21. doi:10.1111/jmwh.12139

Al-Safi Z, Imudia AN, Filetti LC, Hobson DT, Bahado-Singh RO, Awonuga AO. Delayed postpartum preeclampsia and eclampsia: demographics, clinical course, and complications . Obstetrics & Gynecology. 2011 Nov 1;118(5):1102-7. doi: 10.1097/AOG.0b013e318231934c

Jordan RG, Farley CL, Grace KT. Prenatal and postnatal care: a woman-centered approach. John Wiley & Sons; 2018 Apr 23.

DiBari JN, Yu SM, Chao SM, Lu MC. Use of postpartum care: predictors and barriers . Journal of pregnancy. 2014;2014. doi:10.1155/2014/530769

Nazik E, Eryilmaz G. The prevention and reduction of postpartum complications: Orem’s Model . Nursing science quarterly. 2013 Oct;26(4):360-4.

Martin A, Horowitz C, Balbierz A, Howell EA. Views of women and clinicians on postpartum preparation and recovery . Maternal and child health journal. 2014 Apr 1;18(3):707-13. doi:10.1007/s10995-013-1297-7

By Donna Murray, RN, BSN Donna Murray, RN, BSN has a Bachelor of Science in Nursing from Rutgers University and is a current member of Sigma Theta Tau, the Honor Society of Nursing.

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Your First Prenatal Visit

If you did not meet with your health care provider before you were pregnant, your first prenatal visit will generally be around 8 weeks after your LMP (last menstrual period ). If this applies to you, you should schedule a prenatal visit as soon as you know you are pregnant!

Even if you are not a first-time mother, prenatal visits are still important since every pregnancy is different. This initial visit will probably be one of the longest. It will be helpful if you arrive prepared with vital dates and information. This is also a good opportunity to bring a list of questions that you and your partner have about your pregnancy, prenatal care, and birth options.

What to Expect at Your First Pregnancy Appointment

Your doctor will ask for your medical history, including:.

• Medical and/or psychosocial problems
• Blood pressure, height, and weight
• Breast and cervical exam
• Date of your last menstrual period (an accurate LMP is helpful when determining gestational age and due date)
• Birth control methods
• History of abortions and/or miscarriages
• Hospitalizations
• Medications you are taking
• Medication allergies
• Your family’s medical history

Your healthcare provider will also perform a physical exam which will include a pap smear , cervical cultures, and possibly an ultrasound if there is a question about how far along you are or if you are experiencing any bleeding or cramping .

Blood will be drawn and several laboratory tests will also be done, including:

• Hemoglobin/ hematocrit
• Rh Factor and blood type (if Rh negative, rescreen at 26-28 weeks)
• Rubella screen
• Varicella or history of chickenpox, rubella, and hepatitis vaccine
• Cystic Fibrosis screen
• Hepatitis B surface antigen
• Tay Sach’s screen
• Sickle Cell prep screen
• Hemoglobin levels
• Hematocrit levels
• Specific tests depending on the patient, such as testing for tuberculosis and Hepatitis C

Your healthcare provider will probably want to discuss:

• Recommendations concerning dental care , cats, raw meat, fish, and gardening
• Fevers and medications
• Environmental hazards
• Travel limitations
• Miscarriage precautions
• Prenatal vitamins , supplements, herbs
• Diet , exercise , nutrition , weight gain
• Physician/ midwife rotation in the office

Possible questions to ask your provider during your prenatal appointment:

• Is there a nurse line that I can call if I have questions?
• If I experience bleeding or cramping, do I call you or your nurse?
• What do you consider an emergency?
• Will I need to change my habits regarding sex, exercise, nutrition?
• When will my next prenatal visit be scheduled?
• What type of testing do you recommend and when are they to be done? (In case you want to do research the tests to decide if you want them or not.)

If you have not yet discussed labor and delivery issues with your doctor, this is a good time. This helps reduce the chance of surprises when labor arrives. Some questions to ask include:

• What are your thoughts about natural childbirth ?
• What situations would warrant a Cesarean ?
• What situations would warrant an episiotomy ?
• How long past my expected due date will I be allowed to go before intervening?
• What is your policy on labor induction?

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You asked, we answered: I'm pregnant, how soon do I need to see a doctor?

I just found out I was pregnant. How soon should I go see a doctor? Also, does the doctor I see right away have to be the same one that will help me the whole way through the pregnancy? 

Answered by Katherine Lessman, MD :

First, congratulations!   The most common time to have a first appointment is around eight weeks gestation or about a month after that first missed period and positive pregnancy test. That said, many pregnant people should be seen earlier than that. For instance, people with diabetes, high blood pressure, history of ectopic pregnancy, who are on medications that might need to be changed, or who have bleeding or pain should be seen earlier. We also understand fully how brutal that month can be mentally, so if we can shorten that time and get people in sooner, we bend over backward to do it, even if we have to get creative!   It's always nice when the same doctor or team is able to follow a pregnancy all the way through, but there is always the freedom to change. In fact, sometimes a switch is needed for one of many reasons. When people change locations or offices during pregnancy, records go with them, so most testing doesn't have to be repeated, but there is always some redundancy while getting established.     Many things happen at the first visit. We get to know each other, make sure the medical record is up to date, do a physical exam, update the Pap smear when appropriate, get blood work, talk about genetic testing options and check on the pregnancy itself. Whether an ultrasound is done at that appointment depends on gestational age and a few other factors, but we always check on the baby.

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The Ultimate Pregnancy Appointment Guide: What to Expect Week by Week at Your Prenatal Visits

Central to ensuring the health and well-being of you and your growing baby is seeing your care team regularly for touchpoints and milestones that are part of your pregnancy appointment schedule. Diana Kaufman, MD , UnityPoint Health, shares the recommended timeline for prenatal visits, and the importance of each test and discussion that’ll prepare you for a safe pregnancy and delivery.

Confirming Your Pregnancy

Every woman’s body is unique, but it’s a good idea to visit a doctor to confirm a pregnancy when you’re experiencing early symptoms, such as a missed period or you’ve received a positive home pregnancy test. Typically, this visit happens at 6-8 weeks of pregnancy.

Your doctor may confirm your pregnancy through urine tests, blood tests or ultrasounds.

Initial Prenatal Appointment: 5-12 Weeks

Your first prenatal visit consists of important screenings and discussions, so your healthcare team can create a care plan that ensures you and baby stay healthy throughout your pregnancy. Prepare a few things for this visit, including:

• Complete medical history: It’s important for your doctor to know your past and present health conditions or concerns, medications and any history of disease, substance abuse or known genetic conditions in your family.
• Insurance information: This includes consents for care, your insurance carrier and other paperwork

Here’s what to expect at your first pregnancy appointment

• A physical, which will likely include a breast and pelvic exam.
• A urine sample is collected to check for certain infections and conditions that can occur during pregnancy. Urine tests may be taken at your following prenatal visits as well. Urine drug screening tests are also recommended for women, or their partners, with a history of substance use — including smoking.
• Routine testing that includes blood draws to check your blood type and complete blood count (CBC) and look for specific diseases including hepatitis, HIV, syphilis and checking for immunity against rubella. Other testing that may occur includes genetic screening and testing for diabetes.

Your care team will review prenatal educational materials with you and remedies for any unpleasant pregnancy symptoms, such as nausea or vomiting . Your team also will provide an estimated due date for baby.

It’s also important to take good care of your teeth and gums during pregnancy. Changing hormone levels make your gums more sensitive to disease, which increases your risk for a low-birth weight or premature baby. Consider making an appointment to see your dentist during your first trimester.

Prenatal Appointment: Second Trimester (13 – 26 Weeks)

During weeks 13-26, you’ll see your doctor every four weeks. It’s a good idea to write down questions or concerns before your appointments to ensure they’re addressed.

At each appointment throughout the rest of your pregnancy, your care team will check the following:

• Blood pressure
• Position of baby
• Baby’s heartbeat

Here are some additional things to expect.

• Prenatal genetic testing: There are many different options for prenatal genetic testing. Your care team will review these with you.
• Pregnancy blood tests: These are tailored to your specific needs. Most patients are tested for anemia and diabetes of pregnancy between weeks 24-28. Other recommended tests will be reviewed with you.
• Ultrasound: It’s common to have an ultrasound in the first trimester to confirm the estimated due date. Ultrasound is also common at 20 weeks to check on baby's growth and development. Further ultrasounds could be needed if changes in your pregnancy make it necessary, such as concerns about baby’s growth or to see if baby is head down.
• Discuss preterm labor signs: Preterm labor refers to labor that begins before the 37th week of pregnancy and requires medical attention. Knowing what to look for — such as contractions, changes in vaginal discharge  — is important for preventing potential complications.
• Childbirth classes: It’s a good idea to register for a class  to help you prepare for baby’s arrival.

When to Call Your Doctor

Pregnancy creates new and unfamiliar symptoms in many women. However, some symptoms need attention. Here’s when to call your doctor in the second trimester:

• Vaginal bleeding, even a small amount
• Leg pain with numbness or leg weakness
• Pain or tenderness in one of both calves that doesn’t go away
• Thoughts of hurting yourself or others
• Severe headaches that don’t go away with Tylenol
• Persistent changes in vision such as blurriness or floaters
• More than five contractions in an hour

Now, your visits to your care team become more frequent — happening every two weeks until you’re 36 weeks pregnant. Your care team continues to monitor you and baby. Here’s what else to expect:

Prenatal Appointments: Third Trimester (27 Weeks – Baby’s Arrival)

• Check fetal movement: It’s important to be aware of your baby's movements. If you notice a sudden change or absence of fetal movement, let you care team know.
• Rhogam injections: If an Rh-negative blood type was found during your initial prenatal visit, you’ll receive an injection to prevent immune system complications for future pregnancies. This usually happens at 28 weeks.
• Additional prenatal testing: Around 35-37 weeks, you’re checked to see if you carry group B streptococcus bacteria . This is one of many bacteria that can live on our skin and typically does not cause problems. However, it can infect a newborn when you deliver. Antibiotics are given during delivery to prevent infection in a newborn if you test positive.

Prenatal Appointments: 36 Weeks – End of Pregnancy

Once you’ve reached 36 weeks, you’ll see your doctor every week until you deliver. These visits are essential for ensuring the well-being of both you and your little one, as well as preparing for a safe and smooth delivery. In addition to routine physical examinations and checking baby’s heartbeat and movement, here’s what else you can expect:

• Cervical exams: If you’re having frequent contractions or preparing to be induced, your doctor will likely need to perform this exam.
• Discuss labor signs: You’ll likely discuss signs of labor with your doctor and when to go to the hospital.
• Discuss birth preferences: It’s not necessary to have a birth plan. Your care team has that covered. Our goal is to keep you and your baby healthy throughout the entire pregnancy and delivery process. However, if you have strong desires or needs for delivery, please discuss those during a prenatal appointment. It’s also helpful to write these things down and bring them to the hospital, since you may not be able to fully express your wishes during labor.

Postpartum Visits

After delivering baby, but before you leave the hospital, call your doctor to make your postpartum appointment, if it hasn’t been scheduled yet. This visit typically occurs around 6 weeks after you deliver. Other visits are scheduled based on your individual needs.

These visits are a time for your doctor to check on your healing , discuss normal or abnormal postpartum bleeding, talk about your well-being and any signs of postpartum depression or anxiety , discuss when it’s safe to start exercising again and address other questions or concerns you may have .

Our UnityPoint Health care team is here to care for you and baby throughout the entirety of your pregnancy and beyond. Call us  to schedule your first appointment or if you have questions about any future appointments.

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Prenatal care and tests

Medical checkups and screening tests help keep you and your baby healthy during pregnancy. This is called prenatal care. It also involves education and counseling about how to handle different aspects of your pregnancy. During your visits, your doctor may discuss many issues, such as healthy eating and physical activity, screening tests you might need, and what to expect during labor and delivery.

Choosing a prenatal care provider

You will see your prenatal care provider many times before you have your baby. So you want to be sure that the person you choose has a good reputation, and listens to and respects you. You will want to find out if the doctor or midwife can deliver your baby in the place you want to give birth , such as a specific hospital or birthing center. Your provider also should be willing and able to give you the information and support you need to make an informed choice about whether to breastfeed or bottle-feed.

Health care providers that care for women during pregnancy include:

• Obstetricians (OB) are medical doctors who specialize in the care of pregnant women and in delivering babies. OBs also have special training in surgery so they are also able to do a cesarean delivery . Women who have health problems or are at risk for pregnancy complications should see an obstetrician. Women with the highest risk pregnancies might need special care from a maternal-fetal medicine specialist .
• Family practice doctors are medical doctors who provide care for the whole family through all stages of life. This includes care during pregnancy and delivery, and following birth. Most family practice doctors cannot perform cesarean deliveries.
• A certified nurse-midwife (CNM) and certified professional midwife (CPM) are trained to provide pregnancy and postpartum care. Midwives can be a good option for healthy women at low risk for problems during pregnancy, labor, or delivery. A CNM is educated in both nursing and midwifery. Most CNMs practice in hospitals and birth centers. A CPM is required to have experience delivering babies in home settings because most CPMs practice in homes and birthing centers. All midwives should have a back-up plan with an obstetrician in case of a problem or emergency.

Ask your primary care doctor, friends, and family members for provider recommendations. When making your choice, think about:

• Personality and bedside manner
• The provider's gender and age
• Office location and hours
• Whether you always will be seen by the same provider during office checkups and delivery
• Who covers for the provider when she or he is not available
• Where you want to deliver
• How the provider handles phone consultations and after-hour calls

What is a doula?

A doula (DOO-luh) is a professional labor coach, who gives physical and emotional support to women during labor and delivery. They offer advice on breathing, relaxation, movement, and positioning. Doulas also give emotional support and comfort to women and their partners during labor and birth. Doulas and midwives often work together during a woman's labor. A recent study showed that continuous doula support during labor was linked to shorter labors and much lower use of:

• Pain medicines
• Oxytocin (ok-see-TOHS-uhn) (medicine to help labor progress)
• Cesarean delivery

Check with your health insurance company to find out if they will cover the cost of a doula. When choosing a doula, find out if she is certified by Doulas of North America (DONA) or another professional group.

Places to deliver your baby

Many women have strong views about where and how they'd like to deliver their babies. In general, women can choose to deliver at a hospital, birth center, or at home. You will need to contact your health insurance provider to find out what options are available. Also, find out if the doctor or midwife you are considering can deliver your baby in the place you want to give birth.

Hospitals are a good choice for women with health problems, pregnancy complications, or those who are at risk for problems during labor and delivery. Hospitals offer the most advanced medical equipment and highly trained doctors for pregnant women and their babies. In a hospital, doctors can do a cesarean delivery if you or your baby is in danger during labor. Women can get epidurals or many other pain relief options. Also, more and more hospitals now offer on-site birth centers, which aim to offer a style of care similar to standalone birth centers.

Questions to ask when choosing a hospital:

• Is it close to your home?
• Is a doctor who can give pain relief, such as an epidural, at the hospital 24-hours a day?
• Do you like the feel of the labor and delivery rooms?
• Are private rooms available?
• How many support people can you invite into the room with you?
• Does it have a neonatal intensive care unit (NICU) in case of serious problems with the baby?
• Can the baby stay in the room with you?
• Does the hospital have the staff and set-up to support successful breastfeeding?
• Does it have an on-site birth center?

Birth or birthing centers give women a "homey" environment in which to labor and give birth. They try to make labor and delivery a natural and personal process by doing away with most high-tech equipment and routine procedures. So, you will not automatically be hooked up to an IV. Likewise, you won't have an electronic fetal monitor around your belly the whole time. Instead, the midwife or nurse will check in on your baby from time to time with a handheld machine. Once the baby is born, all exams and care will occur in your room. Usually certified nurse-midwives, not obstetricians, deliver babies at birth centers. Healthy women who are at low risk for problems during pregnancy, labor, and delivery may choose to deliver at a birth center.

Women can not receive epidurals at a birth center, although some pain medicines may be available. If a cesarean delivery becomes necessary, women must be moved to a hospital for the procedure. After delivery, babies with problems can receive basic emergency care while being moved to a hospital.

Many birthing centers have showers or tubs in their rooms for laboring women. They also tend to have comforts of home like large beds and rocking chairs. In general, birth centers allow more people in the delivery room than do hospitals.

Birth centers can be inside of hospitals, a part of a hospital or completely separate facilities. If you want to deliver at a birth center, make sure it meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers. Accredited birth centers must have doctors who can work at a nearby hospital in case of problems with the mom or baby. Also, make sure the birth center has the staff and set-up to support successful breastfeeding.

Homebirth is an option for healthy pregnant women with no risk factors for complications during pregnancy, labor or delivery. It is also important women have a strong after-care support system at home. Some certified nurse midwives and doctors will deliver babies at home. Many health insurance companies do not cover the cost of care for homebirths. So check with your plan if you'd like to deliver at home.

Homebirths are common in many countries in Europe. But in the United States, planned homebirths are not supported by the American Congress of Obstetricians and Gynecologists (ACOG). ACOG states that hospitals are the safest place to deliver a baby. In case of an emergency, says ACOG, a hospital's equipment and highly trained doctors can provide the best care for a woman and her baby.

If you are thinking about a homebirth, you need to weigh the pros and cons. The main advantage is that you will be able to experience labor and delivery in the privacy and comfort of your own home. Since there will be no routine medical procedures, you will have control of your experience.

The main disadvantage of a homebirth is that in case of a problem, you and the baby will not have immediate hospital/medical care. It will have to wait until you are transferred to the hospital. Plus, women who deliver at home have no options for pain relief.

To ensure your safety and that of your baby, you must have a highly trained and experienced midwife along with a fail-safe back-up plan. You will need fast, reliable transportation to a hospital. If you live far away from a hospital, homebirth may not be the best choice. Your midwife must be experienced and have the necessary skills and supplies to start emergency care for you and your baby if need be. Your midwife should also have access to a doctor 24 hours a day.

Prenatal checkups

During pregnancy, regular checkups are very important. This consistent care can help keep you and your baby healthy, spot problems if they occur, and prevent problems during delivery. Typically, routine checkups occur:

• Once each month for weeks four through 28
• Twice a month for weeks 28 through 36
• Weekly for weeks 36 to birth

Women with high-risk pregnancies need to see their doctors more often.

At your first visit your doctor will perform a full physical exam, take your blood for lab tests, and calculate your due date. Your doctor might also do a breast exam, a pelvic exam to check your uterus (womb), and a cervical exam, including a Pap test. During this first visit, your doctor will ask you lots of questions about your lifestyle, relationships, and health habits. It's important to be honest with your doctor.

After the first visit, most prenatal visits will include:

• Checking your blood pressure and weight
• Checking the baby's heart rate
• Measuring your abdomen to check your baby's growth

You also will have some routine tests throughout your pregnancy, such as tests to look for anemia , tests to measure risk of gestational diabetes , and tests to look for harmful infections.

Become a partner with your doctor to manage your care. Keep all of your appointments — every one is important! Ask questions and read to educate yourself about this exciting time.

Monitor your baby's activity

After 28 weeks, keep track of your baby's movement. This will help you to notice if your baby is moving less than normal, which could be a sign that your baby is in distress and needs a doctor's care. An easy way to do this is the "count-to-10" approach. Count your baby's movements in the evening — the time of day when the fetus tends to be most active. Lie down if you have trouble feeling your baby move. Most women count 10 movements within about 20 minutes. But it is rare for a woman to count less than 10 movements within two hours at times when the baby is active. Count your baby's movements every day so you know what is normal for you. Call your doctor if you count less than 10 movements within two hours or if you notice your baby is moving less than normal. If your baby is not moving at all, call your doctor right away.

Prenatal tests

Tests are used during pregnancy to check your and your baby's health. At your fist prenatal visit, your doctor will use tests to check for a number of things, such as:

• Your blood type and Rh factor
• Infections, such as toxoplasmosis and sexually transmitted infections (STIs), including hepatitis B , syphilis , chlamydia , and HIV
• Signs that you are immune to rubella (German measles) and chicken pox

Throughout your pregnancy, your doctor or midwife may suggest a number of other tests, too. Some tests are suggested for all women, such as screenings for gestational diabetes, Down syndrome, and HIV. Other tests might be offered based on your:

• Personal or family health history
• Ethnic background
• Results of routine tests

Some tests are screening tests. They detect risks for or signs of possible health problems in you or your baby. Based on screening test results, your doctor might suggest diagnostic tests. Diagnostic tests confirm or rule out health problems in you or your baby.

Understanding prenatal tests and test results

If your doctor suggests certain prenatal tests, don't be afraid to ask lots of questions. Learning about the test, why your doctor is suggesting it for you, and what the test results could mean can help you cope with any worries or fears you might have. Keep in mind that screening tests do not diagnose problems. They evaluate risk. So if a screening test comes back abnormal, this doesn't mean there is a problem with your baby. More information is needed. Your doctor can explain what test results mean and possible next steps.

Avoid keepsake ultrasounds

You might think a keepsake ultrasound is a must-have for your scrapbook. But, doctors advise against ultrasound when there is no medical need to do so. Some companies sell "keepsake" ultrasound videos and images. Although ultrasound is considered safe for medical purposes, exposure to ultrasound energy for a keepsake video or image may put a mother and her unborn baby at risk. Don't take that chance.

High-risk pregnancy

Pregnancies with a greater chance of complications are called "high-risk." But this doesn't mean there will be problems. The following factors may increase the risk of problems during pregnancy:

• Very young age or older than 35
• Overweight or underweight
• Problems in previous pregnancy
• Health conditions you have before you become pregnant, such as high blood pressure , diabetes , autoimmune disorders , cancer , and HIV
• Pregnancy with twins or other multiples

Health problems also may develop during a pregnancy that make it high-risk, such as gestational diabetes or preeclampsia . See Pregnancy complications to learn more.

Women with high-risk pregnancies need prenatal care more often and sometimes from a specially trained doctor. A maternal-fetal medicine specialist is a medical doctor that cares for high-risk pregnancies.

If your pregnancy is considered high risk, you might worry about your unborn baby's health and have trouble enjoying your pregnancy. Share your concerns with your doctor. Your doctor can explain your risks and the chances of a real problem. Also, be sure to follow your doctor's advice. For example, if your doctor tells you to take it easy, then ask your partner, family members, and friends to help you out in the months ahead. You will feel better knowing that you are doing all you can to care for your unborn baby.

Paying for prenatal care

Pregnancy can be stressful if you are worried about affording health care for you and your unborn baby. For many women, the extra expenses of prenatal care and preparing for the new baby are overwhelming. The good news is that women in every state can get help to pay for medical care during their pregnancies. Every state in the United States has a program to help. Programs give medical care, information, advice, and other services important for a healthy pregnancy.

Learn more about programs available in your state.

You may also find help through these places:

• Local hospital or social service agencies – Ask to speak with a social worker on staff. She or he will be able to tell you where to go for help.
• Community clinics – Some areas have free clinics or clinics that provide free care to women in need.
• Women, Infants and Children (WIC) Program – This government program is available in every state. It provides help with food, nutritional counseling, and access to health services for women, infants, and children.
• Places of worship

More information on prenatal care and tests

Read more from womenshealth.gov.

• Pregnancy and Medicines Fact Sheet - This fact sheet provides information on the safety of using medicines while pregnant.

Explore other publications and websites

• Chorionic Villus Sampling (CVS) (Copyright © March of Dimes) - Chorionic villus sampling (CVS) is a prenatal test that can diagnose or rule out certain birth defects. The test is generally performed between 10 and 12 weeks after a woman's last menstrual period. This fact sheet provides information about this test, and how the test sample is taken.
• Folic Acid (Copyright © March of Dimes) - This fact sheet stresses the importance of getting higher amounts of folic acid during pregnancy in order to prevent neural tube defects in unborn children.
• Folic Acid: Questions and Answers - The purpose of this question and answer sheet is to educate women of childbearing age on the importance of consuming folic acid every day to reduce the risk of spina bifida.
• For Women With Diabetes: Your Guide to Pregnancy - This booklet discusses pregnancy in women with diabetes. If you have type 1 or type 2 diabetes and you are pregnant or hoping to get pregnant soon, you can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy.
• Genetics Home Reference - This website provides information on specific genetic conditions and the genes or chromosomes responsible for these conditions.
• Guidelines for Vaccinating Pregnant Women - This publication provides information on routine and other vaccines and whether they are recommended for use during pregnancy.
• How Your Baby Grows (Copyright © March of Dimes) - This site provides information on the development of your baby and the changes in your body during each month of pregnancy. In addition, for each month, it provides information on when to go for prenatal care appointments and general tips to take care of yourself and your baby.
• Pregnancy Registries - Pregnancy registries help women make informed and educated decisions about using medicines during pregnancy. If you are pregnant and currently taking medicine — or have been exposed to a medicine during your pregnancy — you may be able to participate and help in the collection of this information. This website provides a list of pregnancy registries that are enrolling pregnant women.
• Pregnancy, Breastfeeding, and Bone Health - This publication provides information on pregnancy-associated osteoporosis, lactation and bone loss, and what you can do to keep your bones healthy during pregnancy.
• Prenatal Care: First-Trimester Visits (Copyright © Mayo Foundation) - This fact sheet explains what to expect during routine exams with your doctor. In addition, if you have a condition that makes your pregnancy high-risk, special tests may be performed on a regular basis to check the baby's health.
• Ten Tips for a Healthy Pregnancy (Copyright © Lamaze International) - This easy-to-read fact sheet provides 10 simple recommendations to help mothers have a healthy pregnancy.
• Ultrasound (Copyright © March of Dimes) - This fact sheet discusses the use of an ultrasound in prenatal care at each trimester.

Connect with other organizations

• American Academy of Family Physicians
• American Association of Birth Centers
• American College of Obstetricians and Gynecologists
• Center for Research on Reproduction and Women's Health, University of Pennsylvania Medical Center
• Dona International
• March of Dimes
• Maternal and Child Health Bureau, HRSA, HHS
• National Association for Down Syndrome
• National Center on Birth Defects and Developmental Disabilities, CDC
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Postpartum care: What to expect after a vaginal birth

When caring for a newborn, you might forget to care for yourself. But that's important too. Learn what's involved as you recover from giving birth.

Pregnancy changes a body in more ways than you might expect. And that doesn't stop when you give birth. Here's what can happen physically and emotionally after a vaginal delivery.

Vaginal soreness

You might have had a tear in your vagina during delivery. Or your healthcare professional may have made a cut in the vaginal opening, called an episiotomy, to make delivery easier. The wound may hurt for a few weeks. Large tears can take longer to heal. To ease the pain:

• Sit on a pillow or padded ring.
• Cool the area with an ice pack. Or put a chilled witch hazel pad between a sanitary napkin and the area between your vaginal opening and anus. That area is called the perineum.
• Use a squirt bottle to spray warm water over the perineum as you urinate.
• Sit in a warm bath just deep enough to cover your buttocks and hips for five minutes. Use cold water if it feels better.
• Take a pain reliever that you can buy without a prescription. Ask your healthcare professional about a numbing spray or cream, if needed.
• Talk to your healthcare professional about using a stool softener. Or ask about taking a laxative. Those medicines may help prevent problems with bowel movements — a condition called constipation.

Tell your healthcare professional if you have intense pain, lasting pain or if the pain gets worse. It could be a sign of an infection.

Vaginal discharge

After delivery, a mix of blood, mucus and tissue from the uterus comes out of the vagina. This is called discharge. The discharge changes color and lessens over 4 to 6 weeks after a baby is born. It starts bright red, then turns darker red. After that, it usually turns yellow or white. The discharge then slows and becomes watery until it stops.

Contact your healthcare professional if blood from your vagina soaks a pad hourly for two hours in a row, especially if you also have a fever, pelvic pain or tenderness.

Contractions

You might feel contractions, sometimes called afterpains, for a few days after delivery. These contractions often feel like menstrual cramps. They help keep you from bleeding too much because they put pressure on the blood vessels in the uterus. Afterpains are common during breastfeeding. That's because breastfeeding causes the release of the hormone oxytocin.

To ease the pain, your healthcare professional might suggest a pain reliever that you can buy without a prescription. They include acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Leaking urine

Pregnancy, labor and a vaginal delivery can stretch or hurt your pelvic floor muscles. These muscles support the uterus, bladder and rectum. As a result, some urine might leak when you sneeze, laugh or cough. The leaking usually gets better within a week. But it might go on longer. Leaking urine also is called incontinence.

Until the leaking stops, wear sanitary pads. Do pelvic floor muscle training, also called Kegels, to tone your pelvic floor muscles and help control your bladder.

To do Kegels, think of sitting on a marble. Tighten your pelvic muscles as if you're lifting the marble. Try it for three seconds at a time, then relax for a count of three. Work up to doing the exercise 10 to 15 times in a row, at least three times a day. To make sure you're doing Kegels right, it might help to see a physical therapist who specializes in pelvic floor exercises.

Hemorrhoids and bowel movements

If you notice pain during bowel movements and feel swelling near your anus, you might have swollen veins in the anus or lower rectum, called hemorrhoids. To ease hemorrhoid pain:

• Use a hemorrhoid cream or a medicine that you put into your anus, called a suppository, that has hydrocortisone. You can buy either without a prescription.
• Wipe the area with pads that have witch hazel or a numbing agent.
• Soak your anal area in plain warm water for 10 to 15 minutes 2 to 3 times a day.

You might be afraid to have a bowel movement because you don't want to make the pain of hemorrhoids or your episiotomy wound worse. Take steps to keep stools soft and regular. Eat foods high in fiber, including fruits, vegetables and whole grains. Drink plenty of water. Ask your healthcare professional about a stool softener, if needed.

Sore breasts

A few days after giving birth, you might have full, firm, sore breasts. That's because your breast tissue overfills with milk, blood and other fluids. This condition is called engorgement. Breastfeed your baby often on both breasts to help keep them from overfilling.

If your breasts are engorged, your baby might have trouble attaching for breastfeeding. To help your baby latch on, you can use your hand or a breast pump to let out some breast milk before feeding your baby. That process is called expressing.

To ease sore breasts, put warm washcloths on them or take a warm shower before breastfeeding or expressing. That can make it easier for the milk to flow. Between feedings, put cold washcloths on your breasts. Pain relievers you can buy without a prescription might help too.

Hair loss and skin changes

During pregnancy, higher hormone levels mean your hair grows faster than it sheds. The result is more hair on your head. But for up to five months after giving birth, you lose more hair than you grow. This hair loss stops over time.

Stretch marks on the skin don't go away after delivery. But in time, they fade. Expect any skin that got darker during pregnancy, such as dark patches on your face, to fade slowly too.

Mood changes

Childbirth can trigger a lot of feelings. Many people have a period of feeling down or anxious after giving birth, sometimes called the baby blues. Symptoms include mood swings, crying spells, anxiety and trouble sleeping. These feelings often go away within two weeks. In the meantime, take good care of yourself. Share your feelings, and ask your partner, loved ones or friends for help.

If you have large mood swings, don't feel like eating, are very tired and lack joy in life shortly after childbirth, you might have postpartum depression. Contact your healthcare professional if you think you might be depressed. Be sure to seek help if:

• Your symptoms don't go away on their own.
• You have trouble caring for your baby.
• You have a hard time doing daily tasks.
• You think of harming yourself or your baby.

Medicines and counseling often can ease postpartum depression.

Weight loss

It's common to still look pregnant after giving birth. Most people lose about 13 pounds (6 kilograms) during delivery. This loss includes the weight of the baby, placenta and amniotic fluid.

In the days after delivery, you'll lose more weight from leftover fluids. After that, a healthy diet and regular exercise can help you to return to the weight you were before pregnancy.

Postpartum checkups

The American College of Obstetricians and Gynecologists says that postpartum care should be an ongoing process rather than a single visit after delivery. Check in with your healthcare professional within 2 to 3 weeks after delivery by phone or in person to talk about any issues you've had since giving birth.

Within 6 to 12 weeks after delivery, see your healthcare professional for a complete postpartum exam. During this visit, your healthcare professional does a physical exam and checks your belly, vagina, cervix and uterus to see how well you're healing.

Things to talk about at this visit include:

• Your mood and emotional well-being.
• How well you're sleeping.
• Other symptoms you might have, such as tiredness.
• Birth control and birth spacing.
• Baby care and feeding.
• When you can start having sex again.
• What you can do about pain with sex or not wanting to have sex.
• How you're adjusting to life with a new baby.

This checkup is a chance for you and your healthcare professional to make sure you're OK. It's also a time to get answers to questions you have about life after giving birth.

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• Landon MB, et al., eds. Postpartum care and long-term health considerations. In: Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Sept. 6, 2023.
• American College of Obstetricians and Gynecologists' Presidential Task Force on Redefining the Postpartum Visit and the Committee on Obstetric Practice. Committee Opinion No. 736: Optimizing postpartum care. Obstetrics & Gynecology. 2018; doi:10.1097/AOG.0000000000002633.
• Berens P. Overview of the postpartum period: Normal physiology and routine maternal care. https://www.uptodate.com/contents/search. Accessed Sept. 6, 2023.
• Expert view. What to expect at a postpartum checkup — and why the visit matters. American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/experts-and-stories/the-latest/what-to-expect-at-a-postpartum-checkup-and-why-the-visit-matters. Accessed Sept. 6, 2023.
• Kegel exercises. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems-women/kegel-exercises. Accessed Sept. 7, 2023.
• Frequently asked questions. Labor, delivery, and postpartum care FAQ091. Postpartum depression. American College of Obstetricians and Gynecologists. https://www.acog.org/Patients/FAQs/Postpartum-Depression. Accessed Sept. 6, 2023.
• Berkowitz LR, et al. Postpartum perineal care and management of complications. https://www.uptodate.com/contents/search. Accessed Sept. 7, 2023.
• Postpartum care. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gynecology-and-obstetrics/postpartum-care-and-associated-disorders/postpartum-care#. Accessed Sept. 7, 2023.
• Marnach M (expert opinion). Mayo Clinic. Sept. 11, 2023.

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Your Postpartum Checkups

Medical review policy, latest update:.

Added FAQs to the article with updates to sourcing and check on text for #BumpDay 2023.

What is a postpartum checkup?

When is my first postpartum checkup, is there still a six-week postpartum checkup, read this next, how to prepare for your postpartum checkups, can i bring my baby to my postpartum checkups, what happens at my postpartum checkup, give you an annual exam, examine your post-pregnancy body, make sure no serious health issues have cropped up since you delivered, get the go-ahead of when to start working out again and go back to normal activities, discuss your mental health and how you're feeling, talk about resuming sex after baby and get you back on birth control, chat about any future baby plans (if applicable).

Remember: Your health is important, and taking good care of yourself helps you take good care of your baby. That's why it's necessary to schedule and attend your postpartum doctor's appointments. An added bonus? You'll probably feel better and more reassured after the visit with your practitioner too.

Postpartum Checkup FAQs

How many postpartum checkups do you need, what does a postpartum checkup consist of, what happens if i miss my postpartum checkup, do they test urine at postpartum checkup, updates history, go to your baby's age, trending on what to expect, the covid-19 vaccine for infants, toddlers and young children, how to create a night shift system when you have a newborn, ⚠️ you can't see this cool content because you have ad block enabled., when do babies start laughing, baby-led weaning, what happens in the ‘4th trimester’ (and is it a real thing).

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Postpartum recovery timeline

Your postpartum body will recover on its own schedule following childbirth, but there's a general postpartum recovery timeline that applies to most women. Afterpains will stop in the first week, for example, and bleeding will subside during the first month. You may have breast tenderness, night sweats, and exhaustion, and if you've had a C-section, you'll need additional recovery time. From one week to one year postpartum, here's what to expect.

One week postpartum

Two weeks postpartum, six weeks postpartum, six months postpartum, one year postpartum.

You've entered your "fourth trimester" now and are on your way to recovering from pregnancy and childbirth. How that recovery progresses is very individual, depending on everything from your age and overall fitness to what kind of pregnancy, labor, and delivery you experienced. Here are some general guidelines, though, so you know what to expect when it comes to recovering – both mentally and physically – during the postpartum period.

Your physical recovery: vaginal birth

Bleeding: You may still have some spurts of vaginal bleeding on and off through the day. But, overall, the lochia – the combination of blood, tissue and mucus that your body sheds after birth – has decreased and may even already be just a watery, pinkish discharge. Many women continue to have a small gush of light bleeding a few times a day, especially while breastfeeding .

Your lochia will change into a white or yellow-white discharge and then keep tapering off until it stops in another two to four weeks. It's very important that you call your provider immediately if you have extensive bleeding, which is a sign of postpartum hemorrhage .

Perineum soreness: If you had a vaginal birth without tearing, your perineum (which may have been swollen and sore at first) is probably fine by now. Depending on how your labor went and if you tore or had an episiotomy , though, you may still be sore and even have vaginal and perineal pain .

Cramping: Postpartum cramping happens as your uterus contracts and is usually most intense on days two and three after delivery. These afterpains should be gone by now.

Pelvic floor discomfort: You may have symptoms resulting from the stretching and/or injuring of your pelvic floor muscles during delivery. These symptoms – such as incontinence , difficulty walking, and pelvic pain – usually get better within weeks, but they don't always return to pre-pregnancy strength without assistance. If you continue to have symptoms, ask your provider at your postpartum checkup if pelvic floor therapy might help.

Breast changes: Your breasts may have been tender, full, and/or engorged as your milk came in this past week. If you're not breastfeeding, your breasts probably have stopped making milk by now, which means you're more comfortable. If you're breastfeeding, your breasts have likely adapted by now, although some women take a little bit longer to get the supply and demand equation just right. Talk with your provider, your baby's pediatrician, or a lactation consultant for advice. You may feel nipple soreness as your baby latches onto your breast in the first week or so. (The pain shouldn't last through the feeding, though.)

Swelling: Postpartum edema (swelling) should be going away now by now, though it may last a few days more, especially if you had excess swelling due to preeclampsia or pregnancy-related high blood pressure . If you had swollen labia during pregnancy, it should also be getting better now.

Your uterus is now half the size it was after you gave birth. You lost about 13 pounds after delivery, and you probably lost about 4 to 6 pounds of water weight this week.

Fatigue: Tiredness is common. You're recovering from childbirth, experiencing a major life change, learning to take care of your baby, and likely not getting much sleep. It's no surprise that you're tired. Ask for help and talk with your healthcare provider about your level of fatigue .

Hot flashes and night sweats : These may be intense at times, and you may wake up to feed your baby and find your night clothes soaked. Your hormones have changed drastically in the past week, and just as your milk was coming in, the sweating started. This is normal and will pass within the next few days.

Your physical recovery: C-section

In addition to most of the recovery mentioned above for vaginal birth, you're also recovering from major abdominal surgery. That means more healing and a slower recovery.

You might be finding it difficult to move around very much, but it's important that you do. Mild activity speeds healing, plus it prevents blood clots. Just take it slowly.

Your incision should be healing nicely, and your provider may schedule a post-op visit to make sure. It may still feel tender, but it should be a lot less painful now. (Most women are off painkillers by this point.) You may feel numbness and some twinges of pain around the incision for several months.

You're able to lift your baby now (usually within two to four days), but nothing heavier.

Your mental health and postpartum hormones

Your hormone levels are changing - estrogen and progesterone levels are dropping, and prolactin and oxytocin levels rise and fall as baby nurses. Add sleep deprivation to the mix, and it's no wonder you're feeling a little unsteady.

It's normal to feel exhausted and overwhelmed. In fact, many moms experience the baby blues – feelings of sadness, emotional sensitivity, and weepiness – in the days after giving birth. (Think of it like the worst PMS you've ever had.) These feelings can last up to two weeks.

Things to do if you're feeling blue after delivery .

If you're not feeling better in a couple of weeks, or if your feelings are intense, talk with your healthcare provider. You may be experiencing postpartum depression . It's a treatable condition, and the sooner you get help the better.

Take our postpartum depression quiz if you're wondering about the feelings you're having.

Your lochia (vaginal bleeding and discharge) is continuing to taper off and may be very light by now. You may still have occasional, small bursts of bleeding, though.

If you had a second-degree tear (involving skin and muscle), it's probably healing this week and next. Any stitches for a tear may be feeling itchy now. This is a good sign that they're healing.

Depending on how breastfeeding is going, you may have sore nipples for a number of reasons. If your baby's latch is shallow, for example, or if they have thrush or are tongue-tied , your nipples may hurt. Talk with a lactation consultant about possible causes and remedies.

Your uterus has now returned to your pelvis, and you're continuing to lose water weight.

If you had bloodshot eyes from the pushing and straining of labor, these have resolved by now.

While you're still probably a little sore, you can probably move around a bit better now.

Your scar may be a little itchy as the incision heals.

If you had steri-strips (small, white, sticky bandages) on the incision, they should fall off now (if they don't, you can gently remove them). If you have glue over your incision, you can probably remove it now, too. Both the steri strips and glue tend to get a little gross after three weeks, so make sure you remove them at that point. If you have trouble seeing your incision, you can ask your partner (or doctor) for help.

You may be able to drive now, if you're no longer taking narcotic pain killers and if you can react quickly enough to drive safely. You can test to make sure you can move comfortably to check your blind spot, press the brake pedal, etc., by practicing the movements in the passenger seat. If you hesitate or wince prior to pretend braking or merging, it's not quite time yet.

If you had the baby blues, they may be fading now. If you're having extreme feelings of sadness or are crying often, or have other signs of postpartum depression, talk with your healthcare provider to get help as soon as possible.

You may or may not feel 100 percent back to "normal," but six weeks is generally considered a postpartum milestone for recovery. Here's why:

• Though it can start up again once in a while, for most women postpartum bleeding has stopped.
• Your uterus is back to its pre-pregnancy size, having shrunk from about 2.5 pounds after childbirth to only 2 ounces now. That doesn't mean your abdomen looks the same, though. Your abdominal muscles have stretched, and it takes time and exercise to get them back in shape.
• Most moms have lost about half their pregnancy weight at this point.
• Your healthcare provider may give you the go-ahead for exercise and sex at your six-week postpartum checkup.
• If you had an uncomplicated vaginal delivery, you may have regained pelvic floor strength by now. (If you had a multiple birth or a birth injury during delivery, it can take longer.) Ask your provider about pelvic floor physical therapy if you note leaking of urine or signs of prolapse.
• If you're exclusively formula feeding your baby, you may get your first postpartum period in the next couple of weeks.
• Even if you had a third- or fourth-degree laceration during childbirth, the pain should have subsided by now.
• If, during pregnancy, you had diastasis recti (a vertical bulge where the long, flat muscles running vertically down each side of your abdomen have separated), it should have resolved by now. If it hasn't, a physical therapist can work with you to strengthen your muscles and reduce that gap between them.

By your six-week mark, you should be feeling well recovered from surgery. You shouldn't have pain, and your incision scar should be healed, though it may still occasionally feel itchy or burn. You can now lift most things (ask your provider for guidelines).

Hopefully you're adjusting well to your new role and feeling settled in by now. Still, it's normal to feel tired and upset now and then. But it shouldn't be all the time. You still need to be on the lookout for signs of postpartum depression and contact your healthcare provider right away if you're concerned.

Your physical recover: vaginal birth

Most women have lost one-half of their pregnancy weight gain by now (but remember, all women are different, so it may take more or less time for you).

Any melasma (dark spots) or stretch marks on your belly or breasts are beginning to fade. If you have linea nigra (a dark line down your abdomen), it will fade, too, though it may not completely go away.

On the negative side, you may have started noticing some hair loss in recent months, as your estrogen level dropped and your hair follicles entered their resting/shedding phase. (During pregnancy, when your estrogen climbed, the growing stage was prolonged. That's why you may have had such luxurious locks during pregnancy.) You'll notice the new hair growth as short, wispy bits.

Don't be alarmed if you're still feeling tired. Many of your physical symptoms are vastly improved, and you should feel overall pretty recovered from surgery, but it's not unusual to still be tired. In one study Opens a new window of over 1500 women, those who had a C-section were more likely to report extreme tiredness at 6 months postpartum and 12 months postpartum than those who had a spontaneous vaginal birth.

May be feeling pretty upbeat now, especially if your baby is sleeping more and you're adjusting well. If you have any signs of postpartum depression, talk with your healthcare provider right away.

Though they may not completely disappear, any stretch marks and linea nigra have continued to lighten.

You may have a period by now too, even if you're breastfeeding.

Your numbness around the scar will likely have resolved by now. The scar has healed, and while it's appearance will continue to fade over time, it will do so much more gradually now.

Your baby is a toddler now! Your new life comes with new stresses, whether it's balancing work and family , helping siblings get along, weaning your baby from breastfeeding, or deciding whether or not to have another baby . While you're technically outside the definition of "postpartum" depression now, moms carry a lot for their families, and you deserve support. Reach out to your doctor if you're experiencing symptoms of depression.

Learn more:

• Postpartum warning signs
• C-section recovery

Can you take a bath after giving birth – and when?

• When can I go back to work after having a baby?
• How to deal with a difficult birth experience

Was this article helpful?

Warning signs of postpartum complications

Postpartum cramping

Postpartum swelling (edema)

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

March of Dimes. 2018. Your body after baby: The first 6 weeks. https://www.marchofdimes.org/pregnancy/your-body-after-baby-the-first-6-weeks.aspx Opens a new window [Accessed March 2022]

Mayo Clinic. 2020. Postpartum care: What to expect after a vaginal birth. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/postpartum-care/art-20047233 Opens a new window [Accessed March 2022]

Thurston RC et al 2013. Prospective evaluation of hot flashes during pregnancy and postpartum. Fertility and Sterility 100(6): 1667-1672. https://www.fertstert.org/article/S0015-0282(13)02967-1/fulltext [Accessed March 2022]

Woolhouse H et al. 2012. Physical health and recovery in the first 18 months postpartum: Does cesarean section reduce long-term morbidity? Birth 39(3): 221-9. https://pubmed.ncbi.nlm.nih.gov/23281904/ Opens a new window [Accessed April 2022]

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I'm pregnant. When should I visit a doctor?

Why do I need to visit a doctor soon after a pregnancy test?

• Calculate your due date and see how far along in your pregnancy you already are.
• Check for any family or personal health factors, or age-related factors that might pose a pregnancy risk .
• Prescribe several tests that will firstly confirm your pregnancy and then detect any potential health risks for your pregnancy.
• Advise you on prenatal supplements that you need to take as soon as you get pregnant.
• Check that your cervix has closed. During early pregnancy, the cervix (the opening of your uterus) gets closed with thick mucus that forms what is called a mucus plug. This mucus plug seals your womb and acts as a barrier that prevents any bacteria, fungus or anything else from accessing your womb from your vagina. This mucus plug usually stays in place in your cervix till your body gets ready for giving birth.
• If you are already six weeks pregnant, your doctor might also check to hear for your baby's heartbeat .

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• Pregnant at work
• How often will I get internal check-ups during pregnancy?
• First trimester scans

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I Got a Positive Pregnancy Test—Now What?

Some of us dream for months (and sometimes years) of that telltale plus sign. For others, pregnancy is a complete surprise. Either way, you’re definitely not alone if you find yourself wondering, “I got a positive pregnancy test —now what?”

Finding out you’re pregnant is a life-changing moment that comes with its fair share of surging emotions: excitement, joy, relief, panic and maybe an extra dose of confusion over what to do next. But before you start deciding between an epidural or a medication-free birth, pause for a second. You’ve got 40 weeks to find all the answers, so take it one trimester at a time.

The best way to make sense of a positive pregnancy test is with, well, baby steps. “You don’t have to figure it all out the second you’re pregnant,” says Rebekah Wheeler , CNM, MPH, a midwife based in Sonoma County, California. “Pregnancy is a process, and asking yourself if you’ll be a good mother, learning to trust your instincts, is all part of it.” So what are the important steps to take—and when?

Suffice it to say, it’s totally natural to get a positive pregnancy test and think: “I’m pregnant! Now what?” Focusing on all the big and small to-dos on your ever-growing list (not to mention the changes happening in your ever-growing body) can be daunting, to say the least. Fortunately, we’re here to help you streamline and simplify. We’ve created a comprehensive guide to break down exactly what to do after a positive pregnancy test, from scheduling your first prenatal visit to making healthy changes to your current lifestyle. Follow along so you can feel informed and prepared in the early stages of pregnancy.

Consider Taking a Second Test

If your first instinct is to run to the pharmacy and buy all the different pregnancy test options, take a deep breath and slow down. Certainly, there’s no harm in taking a second test. Human error and misreadings can occur—so a little validation can give you some peace of mind.

It’s true that an expired pregnancy test or, more commonly, user error can result in a false positive . This is why it’s important to read labels and carefully follow all included instructions when taking a pregnancy test. Wait too long to check the result, and you may note the appearance of a faint evaporation line and misread the results—meaning you interpret it as positive when it’s actually negative.

Keep in mind that while false positives are very uncommon with pregnancy tests, there’s a small chance that an at-home test can pick up the pregnancy hormone hCG , even if you’ve miscarried shortly after conception—something that doctors refer to as a chemical pregnancy . “You probably wouldn’t even know that you were pregnant, if you didn’t take the pregnancy test,” says Mary Jane Minkin , MD, a clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine in New Haven, Connecticut. If you did have a chemical pregnancy, you’ll likely get your period a little late.

According to the Mayo Clinic , a positive pregnancy test could also happen if you’re taking certain medications, including fertility drugs, and in the event of an ectopic pregnancy . For this reason (and others), it’s important to schedule a doctor’s appointment after getting a positive pregnancy test result.

Calculate Baby’s Due Date

With so much to think about, it’s hard to know what to do when you find out you’re pregnant. But one thing you’ll likely be itching to know is baby’s due date. Conception typically happens between 11 and 21 days after the first day of your last period, but since it’s tricky to know when conception actually occurs, doctors instead base it on the first day of your last period. Check out The Bump due date calculator to get an estimated date. This will also help you gauge how far you are in your pregnancy. Farther along than you expected? Remember, your progress is tallied from the first day of your last period, so the two or three weeks before you ovulated are still counted, even though you technically weren’t pregnant yet.

Let the News Sink in—and Celebrate!

You’ve received a positive pregnancy test—now, what you can and should do is take a beat to let the monumental news sink in. Even if you’ve been looking forward to this day, it’s not uncommon to feel a bit overwhelmed. Give yourself time and grace—and then celebrate!

Bask in this joyful moment, perhaps together with your partner, before well-meaning grandparents and friends accost you with a million questions: “Are you going to find out the sex ? Do you want a boy or a girl? Have you picked out a name?” Finding out you’re pregnant is the first sign your life is about to change in a million ways. Add a surge of pregnancy hormones to the mix and you’ve got yourself a kaleidoscope of emotions. “You’re basically flooded with progesterone, which causes you to feel much more vulnerable,” Wheeler says. This means you might be prone to crying and panicking about the future and your career—and that’s completely normal. “Most of the time these moods will pass if you rest. Don’t take on unnecessary tasks that you can avoid,” adds Minkin.

Make a Doctor’s Appointment

After you see that positive home pregnancy test, you’ll want to confirm it with a professional. And even if you may not see the doctor right away, calling to schedule an appointment is one of the first steps to take after finding out you’re pregnant—depending on the practice, wait times can be long.

When to visit doctor after positive pregnancy test

Your first prenatal visit usually happens around your eighth week of pregnancy. If you have an existing medical condition, had previous miscarriages or are experiencing abnormal pain or other atypical symptoms, your doctor may want to see you sooner. In the meantime, don’t hesitate to reach out to them with any and all questions or concerns.

How to decide on the type of care provider

As you prepare to make your first prenatal appointment, you can decide to seek prenatal care from either an ob-gyn or a midwife . The decision between the two depends on what you’re hoping for during pregnancy and delivery. If you’re interested in a vaginal delivery with an epidural or a planned C-section , or if you think you may have a higher-risk pregnancy (perhaps because of diabetes or high blood pressure), then an ob-gyn is likely the best choice since they’re equipped to offer medication and perform surgery. On the other hand, those hoping for a low-intervention vaginal delivery (maybe even at home ) can look for a midwife. Oftentimes, nurse midwives can request the same labs and ultrasounds as an ob-gyn. But guess what: You don’t necessarily have to pick one or the other. A lot of hospital practices work with midwives who spearhead prenatal care and labor with an ob-gyn backing them up.

How to find the right doctor for you

Once you decide on the type of care for you, start scouting for an awesome provider. If you already have a great ob-gyn and want to stick with them, great! If not, there are many ways to find one you’ll feel comfortable with. “ Yelp.com is actually a pretty good way to find an OB or midwife,” says Wheeler, who suggests cross-referencing well-rated providers with those recommended in prenatal yoga classes and childbirth centers. Zocdoc.com , Healthgrades.com and RateMDs.com are some other sites you can explore to find provider ratings.

If you already know which hospital suits you best, try Minkin’s trick to find an ob-gyn: Call the head nurse at labor and delivery and ask for a recommendation—the nurses see doctors during the most stressful times and know who takes good care of their patients. And don’t worry if you don’t love the first doctor you meet with; it’s more than okay to try out different midwives and ob-gyns before you commit. “You can transfer up until the moment you’re in labor,” says Wheeler. “People feel embarrassed leaving, but you never have to tell the provider and have a confrontation. The new office will request all your medical records.” The important thing is that you find someone trustworthy who makes you feel comfortable.

After your first visit, and if everything is progressing smoothly, you’ll see your doctor once a month for the first two trimesters. After 32 weeks, the visits are twice a month, then once a week after 36 weeks.

Decide Who to Tell and When

You might be tempted to shout “Just found out I’m pregnant!” from the rooftops. And, sure, snapping a picture of your positive pregnancy test and sharing it on social media will do the job, but announcing that you’re expecting a baby is a bit different than Instagramming your lunch. Many couples wait until after 13 weeks to make the news public, since that’s when the risk of miscarriage goes down significantly. When it comes to close family and friends, you may decide it makes sense to spill the beans around six to eight weeks. As one expectant mom put it, “even if we did lose the baby, I would need my parents and close friends for support, so I’d be telling them either way.” Plus, you might want to loop in close family and friends not only so they can celebrate, but so they can also be understanding if you bewilderingly break down in a waterworks of emotions.

Friends and loved ones can help you find your footing in this exciting new role of a lifetime. It takes a village, and creating that community can start now if you choose. At the end of the day, it’s completely up to you and your partner when and how you want to share the happy news.

The one group of people who can wait for your announcement is employers and coworkers. “It’s no one’s business in the first trimester,” says Christine Romans , senior business correspondent for NBC News and the author of Smart is the New Rich: Money Guide for Millennials . “Later, say at 20 weeks when you’re going to start showing, let your boss and human resources know. Together, you’ll want to start plotting through how long you will take off for maternity leave and how to delegate your work in your absence.”

Learn What’s in Store for You and Baby

Among the things to know when expecting baby? Understanding what’s in store for you for the next nine+ months. One of the coolest things after finding out you’re pregnant is tracking baby’s growth—from the size of an apple seed to a watermelon!—and the many changes in your own body via The Bump Pregnancy Week-By-Week guide (and if you haven’t already, download The Bump app .)

While everyone’s body reacts differently, you’re bound to have at least some of the standard early pregnancy symptoms : nausea, cramping and spotting, sore breasts, acne, mood swings, frequent urination, headaches and food cravings and/or aversions, to name a few. You’ll also likely experience a level of exhaustion that rivals all the all-nighters you may have pulled. “You’ll be eating for two and sleeping for two,” Minkin jokes. This please-let-me-lie-down kind of tiredness, courtesy of an uptick in progesterone, peaks between 8 to 12 weeks and then starts to ease up.

If these physical changes come as a surprise—or if this is baby number one—you may find yourself facing a steep learning curve. Of course, instinct may kick into gear and some things will come naturally. Other parts of pregnancy and early parenting will require a bit more time, patience and practice. The good news is that there are plenty of resources available to help you navigate this new stage of life, from books to podcasts and apps . You can also sign up for expert-led classes to gain a deeper understanding of labor and delivery issues, breastfeeding and newborn care; these sessions are often hosted at local hospitals or community centers. Our advice? Do your due diligence, and slowly start your research as soon as you receive that positive pregnancy test—there’s a lot to cover.

Get Into Healthy Habits

You probably already know that smoking and drinking alcohol are no-nos during pregnancy, but there are a bunch of other ways you’ll need to get your body into tip-top shape for a healthy pregnancy. If you’re not already taking prenatal vitamins , now is the time to start—as baby develops, they’re going to need calcium to build bones and iron to make red blood cells, plus folic acid to prevent neural tube defects and loads of other important nutrients. And baby gets all this from what you’ve got stored in your body. “The kid’s going to steal from you,” Minkin says. “You want to make sure your body doesn’t get depleted.”

In terms of changing up your daily menu, a pregnancy diet isn’t all that different from a typical healthy diet—think: lots of fruits, veggies, whole grains and lean proteins. But there are a few foods that should be avoided : Steer clear of cold cuts, deli salads, unpasteurized cheeses and refrigerated smoked seafood, since these can house listeria , a bacteria that can cause pregnancy complications. You’ll also want to avoid raw fish (sushi) and those that are high in mercury (swordfish, tilefish and king mackerel), since the heavy metal is toxic to baby’s nervous system. You should also limit your caffeine intake to no more than 200 mg a day.

While nut butters, salmon and green veggies are great kitchen staples for the next 40 weeks, if you’re battling with morning sickness , you may be living on a diet of applesauce and crackers at first. “Go easy on yourself,” Wheeler says. “Forget the nutrition component until you feel better.” She also recommends high-protein foods, like chicken and eggs, before bed to keep you satiated longer and minimize nausea in the morning.

After finding out you’re pregnant, you’ll also want to drink plenty of liquids. Staying hydrated allows your body to produce more blood volume, build new tissue, carry nutrients through your body and flush out your (and baby’s) waste. Tired of chugging plain water? Sparkling water, fruit-infused H20 and even watermelon smoothies (just blend watermelon with a bit of frozen berries) are excellent alternatives to not-so-appetizing flat water.

Keep Up With Your (Pregnancy-Safe) Workouts

In addition to healthy pregnancy snacks, you’ll want to continue exercising. According to the Centers for Disease Control and Prevention (CDC), you should aim to gain between 25 and 35 pounds during your pregnancy if you’re of normal BMI. If you’re underweight or overweight, the recommended weight gain should fluctuate by about five to 10 pounds, respectively.

Exercising throughout your pregnancy not only helps you manage a healthy pregnancy weight gain—it also prepares your body for the strain of carrying and delivering a baby and builds the stamina you’ll need after childbirth, when you’re constantly lifting and cradling your (often not-so-light) newborn.

So what workouts are pregnancy-friendly ? There are plenty of ways to stay fit safely—from prenatal yoga classes to walking, swimming and more. Anja Pierre , a personal trainer in New York City, recommends focusing on exercises like planks and squats that utilize the core and the pelvic floor. Try moves that engage the glutes and shoulders and work on the proper alignment of the spine, which in turn preps you for carrying your growing frontal load. “You’ll rely on total-body strength to perform tasks you never thought twice about, like opening a door, getting out of a cab or getting out of bed,” Pierre says. “Start working those arms if you haven’t already!”

You’ll want to avoid contact sports and activities where you’re more likely to fall, like skiing and horseback riding, and steer away from exercises in a poorly ventilated space, like hot yoga and even spinning. “The fetus is vulnerable, so you don’t want to be in a situation where you can quickly overheat,” Pierre says. “Stay hydrated and maintain your body temperature at a normal level.” She also nixes crunches, since “they’re really not as effective as people think, and they can lead to abdominal separation .” Above all else, listen to your body; if any type of exercise or movement causes pain, stop immediately.

Start Saving—Stat

Once you see those parallel lines on your positive pregnancy test, it’s time to take a closer look at your bottom line. “Congratulations! You’re going to have a baby! Now start saving for college,” Romans says. “I’m not kidding even a little bit. You have just 18 years to squirrel away the money for a college education (and they go by quickly!).” Sure, thinking about a 529 plan instead of muslin blankets isn’t super-exciting, but it’s the responsible thing to do—and it doesn’t mean you can’t also enjoy indulging your nesting instinct with cute crib sheets, tiny onesies and other registry goodies .

Of course, it’s not just college you’ll have to start saving for: The first few years of baby’s life can be shockingly expensive. Want to guess how much? According to a 2019 survey , most people thought baby’s first year typically costs around $9,400. Sorry, but not even close—that survey found it’s more like $13,200, and others say it can be even more. But don’t freak out: There are plenty of ways to shop smart and save like a savvy parent-to-be.

Brush Up on Your Maternity Leave Options

What else is on the list of what to do after a positive pregnancy test? Head to the benefits department. Once you’ve shared the news with your employer, learn about maternity leave and insurance perks. “Depending on your policies, there could be lactation consultant home visits, a free nutritionist, prenatal vitamins, even a free breast milk pump,” Romans says. At a minimum, the Family and Medical Leave Act allows you to take up to 12 weeks of unpaid leave (as long as you’ve been with the company for at least a year and your employer meets certain federal requirements). Make sure to ask when and how to add baby to your health insurance, since a newborn is only eligible for enrollment within the first 30 days after birth and won’t be subject to any preexisting conditions, even if they have one.

Now that you know what to do after a positive pregnancy test, you can feel a little less panicked and a lot more empowered. You have time, so be kind to yourself and take it milestone by milestone. Prioritize your health and happiness, and everything else will fall into place. You’ve got this.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

What Does a Faint Line on a Pregnancy Test Mean?

What a Positive Pregnancy Test Looks Like

What to Expect at the First Prenatal Visit

Mary Jane Minkin , MD, is a clinical professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine in New Haven, Connecticut. She also received her medical degree there.

Anja Pierre is a personal trainer in New York City.

Christine Romans is a senior business correspondent for NBC News and the author of Smart is the New Rich: Money Guide for Millennials .

Rebekah Wheeler , RN, CNM, MPH, is a midwife, birth trauma specialist and trauma healing coach based in Sonoma County, California. She received a Master’s of Public Health and a Master’s of Science in nursing from Yale University in New Haven, Connecticut.

Mayo Clinic, Home Pregnancy Tests: Can You Trust the Results? , December 2022

Centers for Disease Control and Prevention, Weight Gain During Pregnancy , June 2022

Learn how we ensure the accuracy of our content through our editorial and medical review process .

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‘I felt myself split into before and after’: how giving birth triggered a life-changing illness

Having a baby led to an unexpected disease and then surgery that altered Lauren Bensted’s body for ever. She talks about the pain she felt in being separated from her newborn, and her journey to learn to accept her new life

“W e’re going to have to disconnect you,” says the man at my bedside. Since I was hospitalised a fortnight ago, this man and his team have been trying to save my colon, a 5ft-long tangle of ulcers and inflammation. The speed and scale of my colon’s fury has fascinated doctors. I imagine them in their morning meetings, poring over my colonoscopy with the mystification usually reserved for the Voynich manuscript. But time is up. Unless they “disconnect” me, my bowel will perforate and I will die.

Disconnection, explains the doctor, involves whipping the whole colon out – here he mimes pulling a rabbit from a hat – and diverting my digestion through a hole in my abdomen called a stoma. He sketches my new anatomy on a piece of paper, quick as a high-street caricaturist. He cannot imagine what it is like to receive this news – to hear your body will change for ever and with it your whole life too – just as I cannot imagine what it is to break it. I want to grab his hand, ask him how. How does a body give birth to a healthy baby and then burst into flames?

I hadn’t planned to be living with my parents when I became a mother, but that’s what happens. My boyfriend, Will, and I have bought a fixer-upper whose every wall, floor and ceiling is, according to my dad, “completely pissed”. The latest in a long line of house-building Irishmen, he sets about restoring its broken bones for us with surgical skill. Meanwhile, Will and I Zipvan our lives back to the London suburb I snubbed aged 21. Now, up the duff at 35, I’m won over by it all – the quiet, the Costa Coffees, the middle-aged blokes reverently soaping their Qashqais. I feel unbelievably lucky to have this time with my mum and dad, this last gulp of being someone’s kid before I become someone’s mum.

I am invited for extra scans, having been classified as “high-risk”. “Because I’m 35 and ‘geriatric’?” I ask one consultant. “No,” she says. “Because of your Crohn’s.” I was diagnosed with the inflammatory bowel disease as a teenager. I don’t remember much, besides a few missed school trips and the dark thrill of no longer being the chubby one in my group of friends. I’ve had no symptoms since. “All looks fine!” beams the sonographer. The baby bobs under the ultrasound wand. It’s the only time my disease history is mentioned.

My son is lifted out of me one Sunday in early July, as Joan Armatrading’s Love and Affection blasts from the delivery-room speakers. Navy-eyed and howling, he is totally alien and powerfully familiar to me all at once . We bring him back to my parents’ house where my brother’s old bedroom is ready for us, shelves of school cricket trophies now stuffed with bottles, muslins, nipple cream. We swaddle the baby the way the midwife showed us – tightly, like a tiny nativity play shepherd – and cannot believe our luck.

I begin to feel porous. Leaking boobs, but other things too: sweat-drenched bedsheets, grinding pain, violent splashes of blood in the toilet. Even the smell of my own breast milk sends me running to the bathroom. I am determined to keep pumping, recording diminishing quantities on my phone: 40ml left boob, 30ml right boob . The baby screams , unsatisfied. I promised I’d go easy on myself if breastfeeding didn’t work out, but now the desire to feed him myself is fierce, irrational, like I need to beat whatever is eating me from the inside out.

When I describe how bad things got before I sought help, people assume I was trying to be invincible. They are thinking, perhaps, of those apocryphal women who lift cars off their young, oblivious to pain. But I’m acutely aware of my pain, I’m just unsure what it means. A suspicion takes hold that I am not tough enough for motherhood. For the sleeplessness, nursing, the magnificent horror of being sliced open.

Unable to get a GP appointment, I pay to see a private doctor, a kind-faced man retired from the NHS. I say I think childbirth has reactivated my Crohn’s. Unlikely, he says. Caesareans famously make the bowels grumpy. He prescribes antibiotics which I immediately throw up. Will drives me to A&E, where the triage doctor calls me “honey”, asks how bad the pain is on a scale of one to ten. Six? Ten? I don’t know the metric. Motherhood has made me an unreliable narrator of my own body. It’s almost a relief when, one morning, delirious with pain, I collapse. At least now there is no ambiguity, I think hazily. As paramedics wheel me out, the baby starts to cry and my mum dashes inside to change his nappy. I do not get to kiss him goodbye.

In TV medical dramas, the patients usually only feature in one episode and then they either get discharged or die. There is a rule that predicts their fate. Demanding patients suffer the most, because they need to be humbled and learn not to be a dick. Sweet, quiet patients – the ones who never press the call bell too often – die first. I hedge my bets and go for “friendly but forthright” in the hope I will make it out alive when the credits roll.

Having never been hospitalised before, there is an initial thrill in observing this ecosystem up close, with its otherworldly machines, bleeps, tourniquets. I am a tourist, just stopping by while the doctors work their magic, then I will step out of this hospital drama, back to my four-week old baby.

I spend the first day on a corridor containing so many patients that staff call it the “Corridor ward”, as if Mr Corridor is a trailblazing scientist. Since there is no space on the gastro ward, I am shipped to an A&E overspill area, where I join the miscellaneously broken. On the bay opposite are two elderly drunks who wind everyone up by singing the same three Beatles songs. Next door is a prisoner with an infected leg who threatens anyone who comes near with legal action. The nurses are kind and visibly stressed. The whole place thrums with the panic of a Panorama documentary, a sensation heightened by the steroids flooding my body.

After a colonoscopy reveals my flaming insides in psychedelic detail, I am diagnosed with severe ulcerative colitis. They will later conclude that my teenage Crohn’s diagnosis was erroneous. The idea is that the gastro doctors will visit me on the A&E ward, but after five days I’ve seen a consultant once. I cannot work out who to badger; it feels like all the people who can help me are elsewhere. A junior doctor mutters that the gastro ward should be renamed the Glasto ward: “That’s how impossible it is to get a ticket.” If only I could chuck on a bucket hat, scale the perimeter wall.

My confidence that I will make a Lazarine recovery falters, chipped away by the tedium of 30 toilet trips a day. I must chronicle them on a daily worksheet, a humiliation compounded by the Comic Sans font. Nevertheless, it sparks a nerdy satisfaction. I add an elaborate asterisk system to denote cramps, spasms, blood. I take it very seriously until the day I hand it in and watch the ward sister shove it straight in the bin.

We decide it’s not safe to bring the baby inside the hospital, as he hasn’t had his jabs yet. So, on the days I can get up, Will brings him to the car park or the garden. My arms are so weak that I’m scared to hold him. Will shows me new winding techniques his mum’s taught him, videos of his dad bathing the baby in the kitchen sink. Some days we laugh a lot. On others, our conversation is a careful dance, each trying to conceal the fullness of our sadness from the other.

Will and the baby are living out of a suitcase between our parents’ homes. I wait for the nightfeeds – midnight, 3am, 6am – when Will sends sleepy voice memos, the baby guzzling in the background. We should be doing this together, sharing the exhaustion and the dirty nappies, the magic chaos of it all. None of us are in the right place. “Has he smiled yet?” I ask. “If I miss his first smile, don’t not tell me.” The baby is changing fast, learning about the world somewhere I am not. This is the unbearable ache, the stone I cannot swallow.

I feel myself crossing over into what Susan Sontag called “the nightside of life”. I’m unable to recognise my own moonface, eyes hollow with insomnia. The kingdom of the sick is where I belong now and it’s no picnic for a people-pleaser. “I’m keeping my pecker up” becomes my party line, like a politician on a media round. But I can see the black puddle of despair in the corner of my room. I am scared to go near in case the questions come (Why me?) and I fall in.

I begin to absent myself from my body. The phlebotomist’s catchphrase comes twice a day – “Sharp scratch” – but I feel nothing when the needle goes in. In the middle of the night, I read about the plan to put people on planes to Rwanda, a newsreader’s sex scandal – things that would normally stir me. But they feel like missives from a universe I don’t exist in any more, so what’s the point? Sickness confirms my impotence to do anything about anything. The world is on fire and so is my body and nothing can be done.

After a weekend passes with no consultant visit, I find the private doctor’s email on his personal website. I say I’ve been diagnosed with severe ulcerative colitis and I’m getting worse. I feel a bit ridiculous, like one of those people who tweet Michael O’Leary for a refund on their Ryanair flight. What can he do, this man? He can’t invent beds on the gastro ward, nor time-travel me through to Monday morning when the consultants will be back. He is literally, according to his out-of-office autoreply, on a walking holiday in Norfolk.

He calls immediately. Apparently I am at risk of developing a very straight-to-DVD-sounding condition called “toxic megacolon” where the whole thing bursts. I need to be on immunosuppressant therapy immediately, he says. And something else: “85% of patients in your position end up needing a colectomy.” What is that? I ask. “The bowel is removed and the patient fitted with a stoma,” he says. “The last resort.”

Like you perhaps, what comes to mind is a bag of waste stuck to a stomach. That’s the visual, that’s the extent of my prior knowledge. I know it must cover something – the “stoma” presumably – but I have no interest in that. Because it will not, cannot be me.

The private gastro pulls the emergency lever all the way from the Norfolk Broads. He used to work here in his NHS days, it turns out. Consultants are paged, the immunosuppressant arrives. But it can only be administered by a specific nurse whose shift ends within the hour. A side-room frees up on the gastro ward, but due to staff shortage it has not been cleaned, so I cannot be transferred. My dad – straight off the scaffold, hair full of plaster dust – runs to find the ward sister. “I will clean that room”, he says, in a low voice that I know means he’s scared. My poor, lovely dad. “Please let me clean it.” Soon I am wheeled to a room on the right ward, hooked up to the new drug. “At last!” we all keep saying, as if that was the worst bit. But over the next fortnight, I will discover there is no limit to how terrifying things can get.

There’s the moment I realise no one has accessed my test results for days because the junior doctors are striking and the consultants don’t know how to log on. The evening an unsympathetic registrar tries to throw me out of my room, claiming a palliative patient has greater need. (I later discover this is a fiction: one of the alcoholic Beatles fans is proving too disruptive.) The moment a trainee stoma nurse tries to draw an X on my stomach where a stoma would go, despite no doctor having made the final call on surgery yet, despite me crying “No, please, I’m not ready.”

There’s the nurse who forgets to warn me she’s about to pull a thick tube from inside my belly (agony!) because she is so stressed, trying to teach junior nurses. The day I’m so desperate to see a psychiatrist about my hallucinations that I try to bribe a millennial female doctor with a Facetime from my bestselling author mate to make it happen. (I’d been asking for a week.) The rage when I discover on a late-night Google trawl that “one in three women with inflammatory bowel disease will flare after giving birth” and “women with IBD should be closely monitored postpartum.” How did I not know? Why did no one tell me?

But there are no villains in this story, I know that now. Just people under huge pressure, in an overstretched, underfunded system that doesn’t work any more, doing their best. And there’s no magic medicine, I know that too. Just good luck and bad luck as to whether the drugs will work, save your colon, save your life, save you from the surgery you think will ruin everything. It’s all luck in the end. And my good luck begins the night three brilliant surgeons walk into my room and promise me a stoma is going to give me my life back and I decide to believe them.

I really have no other choice.

I wake up from the eight-hour operation in what appears to be a large industrial storage unit. No free beds on the recovery ward. Something strange surges in me. I feel stuffed full of love for the earth and all of its creatures. I am the Dalai Lama. I am John and Yoko’s bed!

“Is this the fentanyl?” I ask my surgeon, wondering if he’ll let me hold his hand. “Maybe,” he says. “Or you might just be happy to be alive.” I have questions. Who owns my colon now? “Nobody. It’s biological waste.” Where is my colon, exactly? “A lab in Winnersh Triangle.” This sends me into hysterics. I’ve finally cracked, I think.

I don’t want to ruin the lovely opioid high by looking under the sheets, but the nurse says I can’t be discharged until I prove I can deal with the stoma. So I take a deep breath, pull up my gown.

Most people are too polite to ask what a stoma looks like. Their imagination cuts out at the bag, the way mine used to. But the bag is just the figleaf: the madness is what it conceals. The common assumption is a little tube, discreetly passing waste from body to bag, like a tiny hoover. This is cute, but wrong.

Here’s what I can see. A red spout, 3cm across, protruding between my navel and hip. The end of my small intestine, I realise numbly. Covered with a clear bag for monitoring, it flexes and scrunches like a sea urchin. It feels appalling and amazing to see what I can see, this most private and shameful process brought into daylight. It seems improbable that it should actually work – the bag seems so DIY – but I eat a jacket potato and feel the thing murmur into action.

There’s so much paraphernalia to get my head around: bags, seals, sprays, powders. It’s like I’ve taken up a hobby with a dizzying amount of kit, like vaping or golf. “Some people give their stoma a name,” says the nurse, “to help them accept it.” No chance, I think . It’s not a Tamagotchi, it’s my intestine for god’s sake.

I imagine stepping back into my old life now. Teaching, writing, pubs, gigs, sex, holidays. How could I forget for long enough to enjoy anything? It hits me that no one I know would want to have this body – a very particular kind of loneliness.

The doctors love a metaphor. They refer to my plumbing. Pipework. Shuddering, loveless imagery that recalls our fixer-upper, with its wretched old drains. But their favourite metaphor is “disconnected” . I see it in a letter to my GP: “The patient was disconnected on 18 August.” It’s a good metaphor, maybe too good. It’s not only my bowel that has been disconnected, but me too. From everyone I love. From my old innocence, whoever I used to be.

After Will calls to say he is on his way to visit, I try to rejig my bedsheets. A healthcare assistant called Hassan comes by and I’m suddenly in tears. I don’t want Will to be scared by the drains ferrying awful liquids from my body, I explain. Hassan leaves and returns with a pot of raspberry jelly. “You are feeling shame for what happened to you,” he says gently. “But it’s not your fault.”

No doctor has been able to tell me why having a baby made my body burst into flames. I am all arson with no perpetrator. In the absence of a culprit, I have cast myself. What if I had known more about inflammatory bowel disease? What if I had eaten differently, given birth differently, got myself to hospital quicker? Could things have fallen out some other way?

Hassan’s words reach out to me in the dark. I do some more crying, eat the jelly he has brought me.

It is late summer by the time they discharge me. It feels like a jailbreak. Will and I roll down the car windows, sing along to Rusted Root’s Send Me on My Way. My parents are waiting on the doorstep with the baby – eight weeks old now, plump as a peach. I’ve been away half his lifetime.

The doctors warned my mood would crash when the drugs wore off. I wait for the black puddle to turn tidal. Instead, I find illness has shifted the world by a few centimetres. Jokes are funnier, conversations more sincere. Everyday things feel like unbelievable acts of magic. Cooking dinner with my mum. Making up a song for the baby. Life hums with a kind of Technicolor, like falling in love. My opioid high has mellowed into something as warm and steady as the September sunshine. The surgeon was right: I am just so happy to be alive.

I had planned to tell only those closest to me about my stoma. But at some point I realise that discretion’s closest relative is shame and cannot stop talking. I pick up a sandwich from the Jewish deli and am there half an hour, telling the bewildered owner about my exploding colon. I develop a pathological intolerance for pleasantries. Will starts calling me the Truthbomber on account of my tendency to blow up pointless small talk. Friends visit and I gibber away, pulling stories from my ragbag of hospital traumas, prone on the sofa like Elizabeth Barrett Browning on speed. I write long emails about what happened to family, friends, colleagues, finding release in the way I can control its contours now, find something meaningful in the darkness.

In the quiet of the bathroom, I shower and dodge the mirror’s gaze. The baby trills happily in his bouncer, unaware I bring him along for moral support every morning as I tend to my stoma, change the bag. He’ll never know me any other way than this. I need to face my new punctured body, still stained with orange surgical dye. Unwire all of my shame, old and new. I want to learn to look at myself the way the baby does – with uncomplicated, uncritical love.

I try to think of my body as a collection of stories. The freckles inherited from my mum. The scar from a pair of GHD straighteners on my neck, ultimate badge of early noughties girlhood. The queen of hearts tattoo on my wrist my best mate and I got two summers ago. The curve of a belly that kept the baby safe, the five-inch cut where he was prised from me. The laparoscopic holes, incredible portals through which surgeons cut five feet of disease. I think of my body as an old friend I have lived in for 35 years. And though I no longer trust it, I cannot hate it.

When winter comes, we move into our house and throw a party. We lug beer back from the Wembley Tesco Extra, pick up a firepit in B&Q. At some point, I realise I want to make a speech about Will. About the way he’s held me fast, his love unflinching. “We’ve been together six years,” I tell everyone. “But you know how the old adage goes. You never really know a man till your colon explodes.” Our friend Adam gamely conducts a shamanic ritual over the firepit in the garden, wearing a pagan hood off Amazon. We huddle in the cold, pass round Biros, scribble down the worst things that have happened to us, cast them into the flames. A friend brings a piñata emblazoned with “Fuck 2023” which I take great pleasure in thwumping. Surrounded by everyone I love, I feel the threads between my old and new selves begin to reconnect.

The first year of a baby’s life is peppered with milestone moments, not all of them showstoppers. Many happen without ceremony, as you stoop to unload the dishwasher, fish a stone from your shoe. Sometimes there is no “first” time at all, just a seamless switch from nothing to something. The baby’s first smile comes a few days after I get out of hospital. Just the corners of his mouth, then an unmistakable full beam. I had been so convinced I’d miss it. “He saved it till you got home,” says my nan.

I’ve become aware of all my firsts too, since illness split me into a before and after. First time in a swimming pool. First Christmas. It’s been a long time since I got to do things for the first time. I watch the baby’s face flood with shock and delight as he collides with the world. First ride on a double decker. First taste of pineapple. One day, I’ll tell him how he saved me. How, in the moments that I replay the darkness, his little face pulls me back to the present. I’ll tell him how much he taught me in our first year together. Eyes wide open, looking at the big bright world, both of us brand new.

• The Observer
• Health & wellbeing
• Parents and parenting

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