Postnatal care
The weeks after birth are a time of big change, for you and your baby. Dr Anu Mahadik supports you through your recovery and your postnatal check at Westmead and Kogarah. This page explains what to expect and when to ask for help.
The fourth trimester
Recovering after birth
The weeks after your baby is born are sometimes called the fourth trimester. Your body is recovering from pregnancy and birth. You are learning new routines, and your baby is changing and growing every day. It is a lot to take in, and it is normal to have questions.
If you had a caesarean or an assisted birth, your recovery may take a little longer, and that is expected.
Your postnatal check
Your postnatal consultation
A postnatal check is a review of your health, usually around 6 to 8 weeks after the birth. In Australia this check is often done by your GP. If a private obstetrician looked after you during your pregnancy, they will usually do your postnatal check. So this is a chance to see Dr Mahadik again after the birth.
What happens at your postnatal check?
Your check may include:
- Asking how you are feeling, physically and emotionally
- Feeling your tummy to check your uterus has returned to its normal position
- Checking your blood pressure
- Checking any caesarean wound, stitches or tears are healing
- Talking about feeding, and checking your breasts and nipples if you are breastfeeding
- Any immunisations you are still due
- A cervical screening test, if you are due for one (see below)
- Talking about contraception and returning to sex when you are ready
You may be sent for a blood test to check your iron levels if you were anaemic or lost blood during the birth.
Do I need a cervical screening test?
Only if you are due for one. A cervical screening test is not part of every postnatal check. If you choose to have it after the birth, it is best to wait at least 6 weeks, and ideally around 3 months. A test done too soon can be harder to read. Dr Mahadik or your GP will let you know if you are due.
Your recovery
Looking after your body
Your body goes through many changes as it recovers. Some are expected and settle with time; others are worth mentioning at your check.
Bleeding and afterpains
It is normal to have vaginal bleeding for a few weeks after the birth, called lochia. It usually starts like a heavy period and gradually becomes lighter, changing from red to brown and then to a pale colour. You may also feel cramping, called afterpains, especially while breastfeeding, as your uterus contracts back to its usual size. Use pads rather than tampons while you are bleeding.
Your bladder and bowel
After birth you may leak a little urine when you cough, laugh or exercise. This is often temporary. Constipation and wind are also common in the early weeks. Pelvic floor exercises help your recovery, and Dr Mahadik may suggest them. If you are still having trouble controlling your bladder or bowel after 6 weeks, mention it. Help is available, and it is a common thing to raise. You can read more about urinary incontinence if this continues.
Healthy recovery
It is normal for your weight and shape to change gradually after birth. There is no rush. Gentle activity, good food and rest all support your recovery, and your check is a good time to talk through what suits you.
Baby’s check
Your baby’s checks
Your baby also has regular health checks in their first months, at birth, in the first few weeks, at around 6 to 8 weeks, and at 6 months. These checks are done by your GP, paediatrician or child health nurse, not at your postnatal appointment with Dr Mahadik.
Bring your baby's Personal Health Record (the "Blue Book" in NSW) to these visits so the details can be added. They are also a chance to talk about feeding, sleeping and any concerns you have. Your baby's first scheduled vaccinations are usually given from 6 weeks of age.
Your emotional wellbeing
How you are feeling
Becoming a parent is a big adjustment, and your emotional health matters just as much as your physical recovery. Many parents feel tearful or overwhelmed in the first days after birth. This is often called the "baby blues", and it usually settles within a couple of weeks.
Sometimes these feelings last longer or feel heavier. Up to 1 in 5 new mothers, and up to 1 in 10 new fathers, experience postnatal depression or anxiety. This is common, it is not your fault, and it responds well to support. At your postnatal check you may be asked some questions about your mood, sometimes using a short questionnaire, so any difficulties can be picked up early.
If you are struggling at any point, you do not have to wait for your check. You can speak to Dr Mahadik or your GP, or contact:
- PANDA (Perinatal Anxiety & Depression Australia) — 1300 726 306
- Pregnancy, Birth and Baby — 1800 882 436, to speak with a maternal child health nurse
The support you received during your pregnancy continues after the birth.
Breastfeeding & feeding
Feeding your baby
However you feed your baby, support is available. Breastfeeding has health benefits for you and your baby, and it is also common to need help getting started. Sore or cracked nipples are often a sign that your baby needs help to latch, rather than something you have to put up with.
At your postnatal check you can talk about how feeding is going. If you need more help, a lactation consultant or the Australian Breastfeeding Association (1800 686 268) can support you. If breastfeeding is not right for you, your care team can help you feed your baby safely another way.
Contraception
Contraception and sex after birth
It is common to wonder when things return to normal after the birth. There is no fixed timeline. You can start having sex again when your body has healed and you feel ready.
It is worth knowing that you can become pregnant again before your periods return, including while you are breastfeeding. So if you would prefer to wait before another pregnancy, it is a good idea to think about contraception. Your postnatal check is a natural time to talk this through, and some options are suitable while breastfeeding. Dr Mahadik can talk you through your contraceptive options.
When to seek help
When to get help sooner
Most recovery is straightforward, but some symptoms need to be checked before your 6-week appointment. Contact your doctor, midwife or the hospital, or seek urgent care, if you have:
- Heavy or increasing vaginal bleeding, or large clots
- Vaginal discharge that smells unusual
- A fever, particularly a temperature over 38°C
- A wound or stitches that become red, painful, or open, or leak fluid
- A severe headache, changes to your vision, or vomiting
- Pain, redness or swelling in your calf
- Chest pain or trouble breathing
- Feelings of being unable to cope, or thoughts of harming yourself or your baby
Trust your instincts. If something does not feel right, it is always okay to ask. If you or someone you know needs support, Lifeline (13 11 14) is available at any time. In an emergency, call 000.
Common questions
Postnatal care — common questions
Your postnatal check is usually around 6 to 8 weeks after the birth. If a private obstetrician cared for you during pregnancy, they will usually do this check, so it is a chance to see Dr Mahadik again after your baby arrives.
Your health and recovery are reviewed — your blood pressure, your tummy, any wound or stitches, and how you are feeling. You can talk about feeding, contraception and returning to sex, and have a cervical screening test if you are due. Your baby may be checked at the same time.
Only if you are due for one — it is not part of every check. If it became due during your pregnancy, it may already have been done safely while you were pregnant. If you have it after the birth, waiting at least 6 weeks (ideally around 3 months) gives a clearer result.
Bleeding (lochia) usually lasts a few weeks and gradually becomes lighter, changing from red to brown to a pale colour. Contact your doctor or the hospital if bleeding becomes heavy again, you pass large clots, or the discharge smells unusual.
It is common to leak a little urine when you cough, laugh or exercise in the early weeks, and it often improves. Pelvic floor exercises help. If it continues beyond about 6 weeks, mention it at your check — it is common to raise, and help is available.
Gentle activity such as walking can usually start early, but it is best to build up gradually and to check with your doctor first, particularly after a caesarean. Your postnatal check is a good time to talk about returning to exercise.
Sore nipples are often a sign your baby needs help to latch, rather than something to put up with. You can talk it through at your check, or contact a lactation consultant or the Australian Breastfeeding Association (1800 686 268) for support.
The baby blues usually settle within a couple of weeks. If low or anxious feelings last longer or feel heavier, that can be postnatal depression or anxiety, which affects up to 1 in 5 new mothers and responds well to support. You can speak to Dr Mahadik or your GP, or contact PANDA on 1300 726 306. You do not have to wait for your 6-week check.
Yes. It is possible to become pregnant before your first period after birth, including while breastfeeding. If you would prefer to wait, it is worth talking about contraception at your postnatal check.
There is no fixed time — you can start again when you have healed and feel ready. Everyone is different, and it is fine to raise any concerns at your check.
Yes. A referral from your GP allows you to claim a Medicare rebate for your specialist appointments. Your GP can refer you to Dr Mahadik.
Fees depend on the type of appointment and your circumstances. Please contact the rooms for current fees, including any out-of-pocket costs and what Medicare and your health fund may cover.
Support after your baby arrives
The weeks after birth bring plenty of questions. Whether you want to plan your postnatal check or you are unsure whether something is normal, Dr Mahadik is here to help.
