What the six-week check is for

It is a proper appointment about you, and it is separate from your baby's check even if the two happen back to back.

The NHS: "You should have your postnatal check 6 to 8 weeks after your baby's birth to make sure you feel well and are recovering properly. Your GP surgery should offer and provide you with a postnatal check." It adds that you can request the appointment yourself, "especially if you have any concerns", and suggests taking a list of questions.

NICE's postnatal care guideline (NG194) states what the GP should actually do at 6 to 8 weeks: carry out an assessment covering general health and wellbeing, physical health, mental health and birth experience, "taking into account the time since the birth", and "respond to any concerns, which may include referral to specialist services in either secondary care or other healthcare services such as physiotherapy."

In Ireland, the HSE describes the same appointment with your GP or obstetrician at six weeks, with the aim of making sure "you are recovering from giving birth" and "feeling well."

What usually happens

The NHS lists what is normally offered, while noting that "this may vary according to where you live":

A general discussion about your mental health and wellbeing, starting with how you are feeling.
Questions about whether you still have vaginal discharge and whether you have had a period.
A blood pressure check "if you had problems during pregnancy or immediately after the birth."
An examination to see whether your stitches have healed, if you had an episiotomy or a caesarean.
Rescheduling of cervical screening for 12 weeks after the birth, if you were due for it while pregnant.
A conversation about contraception.
Advice on vitamin D supplements if you are breastfeeding.
Weight, plus weight and activity advice, if your BMI is 30 or more.

Notice what is not automatically on that list: a pelvic examination, a check of your abdominal muscle separation, or a blood test. If you want any of those discussed, you will usually need to raise them.

What to raise, even if you are not asked

The NHS has a "tell your doctor if..." section, and it reads like a list of the things people go home without mentioning:

"You're feeling sad or anxious — looking after a baby can sometimes feel overwhelming. Do not feel you have to struggle alone or put on a brave face. It's not a sign that you're a bad mother."
"You're having trouble with farting or holding in your pee, or you're soiling yourself with poo."
"Having sex is painful."
Whether you are up to date with adult vaccines such as MMR and COVID-19.

To that list, add anything from the topics below, because each has its own guidance attached and each is easy to lose in a ten-minute appointment.

Bleeding and periods

Whether lochia has stopped, whether it ever got heavier again, and when you can expect a period. The NHS notes that if you bottle feed or mix feed "your first period could start as soon as 5 to 6 weeks after you give birth."

Contraception

The timing surprises people. The NHS: "You can get pregnant again just 3 weeks after the birth of your baby, even if you're breastfeeding and your periods have not started again yet. It's important to start using contraception within 21 days of giving birth."

Your pelvic floor

NICE's postnatal guideline lists "the importance of pelvic floor exercises, how to do them and when to seek help" among the topics to be discussed at postnatal contacts. If leaking has not resolved, this is the appointment where a physiotherapy referral starts.

Your tummy muscles

The NHS advises contacting the GP if the gap between your stomach muscles "is still obvious 8 weeks after the birth", because of the risk of back problems. Six to eight weeks is exactly when to ask.

Your scar or stitches

The RCOG says that after a perineal tear you will usually be offered an appointment around six weeks "to make sure that you are recovering well", and that this is the point to discuss any ongoing symptoms and any concerns about future pregnancies.

If you had pre-eclampsia or high blood pressure

This appointment carries specific tasks. NICE's hypertension in pregnancy guideline (NG133) says to "offer all women who have had pre-eclampsia a medical review with their GP or specialist 6 to 8 weeks after the birth", and to carry out a urine dipstick test at that review. If protein is still present at 1+ or more, you should be offered a further review at three months to assess kidney function.

NICE also recommends that women who have had a hypertensive disorder of pregnancy be told this is "associated with an increased risk of hypertension and cardiovascular disease in later life", and be advised to discuss reducing that risk. If that conversation does not happen, ask for it.

When not to wait for it

The six-week check is not a gate. The NHS says you can ask a GP or health visitor for help "at any time" if a physical problem is bothering you, and the HSE asks you to contact a GP, midwife or public health nurse immediately for heavy bleeding, foul-smelling discharge, severe tummy pain, a fever over 38°C, wound problems, headache with blurred vision or vomiting, or any symptoms of postnatal depression — and immediately for any thoughts of harming yourself or your baby.

Equally, if you are six weeks out and nobody has offered you an appointment, book one. The NHS is clear that you can request it yourself.

How to get more out of ten minutes

Write your list before you go and lead with the thing you least want to say, because that is usually the thing that matters most. Take someone with you if you can, so you are not managing a newborn and a difficult conversation at once. And if you leave with something unresolved, ask directly what the next step is and who is responsible for it — NICE expects referral onward, not reassurance, when a problem is identified.

The Six-Week Postnatal Check