When to go to the gynecologist after childbirth? Women's consultation at. Local gynecologist

Women in labor often have a question about when to go to the gynecologist after childbirth. Sexual health for a girl is one of the most important points in self-care. A woman's reproductive system is especially susceptible to infections, because it is not possible to thoroughly wash all the microbes from the mucous membrane, as in men.

The reproductive system also depends on care - after all, if the uterine body is infected, complications can arise that lead to the removal of the organ.

Regularly visiting a doctor is extremely important for every sane girl, regardless of whether she is sexually active or not. This article is about why to visit a doctor, when to go to a specialist and what to expect on your first visit.

When to go to the gynecologist after childbirth?

6 weeks after giving birth, the young mother is recommended to undergo an examination by a gynecologist. It is recommended to refrain from intimacy for approximately the same period. Violation of deadlines in both cases can cause negative consequences for a woman’s health. Therefore, do not delay your visit to the doctor and find an opportunity to see a specialist. A child needs a healthy mother, then she can give the baby an ocean of love and care. If a woman feels fine after a natural birth, she should go for examination when the postpartum discharge stops, which can last up to 40 days. At first they resemble heavy periods, around the 7-10th day they become brownish and gradually disappear completely. But you can bring the extract from the maternity hospital to the antenatal clinic earlier, so that the gynecologist records the data on the permission of childbirth in the card. After a caesarean section, you need to see a gynecologist a few days after discharge from the hospital.

Who needs special attention

Particular attention is paid to mothers who experienced complications while carrying a baby. They are at risk for postpartum complications and may require additional treatment after delivery. Complications include, but are not limited to, thyroid dysfunction, prevention of thromboembolic complications in women with genetic thrombophilia, and postpartum depression. Such patients require additional monitoring of clinical indicators, prescription of medications, and consultation with specialized specialists, for example, an endocrinologist or psychotherapist.

What does the doctor look for after a natural birth?

After a natural birth, examination in a chair will not be a very pleasant procedure. But these uncomfortable sensations must be endured to eliminate the risk of endometritis.

On the chair, the doctor will look at how the sutures are healing (if any), and assess the height of the uterine fundus (whether it has completely contracted or not). If the cervix does not regain its shape, repeated suturing may be required. This is a painful but necessary procedure. If this is not done, chronic inflammation of the cervix may develop. The doctor will ask you about the nature of the discharge and your well-being after childbirth. In addition, he will definitely take a smear from the cervix. The analysis will show whether there is an inflammatory process.

Features of the first visit

When a specialist examines you for the first time after childbirth, he visually assesses the condition of the genital organs, as well as palpates and takes tests. Here's what they usually do:

They look at the vagina - its shape, the presence of plaque, redness or other signs of infection.
Examine using a speculum and palpate the cervix. The doctor cares about its shape, size and color.
They take a smear - the laboratory will be able to determine what bacteria are present, whether the acid balance is correct, whether candidiasis is developing and whether any additional ointments and creams are needed for recovery.
If stitches were placed, the sutured wound must be assessed and a scraping taken for the presence of pus.

If there are any suspicions or doubts, the woman is sent for tests and examination in other departments. For example, women are often given a referral to a mammologist in order to eliminate the risk of developing breast cancer. If all is well, a date is set for the next examination by a specialist (usually a break of six months).

If you are in the gynecologist's office after giving birth unnaturally (caesarean section), then the examination is a little different.

After the operation, you need to come to the clinic to have the stitches removed, then you will be consulted about how well the incision is healing. In this case, you will be prescribed ointments that will help tighten the scars so that they are not noticeable in the future and will tell you how to disinfect the wound. You can go the second time in 35-40 days, when a standard examination with palpation and a mirror will be appropriate.

Read also: How long before you can plan a pregnancy again after giving birth?

If there is a suspicion that a large number of blood clots and remains of the baby’s place remain in the body of the uterus, an ultrasound is prescribed. An ultrasound may also be indicated if the doctor is not sure whether the uterus has restored its previous size or whether additional measures are needed in the form of oxytocin injections.

After cesarean to the doctor

Mothers of caesarean babies should see a female doctor soon after being discharged from the hospital. Due to the incision and stitches, their uterus contracts more slowly. Therefore, women still have an ultrasound scan in the maternity hospital. There they evaluate the height of the uterine fundus and make sure that blood clots do not linger in it. Close monitoring of the mother's condition should continue for some time, since according to statistics, the risk of endometritis after a cesarean section is much higher than after a natural birth. At the first appointment after childbirth at the antenatal clinic, the doctor will look at how the uterus continues to contract and whether clots are accumulating in it. He will also assess the condition of the postoperative scar. In any case, a visit to a gynecologist for women after a cesarean section will not differ from a regular visit to a doctor.

List of questions for the gynecologist

We have compiled a list of the most popular and important questions to ask a gynecologist for the first appointment after childbirth. It’s better to write them down in your notebook so you don’t forget to ask at the doctor’s office.

When can you start having sex?
When can you start playing sports?
Is it possible to get pregnant during breastfeeding?
When will the menstrual cycle resume?
How to treat hemorrhoids?
Which method of protection should I choose?
How to care for stitches after an episiotomy?
Should I take multivitamins?
How to deal with constipation?
How long before you can plan your next pregnancy?
How to establish breastfeeding?

Whether or not to go for a gynecological examination after childbirth – this question should not arise at all. Of course, a woman can learn a lot from online resources about childbirth and the postpartum period. But during a personal conversation, the doctor will answer questions specifically about your condition. And then, convinced that everything is in order with her health, a woman with a calm soul can return to caring for the baby.

When you need to urgently go to the gynecologist

There are some symptoms for which a woman should immediately go to the antenatal clinic. You need to rush to the doctor if you have:

pain in the lower abdomen
increased body temperature,
first symptoms of lactostasis
vaginal discharge with an unpleasant odor
bleeding
suppuration of the postoperative suture.

All of these symptoms may indicate the development of inflammation or infection. This needs to be treated immediately.

Third and fourth scheduled examinations with a gynecologist-obstetrician

After 6-8 months, mother and child undergo a third scheduled examination. Even if the patient feels well and the child develops normally after childbirth, you should visit a doctor to assess the condition of the cervix (whether treatment of the cervix is required after childbirth, to discuss the restoration of the menstrual cycle, issues of contraception and planning a subsequent pregnancy.

The fourth scheduled visit is scheduled for 12 months after the baby is born. In addition to consultation with an obstetrician-gynecologist, you need an ultrasound of the mammary glands and pelvic organs. Based on the test results, you can judge how much the body has returned to normal.

Don't forget to ask about important

During their first visit to the doctor, young mothers are often lost and forget to ask important questions. For example, you should definitely check with your doctor about the methods of contraception (after all, standard medications are not suitable for nursing mothers) and ask about the time frame for resuming intimate life.

We have prepared a list of the most common questions to ask your doctor at your first postpartum appointment.

What should you do with seams at home?
How to overcome postpartum hemorrhoids?
Do I need to use protection during breastfeeding and how?
How long will it take for menstruation to return?
If a couple is planning a wedding, when is the best time to start?
What is the best time between pregnancies?
Why do unpleasant relationships appear during intimacy? Perhaps too little time has passed since birth?
When can you play sports and go to the pool again?

All these topics are covered in detail in online articles and books about motherhood. But it’s better if you hear an answer from a specialist who has observed you and knows the characteristics of your body.

After giving birth, it would also be good to see a therapist, dentist, or phlebologist, especially if the pregnancy had complications. But the gynecologist is the very first on this list of mandatory doctors, because he is the main doctor in the life of every woman.

How and why medical support for mothers has changed

The World Health Organization and the American College of Obstetricians and Gynecologists are increasingly raising the issue of the importance of competent medical monitoring of women in the postpartum period. Experts insist on reviewing medical support for mothers: it should be a process, not an event. Therefore, modern medical care is significantly different from what our mothers and grandmothers received.

For a long time, it was believed that visiting an obstetrician-gynecologist once every 6 weeks was sufficient. For emergency situations, telephone communication with the attending physician was provided. Situations that threatened the life of the mother were recognized as emergencies: bleeding that could not be stopped, severe abdominal pain, etc. If a woman encountered such a situation, she was asked to call a doctor and coordinate further actions with him: perhaps the specialist would recommend hospitalization.

Now experts insist that issues of postpartum monitoring need to be discussed before birth. The mother’s lifestyle and schedule will change greatly after the baby is born, she must be prepared for this. Many problems can be avoided if you warn about them in advance or at least stipulate the likelihood of their occurrence: young mothers often hush up the alarming symptoms that they experience because they do not consider them significant or think that it is not worth complaining again.

An obstetrician-gynecologist must prepare a woman in labor for parenthood and explain the basics of caring for her own health and the health of the baby. The patient must understand in advance which doctor to contact after childbirth and in what situations this is necessary.

How will the inspection take place?

At your first visit to the gynecologist after discharge from the maternity hospital, the doctor will ask in detail about how the birth proceeded and how it ended, how the postpartum period proceeded or is proceeding, fill out a medical record, paste into it the documents you submitted from the maternity hospital, and be sure to conduct an examination on the chair.

During natural childbirth, ruptures of soft tissues, cervix, and perineum are possible. Immediately after childbirth, an obstetrician-gynecologist examines the woman’s birth canal and applies sutures. While the woman is in the maternity hospital, the sutures are processed, and before discharge (approximately on the fourth or fifth day), the external sutures are removed. At the same time, the obstetrician-gynecologist recommends not sitting down, not lifting heavy objects, and strictly observing personal hygiene for 6-8 weeks. If these recommendations are not followed, there may be complications: suture dehiscence, suppuration.

During the examination, it is important for the doctor to assess the condition of the external genitalia: whether there are stitches on the perineum, labia and in what condition they are. It is also necessary to examine the walls of the vagina and cervix. Failure of sutures on the walls of the vagina can lead to the formation of fistulas (through holes - for example, between the rectum and vagina).

If the cervix is not sufficiently formed (has an irregular shape), then this is most often due to undetected tears or broken sutures on the cervix. In this case, it is necessary to apply secondary sutures, otherwise it can lead to chronic inflammation of the cervix (cervicitis) and infertility. The gynecologist will take smears from the cervix and vagina for analysis. This analysis will allow you to determine the onset of inflammation in the vagina or cervical canal and prescribe treatment in a timely manner, preventing the spread of infection.

By feeling the body of the uterus and ovaries, the doctor assesses their size and consistency. A flabby, painful, enlarged uterus indicates the onset of endometritis (inflammation of the mucous layer of the uterus).

If the birth ended with a cesarean section, then you should consult a doctor a few days after discharge from the maternity hospital. After a caesarean section, the contraction of the uterus is somewhat slower due to the incision and suture, which disrupt the structure of the muscle fibers.

Both the doctor and the young mother must be sure that the postoperative suture is healing well and will not cause any trouble in the future. Proper care of the postoperative suture at home is very important. After a hygienic shower, the seam must be lubricated with brilliant green (a solution of brilliant green); The underwear that comes into contact with it should be cotton and loose, not constricting. Treatment of the seam with medications should be carried out until crusts form on it.

If there were complications during childbirth

Everything would be fine if most of the births were not difficult. Complications can be very different: from weak labor and poor dilatation of the cervix to surgical intervention and death of the child. If during childbirth there was at least something unnatural and abnormal, then you need to contact a gynecologist within a week after discharge.

This early consultation is necessary to assess your condition. The doctor palpates the uterus, excluding stagnation of blood in it and the formation of clots. Fabrics with sutures (if any) must be inspected. In some women in labor who do not listen to doctors' advice, the thread stitches may come apart.

It's not too late to fix all this. If the cervix is incompetent (often occurs after injury), an inflammatory process or improper fusion of the mucous membrane may occur. All these pathologies can be fraught with serious problems in the future, including infertility. This is why you should play it safe. A gynecologist should examine a woman after a difficult birth in the first 7-10 days after discharge.

How is the first examination after childbirth?

You already know when to go to the gynecologist after childbirth. Many young mothers are afraid of this visit; they are afraid of pain due to recent emotional experiences. You should not intimidate yourself by delaying the moment of consultation. It is better to know what exactly awaits you at the reception.

Anamnesis collection and interview. The gynecologist will definitely find out what exactly is bothering you, how the birth went, how long the process lasted and with what parameters the baby appeared.
If there are no complaints, then the examination will begin on the gynecological chair. There will be nothing new for you here. The doctor will palpate the uterus and appendages, and examine the cervix using mirrors.
Taking smears is a mandatory procedure. Often after childbirth, women experience a hidden inflammatory process. It is very easy to establish it using laboratory tests.
If you have stitches (on the stomach from a cesarean section or in the perineum), then they must be viewed and palpated. This procedure may cause you minor discomfort.

Repeated pregnancy

Repeated pregnancy sometimes forces women to make their first visit to the gynecologist after giving birth. Doctors should explain this danger to every new mother in the maternity hospital. You can get pregnant again in 1-2 months, without waiting for your first menstruation. It is imperative to use contraception, and begin sexual activity only after visiting a gynecologist.

Even if you are planning children with a small age difference, repeat pregnancy is recommended no earlier than a year later. Your body needs time to recover. Otherwise, pregnancy may be difficult.

Ultrasonography

If your lower abdomen hurts after childbirth, you will be immediately scheduled for an ultrasound. Diagnostics will show the size of the uterus and the efficiency of its contraction, and will also determine the condition of the internal surface. Often pain in the lower abdomen indicates clots. In this case, postpartum discharge ends unnaturally quickly. The reason for this is blockage of the cervical canal. If you do not receive medical help in time, sepsis may develop.

Ultrasound after childbirth should be performed on all women. This is a very informative method that allows you to determine the patient’s condition. In most cases, it is carried out before discharge from the maternity hospital. If this has not been done, then this issue should be resolved in the first days after returning home.