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During pregnancy, much has changed in the woman’s body. The birth has also cost it a great deal of effort once again. At the end of the postpartum period, the gynecologist checks in a final examination whether the female body has recovered healthily and whether the woman could become pregnant again.
Only a few days – then mother and child are usually allowed to go home. On the day of discharge from the maternity clinic, the doctor once again makes sure that the new mother is in good health: In the brief, final pregnancy examination, he palpates the breast and abdomen and checks whether the uterus has begun to regress and the birth injury is healing well. A vaginal examination is only done in exceptional cases at this early stage in order to spare the woman.
The physician enters the most important medical data on page 15 of the maternity record. The baby’s first health data (APGAR test), which the pediatrician determined during the vitality check in the delivery room, are also written there.
Time Of Regression
For eight weeks, you and your baby are allowed to get used to each other in peace. In addition, your body should be able to recover from the exertions of pregnancy and birth during the postpartum period. This is what the German maternity protection guidelines say. The law stipulates that as a new mother, you will also receive a daily visit from a midwife until ten days after the birth. Even after that, she remains your contact person in matters of regression until the end of the breastfeeding period.
If you experience severe discomfort, fever, conspicuous postpartum flow, unclear lower abdominal pain, or bleeding, you should see your gynecologist. However, if everything goes without complications, your next appointment with the gynecologist will not be until six to eight weeks later: for the “second examination after delivery” – as it says in the maternity passport (pages 16 – 17).
The Final Gynecological Examination
In a detailed consultation, your gynecologist will find out whether you had any minor or major problems during the postpartum period. If the changes and the stress of having a baby are causing you any problems, you can talk about them. Sometimes it already helps to hear from your doctor that these feelings are completely normal.
Breastfeeding and possible breastfeeding problems are also big topics for gynecologist appointments. Since many new mothers can become pregnant again at this point, your gynecologist will also talk to you about an appropriate birth control method and may fit you with an IUD or a new diaphragm. If you decide to use an IUD, you should not make the final appointment until ten to 12 weeks after the birth.
Diagnosis: Everything Ok!?
In the examination part of the appointment, the doctor will first check your weight and blood pressure (RR). By means of a blood test, he checks your hemoglobin level (Hb level). It indicates whether you (still) have an iron deficiency: Due to the increased need during pregnancy, women often have a low value – especially since they often still lost blood during childbirth. In the weeks after delivery, the blood values must first level off again. If the hemoglobin concentration is too low, the doctor prescribes an iron supplement. Now he can also catch up on a due rubella vaccination, which had to wait because of the pregnancy. A urine check for sugar and protein is also part of the final examination. If the values are positive, the doctor must follow up with further tests.
During the vaginal exam, your gynecologist will palpate your vagina and uterus and look at your perineal area to make sure the scars are well blended. Sometimes it is necessary for you to promote healing with an ointment.
Many doctors also recommend additional exercises to strengthen the vaginal walls and pelvic floor, which you can use to help with involution. Your gynecologist will also swab your cervix during your exam for one of the regular cancer screening tests. They have also now had to wait nine months.
If the cervix, size of the uterus, and ovaries are unremarkable and have formed back well, the doctor will note this as a “gynecological finding” next to the other entries in the maternity record (page 16 / 17). If the uterus has regressed badly or if he discovers adhesions, your doctor can usually correct this directly. The entries in the maternity log are completed with the final gynecological examination. The booklet will not be important again until the next pregnancy.
Anti-D prophylaxis is a precautionary injection of anti-D immunoglobulin to a rhesus-negative pregnant woman with a rhesus-positive baby. It is given immediately after birth to prevent rhesus incompatibility in a subsequent pregnancy.