The Six-Week Postnatal Check
What your O&G or GP actually does at this appointment, how to prepare, what to say if you are struggling, and what is different after a C-section.
What the Six-Week Check Is
The six-week postnatal check (also called the postnatal review or 6-week check) is a structured medical appointment that happens approximately 6 weeks after birth. In Singapore it is typically conducted by your O&G (obstetrician and gynaecologist) if you delivered at a private or restructured hospital, or at your polyclinic by a GP if you prefer a subsidised option.
This appointment is often rushed because mothers arrive exhausted with a six-week-old baby and feel like everything is "fine enough." In reality it is one of the most valuable medical touchpoints you will have in the postpartum period - for both your physical recovery and your mental health.
When to book
Book at 5-6 weeks postpartum. Most private O&Gs in Singapore schedule this automatically before you are discharged from hospital. If yours did not, call the clinic to book. At a polyclinic, book online via HealthHub or call your nearest clinic directly. Aim for the appointment between day 38 and day 45 after birth - not significantly earlier (recovery not complete) or much later (you miss the depression screening window).
What Your Doctor Checks
| What Is Checked | How | What They Are Looking For |
|---|---|---|
| Blood pressure | BP cuff | Postpartum hypertension, pre-eclampsia resolution |
| Weight and BMI | Scale | Baseline for postpartum weight trajectory; context for exercise discussion |
| Urine test | Dipstick or lab test | Protein (pre-eclampsia), glucose (gestational diabetes follow-up), infection |
| Abdominal exam | Palpation | Uterine involution, C-section wound healing, tenderness |
| Perineal exam (vaginal birth) | Visual inspection; internal exam if needed | Episiotomy or tear healing, granulation tissue, prolapse symptoms |
| C-section wound check | Visual inspection of scar | Full closure, signs of infection, keloid formation, skin adherence |
| EPDS (Edinburgh Postnatal Depression Scale) | 10-question self-report form | Postnatal depression and anxiety screening; scored 0-30, cutoff at 10-13 |
| Breastfeeding review | Discussion | Current status, issues, referral to lactation consultant if needed |
| Contraception discussion | Discussion | Preferred method; options safe for breastfeeding mothers |
A Pap smear is not routine at the six-week check unless it is due as part of your regular cervical screening schedule.
The EPDS: Depression Screening at Six Weeks
The Edinburgh Postnatal Depression Scale (EPDS) is a validated 10-question questionnaire that asks how you have been feeling over the past seven days. It takes about three minutes to complete. Questions cover mood, anxiety, ability to cope, sleep beyond baby-related waking, and thoughts of self-harm.
How it is scored
Each question is scored 0-3. Total score ranges from 0-30. A score of 10 or above suggests possible depression requiring follow-up. A score of 13 or above suggests probable depression. Any score above zero on question 10 (about thoughts of self-harm) is treated seriously regardless of total score. Your O&G or GP will review your score and discuss it with you directly.
Many mothers underreport on the EPDS because they fear being judged or having their baby taken away. Neither of these things happens. A high score leads to a conversation about support options - counselling referral, medication discussion, or more frequent follow-up. Honest answers help you get appropriate help. The EPDS is a clinical support tool, not a surveillance exercise.
If you are not offered the EPDS at your six-week check, you can ask for it directly - or complete one yourself online and bring your score to the appointment.
Questions to Prepare Before Your Appointment
The six-week check is often 15-20 minutes. Come prepared so you do not leave with unanswered questions.
Physical recovery
- - When can I start running / gym / swimming?
- - Is my wound / scar healing normally?
- - Is it normal that I still feel pain / numbness / discomfort here?
- - Can I get a physio referral for pelvic floor or diastasis?
- - My lochia stopped - is that normal?
- - I still have bladder leakage / urgency - what should I do?
Mental health and mood
- - I have been crying a lot / feeling anxious / not feeling like myself
- - I am not bonding with my baby the way I expected
- - I am having intrusive thoughts I am ashamed of
- - My partner / family says I seem different - who should I talk to?
- - Can I take antidepressants while breastfeeding?
Contraception and sex
- - When is it safe to have sex again?
- - What contraception options are safe if I am breastfeeding?
- - Can I get pregnant while breastfeeding?
- - Sex is painful - is that normal and will it resolve?
Next pregnancy
- - How long should I wait before trying again?
- - Is VBAC possible after my C-section?
- - Will I need the same amount of support next time?
- - When should I come off contraception if I want to try within a year?
What Is Different After a C-Section
C-section mothers have additional topics to cover at the six-week check because the recovery involves both the skin incision and the internal uterine scar, which heals more slowly.
Extra items at the six-week check for C-section
- - Wound inspection: your O&G will check that the incision is fully closed and healing cleanly with no signs of infection, keloid, or hypertrophic scarring
- - Clearance to drive: most Singapore O&Gs advise no driving for 6 weeks after C-section; this is the appointment where driving is typically cleared
- - Scar massage instruction: your O&G should confirm the wound is closed and advise when to start scar massage (usually after 6-8 weeks)
- - Adhesion discussion: mention any pelvic pain, bladder urgency, or pulling sensations that could indicate internal adhesions
- - Exercise timeline: C-section mothers typically need 8-12 weeks (not just 6) before returning to high-impact exercise and core work
- - Next pregnancy gap: the uterine scar takes up to 12 months to heal internally; most O&Gs recommend 18-24 months between C-section birth and next conception
If you have ongoing pain, numbness, or a scar shelf that concerns you, ask for a physio referral at this appointment. Women's health physiotherapists assess and treat C-section adhesions and can significantly improve long-term pelvic function.
What to Say If You Are Struggling
Many mothers find it hard to be honest at the six-week check. There is social pressure to say everything is fine - especially after a healthy baby, financial support, and a supportive partner. If something is not fine, say so clearly.
Phrases you can use directly
- "I have not been feeling like myself and I am not sure if it is normal."
- "I am more anxious than I expected and it is affecting my daily life."
- "I feel disconnected from my baby and I am worried about it."
- "I have thoughts that scare me and I have not told anyone."
- "I do not feel I can cope and I need help - who should I talk to?"
Your O&G or GP cannot refer you for appropriate support unless they know what is happening. Postnatal depression affects roughly 1 in 10 Singapore mothers. You are not alone and you are not failing. Speaking up at this appointment is often the turning point.