Your postnatal six-week check: what happens and what to raise

Newborn · Wellbeing · Reviewed 20 June 2026 · All articles

Somewhere around six to eight weeks after birth, you and your baby will have a postnatal check with a GP. For many new mothers, this appointment arrives before they feel ready, in the middle of a period of sleep deprivation, relentless feeding, and physical recovery. It is also, if you use it well, one of the most useful appointments of the postnatal period.

This article explains what happens at the check, what clinicians look for in both mother and baby, and what to raise if nobody asks. Because the appointment is often shorter than it should be, knowing what matters in advance makes a real difference.

What the six-week check is

The six-week postnatal check is a clinical review offered to all new mothers and their babies, typically between six and eight weeks after birth. In most places it is carried out by a GP, either as a combined appointment covering both mother and baby or as two separate appointments close together. Some practices offer a combined slot and use a nurse or health visitor for parts of the baby review.

The check is not a formality. It is the point at which a clinician reviews your recovery and your baby's development for the first time since you left hospital or the community midwifery team signed you off. It is a genuine clinical assessment, and it covers a wider range of issues than many people expect.

The appointment is typically ten minutes long, sometimes less if it is a combined slot. That is genuinely not long, and it is one of the most common complaints about this check. Going in with a list of what you want to cover helps ensure nothing important gets missed.

What the mother's check covers

The clinical review of the mother focuses on several distinct areas.

Physical recovery. The GP will ask how you are recovering physically and will usually carry out or review relevant assessments depending on how you gave birth. If you had perineal stitches following a tear or episiotomy, they may examine the area to check it has healed. If you had a caesarean, they will check the scar for signs of normal healing and will ask about any pain, redness, discharge, or areas of skin separation. Lochia (postnatal bleeding) should have stopped or reduced significantly by this point; if it has not, that is worth reporting.

Blood pressure may be checked, particularly if you had hypertension or pre-eclampsia during pregnancy. If you were anaemic during pregnancy or after birth, your GP may review whether iron supplementation is still needed. Any ongoing symptoms from pregnancy complications, such as obstetric cholestasis or gestational diabetes, should also be followed up at this point if they have not been already.

Mental health screening. Most GPs use the Edinburgh Postnatal Depression Scale (EPDS) at the six-week check, either as a written questionnaire or by asking the questions directly. The EPDS is a validated ten-question tool that asks about mood, anxiety, self-harm thoughts, and ability to manage day-to-day. It is not designed to catch only severe depression: it screens for a range of difficulties, including postnatal anxiety, which is common but often not recognised.

A score above a threshold does not mean you have postnatal depression. It means further conversation is warranted. If your GP uses the EPDS, answer honestly. There is a tendency to minimise because you are worried about what happens if you score high, but a GP who knows you are struggling can help. One who thinks you are fine cannot.

Contraception. Your GP will usually raise contraception at this appointment, if they have not already. This is clinically relevant because fertility can return before the first period after birth, including while breastfeeding, and the six-week check is a formal opportunity to discuss your options and wishes. It can feel strange to be talking about contraception when you are still in the early weeks of new parenthood, but it is a routine part of postnatal care.

Feeding. The GP will ask about feeding, whether you are breastfeeding, formula feeding, or mixed feeding, and how it is going. This is an opportunity to raise any feeding concerns you have not been able to resolve: persistent nipple pain, concerns about supply, difficulty with bottle feeding, or worries about your baby's weight gain.

What happens at the six-week postnatal check for the mother?

The GP checks your physical recovery including wound healing, asks about your mental health using the Edinburgh Postnatal Depression Scale, discusses contraception, and reviews how feeding is going. It is also a chance to raise any concerns you have not yet mentioned.

What the baby's check covers

The six-week check for your baby is a full physical examination, not just a weight check. It follows a structured protocol and covers the following.

Weight and growth. Your baby will be weighed and the measurement plotted on the growth chart in the personal child health record (the red book or its equivalent). The GP will look at the trajectory since birth, not just the single number, and will consider whether weight gain is consistent with your baby's pattern.

Heart sounds. The doctor will auscultate the baby's heart to listen for murmurs. A murmur detected at six weeks does not automatically mean there is a structural problem: many innocent murmurs are present in newborns and resolve without intervention. However, any murmur warrants further assessment to determine whether it is innocent or whether cardiology review is needed.

Hip stability. The Ortolani and Barlow manoeuvres are used to screen for developmental dysplasia of the hip (DDH), a condition in which the hip joint does not form correctly. The hip examination at six weeks is a repeat of the one done at the newborn examination. If instability or limited movement is detected, referral for ultrasound imaging is the next step. DDH is treatable, and outcomes are significantly better with early diagnosis.

Eyes. The doctor will check the red reflex in both eyes using an ophthalmoscope. The red reflex is the reflection of light from the back of the eye: its absence or asymmetry can indicate cataracts or other conditions that require early treatment. The examination also checks that the eyes are aligned and moving together appropriately.

Genitals. In male babies, the examination includes checking that both testes have descended into the scrotum. Undescended testes (cryptorchidism) are relatively common and are monitored across the first year: if they have not descended by 12 months, surgical referral is usually recommended. In all babies, the doctor checks that the genitals appear normally formed.

Tone and reflexes. The doctor will assess general muscle tone and may check primitive reflexes. Reduced or asymmetric tone can be a sign that neurological review is warranted.

Overall development and behaviour. The GP will ask about your baby's behaviour: how they are feeding, sleeping, settling, and whether you have noticed any social responsiveness (eye contact, responding to voices, early social smiling, which typically appears around six weeks). These questions are not a formal developmental assessment but a clinical impression of how your baby is progressing.

What is checked at the baby's six-week check?

The doctor checks the baby's weight and growth, heart sounds, hip stability (to screen for developmental dysplasia), eyes, reflexes, and genitals. They will also ask about feeding, sleeping, and how the baby is developing overall.

What to raise if the doctor does not ask

The ten-minute appointment structure means that not every clinician covers every relevant topic in every appointment. Some things are routinely screened; others depend on whether you bring them up. These are the areas most likely to be missed or under-explored, and most worth raising yourself if they apply to you.

Pelvic floor symptoms. Stress urinary incontinence (leaking when you cough, sneeze, laugh, or exercise), urge incontinence (needing to rush to the toilet with little warning), and pelvic heaviness or a sensation of bulging are all symptoms that warrant assessment. These symptoms are common after birth, but common does not mean normal in the sense of something to accept. Referral to a pelvic health physiotherapist is the appropriate next step, and it is available in most healthcare systems for postnatal women.

Diastasis recti. If your midline abdominal muscles have separated (a condition called diastasis recti or divarication of the recti), you may notice a gap or ridge down the centre of your abdomen when you raise your head while lying flat. This is very common in the postnatal period and does not always need treatment, but certain exercises can make it worse rather than better. A pelvic health physiotherapist can assess the degree of separation and guide you on appropriate rehabilitation.

Pain during sex. Dyspareunia (pain during penetrative sex) is common after birth, whether vaginal or caesarean. It can result from tissue changes, reduced oestrogen levels (particularly when breastfeeding), scar tissue from a tear or episiotomy, or pelvic floor tension. It is not something to push through: it is a clinical symptom that warrants assessment, and in many cases it is very treatable with appropriate guidance.

Mental health and anxiety. If you complete the Edinburgh Postnatal Depression Scale and score below the threshold, or if the GP does not ask directly about your mental health, this does not mean nothing needs to be said. If you have been experiencing persistent low mood, anxiety, intrusive thoughts, difficulty bonding with your baby, or anything that has felt hard to manage beyond the first two weeks, say so directly. These experiences are clinical matters, not personal failures, and they are more responsive to early support than to delayed intervention.

Scar concerns. If you had a perineal repair or a caesarean, and you have concerns about the scar, this is the appointment to raise them. Scar sensitivity, areas of numbness, itching, or pain on movement are all worth mentioning. Some women also experience scar sensitivity during breastfeeding, which can be related to the local nerve pathways. A referral to a physiotherapist who specialises in scar tissue can be helpful if your symptoms are significant.

Relationship strain and support. The early postnatal period puts relationships under significant pressure. If you are experiencing difficulties with your partner, your support network, or your own sense of identity, these are relevant to your health and recovery. Your GP may not ask, but raising it is not outside the scope of the appointment. At minimum, your GP can signpost you to appropriate support.

What should I raise at my six-week check if the doctor doesn't ask?

Bring up any pelvic floor symptoms such as leaking or urgency, any pain during sex, low mood or anxiety that has persisted beyond the first two weeks, feeding difficulties, and concerns about your scar if you had stitches or a caesarean.

Follow-up referrals to know about

A number of things identified at the six-week check lead to referrals rather than treatment at the GP appointment itself. Knowing what to expect reduces the anxiety of being told you need to see someone else.

Pelvic health physiotherapy. This is the appropriate referral for pelvic floor symptoms (leaking, urgency, prolapse symptoms) and for diastasis recti. In many healthcare systems you can self-refer, which means you do not need to wait for the GP to initiate it. It is worth asking about direct access options.

Mental health referrals. Depending on what you report at the six-week check, your GP may refer you to a perinatal mental health team, a talking therapies service, or simply to a follow-up appointment with themselves. Perinatal mental health teams provide specialist support for mental health conditions in the postnatal period and beyond, and their input can be significantly more tailored than general talking therapies alone.

Cardiac referral for a murmur. If a heart murmur is detected in your baby, you may be referred to a paediatric cardiologist or for an echocardiogram. The majority of murmurs in infants are innocent (not caused by structural heart disease), but the only way to confirm this is with appropriate investigation.

Audiology. If your baby had a newborn hearing screen and the result was a refer (meaning a clear response was not obtained), follow-up audiology testing is needed. This is usually arranged directly, but if there has been no contact by the time of your six-week check, raise it with your GP.

Hip ultrasound. If the hip examination is abnormal or equivocal, referral for ultrasound imaging is the appropriate next step. DDH is treated with a harness in the majority of cases when caught early, so prompt follow-up matters.

Ophthalmology. If the red reflex is absent or abnormal in one or both eyes, urgent referral to ophthalmology is needed. Congenital cataracts require early surgery to prevent permanent vision loss: this is a clinical urgency, not a routine referral.

What if you cannot get the appointment or miss it

The six-week check is not always easy to access. GP surgeries vary in how proactively they invite new mothers, and some people fall through the gap entirely, particularly if they have moved address, registered at a new practice, or faced administrative delays.

If you have not received an invitation by six weeks postpartum, contact your GP surgery directly to request the appointment. When you do, describe it as a clinical need, not a routine review. The distinction matters for how quickly you are seen. If there is significant delay and you have active concerns about yourself or your baby, say so explicitly, as practices can usually prioritise urgent postnatal assessments.

If you are having difficulty accessing the appointment and you have a community midwife or health visitor still in contact with you, ask them to flag the need with the practice. Health visitors in particular are trained to escalate postnatal care concerns, and their involvement often helps move things forward.

You should not have to wait beyond eight weeks for this check. If the delay is going to be longer than that and your concerns are significant, attending an urgent GP appointment or a walk-in service for specific symptoms is reasonable rather than waiting.

If you missed the appointment and time has passed, it is still worth booking it. There is no formal cut-off after which the check cannot happen: the clinical value does not disappear at seven weeks. Some of the things assessed at the check, such as mental health screening and pelvic floor symptoms, remain relevant well beyond the six-week window.

What if I cannot get a six-week check appointment?

Contact your GP surgery to request the appointment as a clinical need, not a routine review. If there are significant delays, speak to your midwife or health visitor, who can flag the need. You should not have to wait more than 8 weeks.

Getting the most from the appointment

Given how short the appointment typically is, a small amount of preparation makes a meaningful difference.

Write down your concerns before you go, in order of priority. If you only get to cover two or three things, you want the most important ones at the top. Include any physical symptoms (bleeding, pain, wound concerns, pelvic floor symptoms), any mental health concerns (persistent low mood, anxiety, intrusive thoughts), and any questions about your baby that have not been answered elsewhere.

Bring your baby's personal child health record (the red book or its equivalent) so that growth measurements can be recorded and the immunisation schedule can be reviewed. Your baby's first vaccinations are typically due at eight weeks, and the GP may confirm the schedule or the referral to a clinic at this appointment.

If there is something you find hard to say out loud, write it down and hand it to the GP. This sounds simple, but it works. A written note about mental health symptoms, relationship difficulties, or pain during sex bypasses the hesitation that many people feel when trying to raise sensitive topics in a short appointment.

If you are not satisfied with the time you were given or the issues you were able to raise, you can book a follow-up appointment. The six-week check is a scheduled clinical review, not the only appointment you are entitled to in the postnatal period.