Maternal-fetal medicine and delivery

Post-partum follow-up

Post partum follow up is the medical care you receive after birth. It covers the first days and weeks, but also the months after delivery when your body and life are adapting again.

In Lisbon, Dra. Joana Faria offers post partum consultations in Portuguese, English, French, and Spanish. She sees women after vaginal birth or caesarean section, whether the birth took place at Hospital da Luz Lisboa or in another maternity unit.

Post partum follow up is a natural continuation of pregnancy surveillance and delivery. It is also an opportunity to prepare the next steps, including contraception and long term gynaecological care.

What it is

Post partum follow up is a structured programme of care after birth. It includes at least one post partum consultation, usually around 4 to 8 weeks after delivery, and earlier contact if needed.

During these visits, the focus is on several areas:

  • Physical recovery of the uterus, perineum and abdominal wall.
  • Caesarean or episiotomy scars, bleeding and pain.
  • Breastfeeding or bottle feeding, breast problems and feeding choices.
  • Sleep, fatigue, mood and emotional adaptation to life with a baby.
  • Sexuality, pelvic floor symptoms and urinary or anal incontinence.
  • Contraception and planning of future pregnancies.

The aim is not only to check if everything is normal, but to listen to what you are living, answer questions and propose concrete solutions.

Main concerns after birth and when to worry

After delivery, many changes are normal, but some require urgent medical attention. Knowing the difference helps you react in time.

You should seek urgent care if, in the weeks after birth, you experience:

  • Heavy vaginal bleeding that soaks pads very quickly or contains large clots.
  • Fever, chills, foul smelling vaginal discharge or severe pelvic pain.
  • Redness, heat, discharge or increasing pain at a caesarean or episiotomy scar.
  • Shortness of breath, chest pain or sudden pain and swelling in one leg.
  • Severe headache with visual changes or high blood pressure readings.
  • Thoughts of harming yourself or the baby, or feeling unable to cope with everyday tasks.

These symptoms can indicate complications such as infection, thrombosis, severe hypertension or post partum depression. In these cases, you should not wait for the routine check up.

You should also contact your doctor if bleeding returns after having almost stopped, if breastfeeding is very painful, or if you feel that something is not right even if you cannot describe it clearly.

Post partum assessment: exams and what to expect

At the main post partum consultation, Dra. Joana Faria reviews your pregnancy, birth and early days at home. She asks how you are feeling physically and emotionally, how feeding is going and what your biggest concerns are.

The visit may include:

  • Measurement of blood pressure, pulse and weight.
  • Review of bleeding pattern, pain, urinary and bowel habits.
  • Breast examination if you are breastfeeding or have breast symptoms.
  • Inspection of scars after caesarean section or episiotomy and assessment of healing.
  • Pelvic examination when appropriate, to evaluate uterus, vagina, cervix and pelvic floor.
  • Discussion of test results from pregnancy and birth, and planning of any further exams if needed.

It is also the moment to talk about sexuality, resuming physical activity, returning to work and practical organisation at home.

Treatment options, support and realistic expectations

Many post partum discomforts improve with time, but that does not mean you have to suffer in silence. There are several ways to support recovery.

Depending on your situation, care may include:

  • Pain relief medicines that are compatible with breastfeeding, if needed.
  • Local treatments or small procedures for scars that are painful or healing poorly.
  • Referral to pelvic floor physiotherapy in case of perineal trauma, incontinence or pelvic heaviness.
  • Support for breastfeeding difficulties, including sore nipples, engorgement or mastitis.
  • Individual counselling on contraception that fits your health, your wishes and whether you are breastfeeding.
  • Screening and support for post partum anxiety or depression, with referral to mental health professionals when appropriate.

Recovery after birth is not linear. It is normal to have good days and harder days. Realistic expectations and a clear plan can reduce guilt and pressure, especially in the first weeks.

How Dra. Joana Faria approaches post partum follow up

Dra. Joana Faria sees post partum care as an essential part of obstetrics, not as a quick final visit. She knows that many questions only appear after you are at home with the baby.

In her practice she:

  • Provides a calm space where you can speak openly about your experience of birth, whether vaginal or caesarean.
  • Explains what is expected in terms of bleeding, pain, scars and mood, so that you can recognise warning signs.
  • Involves your partner when you wish, acknowledging that post partum adaptation affects the whole family.
  • Coordinates care with paediatrics, pelvic floor physiotherapy and mental health when needed.
  • Connects post partum follow up with long term gynaecological care, including prevention and regular check ups.

The aim is that you feel supported and not alone during the transition from pregnancy to parenthood, with clear guidance adapted to your reality.

FAQ

Frequently Asked Questions


When should I book my first post-partum consultation?

In many cases, the main post partum consultation takes place around 4 to 8 weeks after birth. If you had a complicated delivery, a caesarean section or important symptoms, an earlier visit may be recommended. You should also seek care sooner if you have heavy bleeding, fever, intense pain, problems with the scar or doubts about your mood or breastfeeding.

Is it normal to still have bleeding several weeks after delivery?

It is normal to have post partum bleeding, called lochia, for several weeks. The flow and colour should gradually decrease and become lighter. If bleeding becomes heavier again, has a strong odour or is associated with pain or fever, you should be seen by a doctor. At the post partum consultation, the pattern of bleeding is reviewed and any concerns are discussed in detail.

When can I start having sex again after childbirth?

There is no fixed date that suits all women. Many couples resume sexual activity after the first post partum consultation, once bleeding has stopped and pain has improved. However, it is important to respect your own rhythm and to discuss any pain, fear or lack of desire. During the consultation, you can talk about lubrication, positions, contraception and when it is safe for you personally to restart sexual activity.

When can I exercise or return to sport after giving birth?

The timing of return to physical activity depends on the type of birth, the presence of complications and how you feel. In general, gentle walking can start early, while more intense exercise and impact sports should wait until your doctor confirms that recovery is adequate. Pelvic floor exercises are often recommended and may be guided by a physiotherapist. During post partum follow up, you receive personalised advice according to your situation.

How is contraception managed after birth, especially if I am breastfeeding?

Contraception is an important part of post partum follow up. If you are breastfeeding, some methods are preferred because they do not interfere with milk production, such as progestogen only pills, certain intrauterine devices or implants. If you are not breastfeeding, more options are available. At the post partum consultation, you and Dra. Joana Faria discuss which method fits best with your health, your plans and your preferences.

How do I know if I have post-partum depression and what can I do?

Feeling tired and emotional after birth is common, but if sadness, anxiety, irritability or loss of interest persist for more than two weeks and interfere with your daily life, this may indicate post partum depression. Other warning signs include feeling overwhelmed all the time, difficulty bonding with the baby, or thoughts of harming yourself. You should talk about these symptoms at the post partum consultation or earlier. There are effective treatments and you do not have to face this alone.

Schedule

Book your consultation


In person

XClinic

Av. Eng. Duarte Pacheco, nº26 - Piso intermédio 1070-110 Lisboa (in front of Amoreiras Shopping)

Online

Video consultation

On zoom

photo gallery of Dra Joana Faria operating and performing lectures