Kirsten Fisch
Co-Founder at - Momentum Health NetworkKirsten Fisch, MSN, RNC-MNN, IBCLC, LCCE Kirsten is a women's health nurse who specializes in high-risk pregnancy and postpartum care. She is certified in Maternal Newborn Nursing, a board-certified lactation consultant (IBCLC), and a Lamaze Certified Childbirth Educator. She works with women from conception through the postpartum period. Passionate about empowering women throughout their reproductive journeys, Kirsten combines evidence-based care with compassionate support to promote the health and well-being of mothers and babies.
The postpartum period—those first weeks and months after childbirth—is a time of incredible transition. While much of the focus is rightfully on the newborn, it’s essential not to overlook the mother’s health. Postpartum testing is key in ensuring a smooth recovery and addressing any issues that might arise after delivery.
Immediate Postpartum Tests and Assessments (Hospital or Birth Center)
In the hours and days right after birth, your healthcare team will keep a close eye on your recovery with frequent checks to ensure your body is healing well. Here’s what those assessments may include:
The BUBBLEHE Exam
This bedside assessment helps providers monitor physical recovery. It stands for:
- Breasts – Checked for fullness, signs of engorgement, or nipple trauma (especially if breastfeeding).
- Uterus – Assessed for firmness and position to ensure it is contracting properly and reducing bleeding.
- Bladder – Monitored for proper function; difficulty urinating can increase the risk of bleeding.
- Bowels – Assessed for return of bowel function and signs of constipation.
- Lochia – Postpartum bleeding is monitored for amount, color, and consistency.
- Episiotomy/Incision – Any perineal tears, episiotomies, or cesarean incisions are checked for healing, signs of infection, or discomfort.
- Homan’s Sign/Extremities – Legs are evaluated for swelling, warmth, or tenderness to screen for possible blood clots.
- Emotion – Emotional well-being and bonding are informally assessed.
Preeclampsia Monitoring
Even after delivery, preeclampsia can develop or persist. Nurses and providers may ask about:
- Headaches that don’t improve with medication
- Vision changes (blurry vision, spots, light sensitivity)
- Upper abdominal pain
- Nausea or vomiting
- Sudden or worsening swelling in the hands, face, or legs
- Difficulty breathing
These are vital warning signs that require immediate evaluation.
Edema (Swelling)
Some swelling is normal after childbirth, especially in the legs and feet. However, significant or sudden swelling—especially if only on one side—may need further evaluation to rule out a blood clot or cardiac concerns.
Incision Checks
If you’ve had a cesarean section or an episiotomy, your incision will be inspected regularly for:
- Redness
- Swelling
- Warmth
- Drainage or discharge
- Pain at the site
Epidural Site Exam
If you had an epidural, the insertion site will be monitored for signs of infection, bruising, or cerebrospinal fluid leakage. You’ll also be asked about persistent headaches, which could signal a rare but treatable condition called a spinal headache.
Blood Work: CBC and CMP
- CBC (Complete Blood Count): Measures red blood cells, white blood cells, and platelets. It helps assess for anemia (from blood loss), infection, and clotting issues.
- CMP (Comprehensive Metabolic Panel): Evaluates kidney and liver function, electrolyte balance, and glucose levels. It’s especially important for those at risk of preeclampsia, HELLP syndrome, or gestational diabetes.
These labs are typically drawn if you had complications during delivery, symptoms of concern, or a history of high blood pressure, diabetes, or hemorrhage.
Follow-Up Tests in the Weeks After Birth
Once you leave the hospital or birth center, ongoing care and check-ups are important. Here are some of the most common tests and screenings during postpartum recovery:
1. Blood Pressure Checks
Especially important for those who experienced high blood pressure or preeclampsia during pregnancy, postpartum blood pressure monitoring helps ensure those numbers return to a safe range. Even women with no prior issues can develop postpartum hypertension, so regular checks are key.
2. Hemoglobin or Hematocrit Testing
Blood loss during delivery can lead to anemia. A simple blood test can assess your hemoglobin levels and determine whether you need iron supplements or dietary adjustments to regain strength and energy.
3. Glucose Testing (for gestational diabetes follow-up)
If you had gestational diabetes, your provider will likely recommend a glucose tolerance test around 6–12 weeks postpartum. This helps determine whether your blood sugar levels have normalized or if you may be at risk for type 2 diabetes.
4. Thyroid Function Tests
Thyroid imbalances, such as postpartum thyroiditis, can emerge within the first year after giving birth. Symptoms can mimic normal postpartum feelings (like fatigue or mood swings), so a thyroid test can clarify if you’re feeling “off.”
5. Pelvic Exam
At your postpartum check-up (usually around 6 weeks), your provider may perform a pelvic exam to check the healing of vaginal or cesarean incisions, assess uterine size, and address any pain or concerns with bleeding, discharge, or sexual activity.
6. Mental Health Screenings
Postpartum depression and anxiety are more common than many realize. Your provider may ask you to complete a screening tool like the Edinburgh Postnatal Depression Scale (EPDS) to assess your emotional well-being. Don’t be afraid to speak openly about how you’re feeling—mental health matters just as much as physical recovery.
7. Breast Health Check
If you’re breastfeeding, your provider may check for signs of clogged ducts, mastitis, or nipple trauma. If you’re not breastfeeding, they’ll still assess breast health and provide support for engorgement or discomfort.
8. Contraceptive Counseling
You may be surprised how soon fertility can return after giving birth. Your provider might discuss birth control options that are safe during breastfeeding or help you plan future pregnancies.
The postpartum period is not just about “bouncing back”—it’s about healing, adjusting, and taking care of yourself as you take care of your baby. These tests are designed to support your recovery and catch any issues early. Always speak up about your feelings—your health is just as important now as it was during pregnancy.
Do you have questions or want to share your postpartum experience? Comment below or reach out—we’re in this together.
Kirsten Fisch, MSN, RNC-MNN, IBCLC, LCCE Kirsten is a women's health nurse who specializes in high-risk pregnancy and postpartum care. She is certified in Maternal Newborn Nursing, a board-certified lactation consultant (IBCLC), and a Lamaze Certified Childbirth Educator. She works with women from conception through the postpartum period. Passionate about empowering women throughout their reproductive journeys, Kirsten combines evidence-based care with compassionate support to promote the health and well-being of mothers and babies.
