The 6-Week Check: What It Covers (And What It Misses)

For most new mums, the 6-week postnatal check feels like the finish line of early recovery. It is often framed - by healthcare providers and popular culture alike - as the appointment that gives you the all-clear to resume normal life, exercise, and sex. The reality is more nuanced, and understanding what this appointment actually covers can save you from inadvertently pushing your recovery in the wrong direction.

What the 6-week check typically includes

The standard 6-week postnatal appointment with your GP or obstetrician covers a broad range of wellbeing checks. These typically include your blood pressure and general physical health, wound healing (for perineal tears or C-section scars), mental health screening using validated tools such as the Edinburgh Postnatal Depression Scale, contraception discussion, and a general conversation about how feeding and sleep are going.

Some GPs will also check your uterine involution (whether the uterus has returned to its pre-pregnancy size) and discuss any ongoing symptoms. This is a genuinely valuable appointment and should not be skipped.

What it does not assess

Here is the gap that catches many women by surprise: the standard 6-week check does not include a pelvic floor assessment. Your GP is not trained to perform internal pelvic floor muscle testing, and in the typical 15-minute appointment, there is neither time nor scope for it.

This means that even if your GP has given you the "all clear", they have not assessed whether your pelvic floor muscles are contracting and relaxing correctly, whether you have any degree of pelvic organ prolapse, whether your perineal scar tissue is healing well and supple, whether your abdominal separation (diastasis recti) is functionally significant, or whether your pelvic floor is hypertonic (too tight) rather than weak.

The "all clear" from a GP at 6 weeks means your general health looks stable. It does not mean your pelvic floor is ready for running, high-impact exercise, or heavy lifting.

The gap between GP check and physio assessment

A pelvic floor physiotherapist performs a fundamentally different assessment. This typically involves a detailed history of your pregnancy, birth, and current symptoms, an external assessment of posture, breathing patterns, and abdominal wall function, and (with your consent) an internal vaginal examination to assess pelvic floor muscle strength, coordination, endurance, and tone.

This type of assessment routinely identifies issues that the 6-week check cannot: levator ani muscle tears, pelvic organ prolapse at various grades, pudendal nerve involvement, hypertonic pelvic floors that will not benefit from more squeezing exercises, and scar tissue adhesion at perineal or C-section sites.

The Australian Physiotherapy Association recommends that all women access pelvic floor physiotherapy in the postnatal period - not just those with obvious symptoms. Many significant pelvic floor findings are asymptomatic in the early weeks, only becoming apparent when women return to exercise.

When should you see a pelvic floor physio?

Ideally, every postpartum woman would have access to a pelvic floor physiotherapy assessment. In practice, access varies. As a guide, booking an appointment at 6-12 weeks postnatal is appropriate for most women. See a physio sooner if you are experiencing any leaking (urine, wind, or bowel), heaviness or dragging in your pelvis, pain during sex or when inserting tampons, difficulty with bowel emptying, or significant pain at your perineal or C-section scar.

If you are thinking about returning to running or gym-based exercise at the 6-week mark, a physiotherapy assessment first is strongly recommended. Current evidence-based guidelines (Goom, Donnelly and Brockwell, 2019) suggest that high-impact exercise is generally not appropriate before 12 weeks at the earliest, and readiness should be assessed rather than assumed based on time elapsed.

Working within what you have access to

Not everyone has immediate access to a pelvic floor physiotherapist - cost, geography, and availability are real barriers. The Postnatal Recovery programme was designed specifically for this gap: to give you evidence-based, physiotherapist-designed guidance that bridges the space between your 6-week check and your first physio appointment, or to support your rehabilitation alongside physiotherapy care.

The programme does not replace individual clinical assessment - nothing does. But it gives you a structured, safe starting point grounded in the same principles your physio would use. If you have any concerns about your symptoms, please advocate for yourself at your 6-week appointment and specifically ask for a referral to a pelvic health physiotherapist.