The six-week check is not what the guidance actually says
ACOG replaced it in 2018 with something quite different, and reaffirmed that in 2025.
Almost every woman is told "see you at your six-week check." That is not what the governing guidance recommends, and has not been since 2018.
To optimize the health of women and infants, postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman's individual needs.
All women should ideally have contact with a maternal care provider within the first 3 weeks postpartum. This initial assessment should be followed up with ongoing care as needed, concluding with a comprehensive postpartum visit no later than 12 weeks after birth.
And explicitly on the six-week check:
Rather than an arbitrary '6-week check,' the American College of Obstetricians and Gynecologists recommends that the timing of the comprehensive postpartum visit be individualized and woman centered.
So: contact within three weeks, ongoing care as needed, and a full visit by twelve weeks. If you have been given a single appointment at six weeks and nothing before it, that is the old model.
The visit is also not a discharge. ACOG is unusually direct about this: However timed, the comprehensive postpartum visit is a medical appointment; it is not an 'all-clear' signal. Obstetrician-gynecologists and other obstetric care providers should ensure that women, their families, and their employers understand that completion of the comprehensive postpartum visit does not obviate the need for continued recovery and support through 6 weeks postpartum and beyond.
Seven things the visit should cover. Quoted from the same document: mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease management; and health maintenance.
as many as 40% of women do not attend a postpartum visit.A survey of 64,952 women across 17 states and New York City in 2009 to 2011 found 89.4% did attend. No current national attendance figure could be verified for this guide.
Both are real. ACOG does not say where the 40% figure comes from, though it is generally drawn from lower-resourced and Medicaid-insured populations. The honest reading is that attendance is worst in exactly the groups at highest risk. It should not be quoted as a national average in either direction. Note also that attending is not the same as being helped: ACOG reports that fewer than half the women who did attend felt they got enough information about depression, birth spacing, eating, exercise, or changes in sexual response.
"Who do I call at 2am in week three, and is it the same number as in week one?"
"What am I being screened for at the comprehensive visit, and with what questionnaire?"