Postpartum recovery check

The postpartum recovery check is a nine-marker blood panel for the first year after birth. It covers iron stores and red cells, thyroid function including antibodies, vitamin D, folate, B12 and long-term blood sugar. It costs $199 with your own doctor's signed request, or $279 with a KnowLuna doctor who requests the panel and explains the results in a 20-minute video consult. Collect at an accredited Australian centre from six weeks after birth, or choose a home kit or a nurse visit at checkout (options below).

What it measures

• Iron studies: ferritin and iron stores. Pregnancy draws iron down, birth takes more, and stores rebuild slowly. Low iron is one of the most common findings after a baby.
• Full blood count: haemoglobin and red cell size, which show whether depleted stores have become anaemia.
• TSH: the first-line thyroid check, and the thyroid marker most likely to shift in the year after birth.
• Free T4: the circulating thyroid hormone, read with TSH so a shifting thyroid picture can be interpreted properly.
• Thyroid antibodies: these tell your doctor whether an abnormal thyroid result is likely to be autoimmune, which changes what happens next and how long it is followed.
• Vitamin D: commonly low in new mothers who are indoors more and outdoors less than usual.
• Folate: drawn down by pregnancy and worth confirming, particularly if another pregnancy may follow.
• Vitamin B12: needed for energy, red cells and nerves, and lower in women who eat little or no meat.
• HbA1c: average blood sugar over two to three months, included here as a general metabolic check. It is not the follow-up test after gestational diabetes: that is a 75 g glucose tolerance test 6 to 12 weeks after birth, arranged through your GP.

Who it's for

Anyone in the first year after a baby who is exhausted beyond what broken sleep explains, who feels flat, foggy, anxious or not themselves, whose hair is shedding, who is breathless on stairs, who had a heavy bleed at delivery, or who had gestational diabetes and wants to know where their blood sugar sits now. It is for adults aged 18 and over.

What the six-week check usually does not include

The standard six-week postnatal appointment is a good appointment, but it is mostly a clinical review: how you are healing, how feeding is going, contraception, mood and a physical examination. Blood tests are not routine at that visit unless something specific prompts them.

That leaves a gap. The symptoms that show up at three, six or nine months, the exhaustion, the fog, the shedding hair, the feeling of being flattened, arrive after the appointment has passed and are easy to put down to having a baby. Sometimes that is exactly what they are. Sometimes they are low iron or a thyroid that has shifted, and those are measurable.

Postpartum thyroiditis

Postpartum thyroiditis is inflammation of the thyroid that appears in the year after birth. It affects roughly 1 in 20 women in the year after birth, and it is frequently missed because everything it causes is also caused by having a newborn.

It often runs in two phases. An overactive phase can appear from roughly one to four months after birth, with anxiety, a racing heart, heat intolerance, weight loss and trouble sleeping even when the baby sleeps. An underactive phase commonly follows from about four to eight months, sometimes up to a year, bringing exhaustion, feeling cold, weight that will not shift, constipation, dry skin, low mood and hair shedding. Many women only notice the second phase.

Most cases settle on their own within a year or so, but not all, and a proportion of women go on to have an ongoing underactive thyroid. Testing TSH, free T4 and thyroid antibodies together is what lets your doctor tell where you are in that picture, whether it is likely to resolve and how often to recheck.

What you'll learn, and what you won't

You'll learn whether iron, thyroid, vitamin D, B12, folate or blood sugar is contributing to how you feel, and each result is explained against your laboratory's range and read as a pattern rather than as a list.

What it cannot do: it cannot measure sleep deprivation, the mental load of a new baby, pelvic floor recovery or feeding difficulty, and none of those shows in blood. It also cannot assess postnatal depression or anxiety, which are diagnosed clinically. If you feel persistently low, hopeless, unable to cope, or you have thoughts of harming yourself or your baby, contact your doctor or maternal and child health nurse promptly, or go to an emergency department. A blood test is one input to a doctor's assessment, not a diagnosis on its own.

Reference ranges and what they mean

Marker	Typical adult range	What it usually means
Ferritin	Below about 30 ug/L is widely used in Australia to indicate low iron stores, and some laboratories use 15; many doctors prefer stores comfortably above that in the first year	Low stores are very common after birth and are one of the most treatable findings on this panel.
Haemoglobin	About 115 to 165 g/L for women, and laboratory-specific	Below range with low ferritin points to iron deficiency anaemia, especially after a heavy bleed at delivery.
TSH	About 0.4 to 4.0 mIU/L	In the first year after birth an abnormal TSH is often part of a shifting picture, so it is repeated rather than read once.
Free T4	About 10 to 20 pmol/L, and laboratory-specific	Read with TSH to tell an overactive phase from an underactive one.
Thyroid antibodies	Reported as detected or not detected against a laboratory cut-off	Antibodies present with an abnormal TSH suggest an autoimmune process and change how long you are followed up.
Vitamin D (25-OH)	50 nmol/L or above is generally considered sufficient	Below 50 nmol/L is deficiency: mild 30 to 49, moderate 12.5 to 29, severe below 12.5. It is common in the first year at home with a baby.
Folate and vitamin B12	Laboratory-specific. Serum folate is generally reported as low below about 10 nmol/L, and serum B12 as low below about 150 pmol/L, with roughly 150 to 220 pmol/L borderline	Low or borderline results are followed up with your doctor, particularly if another pregnancy is planned.
HbA1c	Below 6.0 percent (42 mmol/mol) is typical; 6.0 to 6.4 percent (42 to 47 mmol/mol) is the higher-risk band that is followed up; 6.5 percent (48 mmol/mol) or above on repeat is in the diabetes range	Useful for the ongoing checks recommended for years after gestational diabetes, but it can read falsely low in the first months after birth and does not replace the 6 to 12 week glucose tolerance test.

Ranges vary by laboratory; your report shows the range your lab uses. Typical ranges on this page are drawn from Pathology Tests Explained (RCPA) and the sources listed below.

When to do this test

Any time from six weeks after birth, on any day, with no fasting. Six weeks lets the changes of pregnancy and delivery settle so the results reflect you rather than the birth. If you are chasing thyroid symptoms specifically, the window from three to twelve months is when postpartum thyroiditis most often shows, and a repeat test some weeks later is normal rather than a sign something is wrong. Collect in the morning if you can, for steadier iron readings. Tell us about any supplements, because recent iron, B12 or vitamin D doses lift the reading, and about any thyroid medicine your doctor has prescribed.

Testing while breastfeeding

Every marker on this panel is a standard blood test and none of them affects breastfeeding, your milk or your baby. Nothing is injected, nothing is swallowed and there is no waiting period afterwards. Feed before you go if that makes the appointment easier, take the baby with you, and tell the collector you are feeding so they can make you comfortable.

How it works

• Order online. Either upload the request your own doctor has signed, or a KnowLuna women's health doctor reviews your short questionnaire and requests the panel.
• Collect at an accredited centre near you, or choose a home kit or a nurse visit (options below). One collection, any day, no fasting, from six weeks after birth.
• Results are usually ready within a few business days, explained in plain English in your account, with a 20-minute doctor consult if you chose that option. Abnormal results are always followed up by a doctor.

Choose how you collect

Every option is the same accredited test and the same report. Pick what suits you at checkout; the fee, if any, is added to either pathway price.

Common questions

Sources and further reading

• Pathology Tests Explained (RCPA): thyroid function tests
• Alexander EK et al. 2017 ATA guidelines for thyroid disease during pregnancy and the postpartum
• Pathology Tests Explained (RCPA): ferritin
• ADIPS: consensus guidelines for the testing and diagnosis of gestational diabetes
• Pregnancy, Birth and Baby: gestational diabetes
• Pregnancy, Birth and Baby: your first few days after giving birth

General information only, not medical advice. A test result is one input to a doctor's assessment, not a diagnosis on its own, and every abnormal result is followed up by a KnowLuna doctor. If your symptoms are severe or sudden, see a doctor promptly. Read our medical disclaimer.

Related

• All pregnancy tests
• Thyroid panel
• Iron studies
• Postpartum blood tests: thyroid, iron and the six-week check
• Thyroid blood tests explained
• Ferritin and iron studies explained