Content and timing of the 6-8 week maternal postnatal check: a mixed-methods study.

Abstract

Since 2020, the General Medical Services contract requires GP practices in England to offer women a GP appointment 6-8 weeks after birth: the '6-8 week postnatal check' or 'consultation'. Historically, provision of checks was variable, and women still frequently report poor experiences. To explore GPs' and women's perspectives of the 6-8 week postnatal check, including key components and timing. A mixed-methods study was undertaken with focus groups of GPs and women, and an online survey of GPs in England. Focus groups explored GPs' and women's experiences of postnatal consultations. An online survey explored GPs' clinical approach, organisation, and improvement potential. Quantitative analysis examined associations between demographics and clinical approach. Thematic framework analysis was used for qualitative data. In total, 18 women and 14 GPs participated in focus groups; 671 GPs completed the survey. Mental wellbeing and contraception were reported as important topics, although some women were not asked about mental health. GP survey responses indicated most recommendations from national guidance were 'always' or 'very often' covered by most, but not all GPs. Clinical coverage was higher for GPs who used clinical templates, had awareness of guidance, were female, or were a parent. Many GPs (<i>n</i> = 326/670, 49%) needed more time than they were allocated for the consultation (<i>n</i> = 524/670 [78%] allocated ≤15 minutes; <i>n</i> = 351/670 [52%] completed in ≤15 minutes). This study suggests GPs are allocated insufficient time for postnatal consultations, with substantial variation in practice. Specifying consultation duration and consideration of template usage in policy may improve care and outcomes for women.