New mothers are being failed at their six-week postnatal GP check and commissioners should do more to ensure they are being done well, a patient organisation has warned.
Healthwatch England said not all practices are complying with the contractual requirement to provide the postnatal review.
And when checks are done, NICE guidance on best practice is not always followed, particularly around mental health, the organisation said after a patient survey.
Feedback from more than 2,600 new mothers and birthing parents since April 2020 found that 16% had not received the check which should happen at six to eight weeks.
Of those who had a check, 44% said the GP did not spend enough time talking to them about mental health issues and 30% said it was not mentioned.
One in seven who responded to the survey said they had their six-week check over the phone.
Healthwatch said while the survey participants were self-selected they were likely to reflect those of a significant group of those who had recently given birth.
In 2021, a survey by the National Childbirth Trust found a quarter (25%) of new mothers in said they were not asked about their own mental health at their postnatal GP six-week check.
These appointments, which should take place 6-8 weeks after a mother gives birth, have been a longstanding recommendation but became a GP contractual requirement in 2020, with a £12m addition to the global sum.
In response to their findings, Healthwatch called for better consistency in how postnatal checks were done as well as more support for GPs to provide quality mental health care for new mothers.
Their recommendations include:
- ICSs monitoring the delivery of six- week checks as part of primary care commissioning.
- An update the GP contract to make clear that mental health reviews at the six-week postnatal check should be part of an open-ended discussion.
- NHS England considering what additional support and guidance it can provide
for GPs to have quality conversations about mental health during postnatal checks.
Louise Ansari, national director of Healthwatch England said: ‘With mental ill health affecting up to a third of new and expectant mums, six-week postnatal checks are key to assessing their wellbeing after the birth.’
She added: ‘Unfortunately, our findings show that although most new mothers and birthing parents are likely to be invited to a postnatal consultation, these are frequently carried out as a tick-box exercise, where mental health is not treated as a priority or not assessed at all.
‘Monitoring the delivery of six-week checks should be the first step to ensuring there’s a consistent approach to offering quality mental health support to all new mothers.
‘NHS England should consider what additional support and guidance it can provide to GPs so that the help new parents get is of the best quality.’