NHS England issues postnatal maternal care guidance

 

As reported by GP Online, NHS England, in collaboration with the RCGP, releases guidance to GP practices aimed at ensuring consistent and comprehensive postnatal checks at six to eight weeks after delivery, emphasising the importance of mental health and personalised care

Maternal postnatal checks became a contractual requirement for GP practices in 2020 – and the guidance says it aims to offer ‘clear national advice to address unwarranted variation for the delivery of safer, more equitable, more personalised care’.

An introduction adds: ‘While this guidance does not override GPs’ clinical discretion in accordance with their professional duties, they should take it into account in delivering and organising the maternal postnatal consultation unless they can articulate a valid reason to do otherwise.’

Postnatal GP check

The advice says specialty training should ensure all GPs are trained to deliver the checks, and that they should be ‘universal’ – offered to all women including those whose baby has died or does not live with them.

Practices are urged to consider equity in access and to take a holistic approach that balances physical and mental issues and how they interact, and that GP checks should be offered even if a specialist has already completed a review.

In line with NICE advice, the guidance says these maternal consultations should be carried out by a GP and focus on perinatal mental health, physical health, as well as family planning and health promotion.
Family planning and health promotion: contraception, family planning and long-term health promotion.

In addition to advice on support and referral around mental health issues, NHS England said the guidance outlines ‘conversation points for GPs to discuss breastfeeding, physical recovery, pelvic health, contraception and any preexisting medical conditions or conditions that arose during pregnancy, such as gestational diabetes’.

Mental health support

It added: ‘The aim is for the consultation to be tailored to what is important to the woman, rather than a checklist of questions.’

NHS medical director for primary care Dr Claire Fuller said: ‘More than 600,000 women give birth every year in England, and so it is vital that they can get the right NHS mental health and physical support at what can be a hugely pressured moment in their lives.

‘GPs are perfectly placed to offer new mums a welfare checks six to eight weeks after giving birth – for not only their physical health but also their mental wellbeing and this new NHS guidance published today ensures that family doctors have the resources to provide this comprehensive support.’

Health and social care secretary Victoria Atkins said: ‘Mothers should be supported after giving birth. This includes being able to get the mental and physical health support needed for a healthy recovery – while giving new-borns the best start in life.

‘The postnatal check provides an important opportunity for GPs to listen to women in a discrete, supportive environment.

‘This builds on part of a wider scheme of support – including making new maternal mental health services available across all areas of England by March 2024 and £25 million to expand women’s health hubs.’