Article Figures & Data
Figures
- Figure 1. Time taken and given for GP postnatal care appointments. Green points represent where the time taken is less than the time given (below the dotted line); orange points represent when the time taken is the same as the time given (intersecting the line); and red points represent when the time taken is more than the time given for appointments (above the line). Frequency weights are used
Tables
Characteristics of GPs (n = 14) n Years qualified N/A (GPST) 1 ≤5 5 6–10 2 11–20 4 ≥21 2 GP job role Locum 1 Partner 2 Salaried 10 Trainee 1 Is a parent Yes 11 No 3 Gender Female 13 Male 1 Location East Midlands 5 North East 1 London 2 West Midlands 6 Deprivation level of practicea Affluent 2 Deprived 9 Mixed 2 Ethnic diversity of practicea Very little diversity, mostly White British 8 Very diverse, multi-ethnic 2 Mixed 3 an = 13, not applicable to locum GP. GPST = general practice specialty trainee
Characteristics of women (n = 18) n Agea 21–24 1 25–29 8 30–34 5 35–40 3 Ethnicity African 1 Arab 1 Bangladeshi 2 Chinese 1 English, Welsh, Scottish, Northern Irish, or British 4 Indian 4 Other Asian background not specified 1 Other White background not specified 1 Pakistani 3 Number of children 1 12 2 6 Long-term condition before pregnancy Yes 3 No 15 Developed diabetes, high blood pressure, or mental health problem during pregnancy Yes 6 No 12 Type of birth Caesarean section 11 Instrumental 2 Vaginal 5 an = 17, one participant did not disclose age
Characteristics of survey participants (n = 671) Participants responding Total responders, n n % Years qualified 671 N/A (GPST) 35 5 ≤5 159 24 6–10 166 25 11–20 180 27 ≥21 131 20 GP job role 671 Locum 45 7 Partner 311 46 Salaried 272 41 Trainee 35 5 Other (for example, military GP) 8 1 Gender 668 Female 548 82 Male 118 18 Non-binary 1 <1 Prefer not to say 1 <1 Is a parent 671 Yes 561 84 No 109 16 Prefer not to say 1 <1 Location 671 East of England 64 10 London 75 11 Midlands 225 34 North East and Yorkshire 126 19 North West 50 7 South East 64 10 South West 67 10 Setting of practice 669 City 242 36 Town 207 31 Rural 91 14 Mixed 129 19 Deprivation level of practice 669 Affluent 84 13 Mixed 413 62 Deprived 172 26 List size of practice 657 ≤3000 5 1 3001–10 000 231 35 10 001–20 000 329 50 ≥20 001 92 14 Ethnic diversity of practice 671 Very little diversity, mostly White British 335 50 Mixed 207 31 Very diverse, multi-ethnic 129 19 Aware of national guidance on the 6–8 week check 671 Yes 422 63 No 249 37 Uses a template to document the consultation 665 Yes 466 70 No 189 28 Don’t know 10 2 - Table 4. GP reported frequency of completion of 26 clinical items taken from NICE guidance for the routine 6–8 week consultation
Always Very often Sometimes Rarely Never Discussion about: n % n % n % n % n % Mental health 551 82 75 11 36 5 7 1 2 0.3 Recognising physical problems 455 68 122 18 70 10 20 3 4 1 Pelvic floor exercises 241 36 166 25 149 22 86 13 29 4 Fatigue 157 23 179 27 215 32 100 15 20 3 Diet, exercise, smoking, etc 152 23 179 27 190 28 126 19 24 4 Contraception 647 96 21 3 2 0.3 1 0.2 0 0 Sexual intercourse 324 48 151 23 130 19 58 9 8 1 Safeguarding 252 38 152 23 186 28 69 10 12 2 Birth experience 388 58 147 22 93 14 35 5 8 1 Specific history taking for: Infection 226 34 140 21 198 30 91 14 16 2 Pain 250 37 167 25 171 25 69 10 14 2 Vaginal loss 476 71 105 16 57 8 27 4 6 1 Bladder function 285 42 134 20 158 24 79 12 15 2 Bowel function 267 40 121 18 179 27 82 12 22 3 Breast problems 264 39 161 24 161 24 71 11 14 2 Thromboembolism 36 5 80 12 209 31 264 39 82 12 Pre-eclampsia 51 8 67 10 169 25 269 40 115 17 Wound healing 459 68 148 22 42 6 18 3 4 1 Anaemia 103 15 155 23 251 37 129 19 33 5 Psychological wellbeing 585 87 71 11 14 2 1 0.15 0 0 Clinical examination of: Signs of possible VTE 17 3 14 2 130 19 290 43 220 33 Blood pressure 219 33 122 18 227 34 85 13 18 3 Vaginal problems 50 7 73 11 324 48 169 25 55 8 Caesarean section wound (when applicable) 290 43 204 30 152 23 18 3 7 1 Perineal wound (when applicable) 146 22 179 27 246 37 79 12 21 3 Review and plan follow-up for: Pregnancy complications, for example, diabetes, hypertension 442 66 163 24 58 9 8 1 0 0 NICE = National Institute for Health and Care Excellence. VTE = venous thromboembolism.
- Table 5. Associations between 26 clinical items from NICE recommendations and GP characteristics; differences reported where P<0.05. In all cases for gender, female GPs reported higher frequency. In all cases for parent status, parent GPs reported higher frequency. In all cases for ‘awareness of guidance’, GPs who were aware of national guidance on the 6–8 week check reported higher frequency. In all cases for ‘use of template’, GPs who used templates to document the consultation reported higher frequency. Specific associations between ‘years of experience’ and ‘role’ varied and are described in the comments column. (Contingency tables in the Supplementary Data.)
Years of
experienceRole Gender Parent Awareness of guidance Use of template Comments Discussion about: Mental health - - - - - - Recognising physical problems - - - - <0.001 0.002 Pelvic floor exercises - - <0.001 0.002 <0.001 <0.001 Fatigue 0.000 0.039 0.003 <0.001 <0.001 0.046 more frequent in 11–20 and ≥21 years more frequent in partners and locums Diet, exercise, smoking, etc - 0.002 - - <0.001 <0.001 more frequent in locums and GPSTs Contraception - - 0.006 - - - Sexual intercourse - - <0.001 0.004 <0.001 <0.001 Safeguarding 0.000 - - - <0.001 <0.001 more frequent in GPST and ≤5 years Birth experience - - <0.001 - 0.009 0.042 Specific history taking for: Infection - - - - 0.001 0.009 Pain - - - <0.001 <0.001 Vaginal loss - - <0.001 - 0.003 0.017 Bladder function - - <0.001 - <0.001 0.003 Bowel function - - 0.003 - <0.001 0.024 Breast problems - - 0.001 - 0.001 - Thromboembolism - - - - <0.001 <0.001 Pre-eclampsia - - - - <0.001 0.004 Wound healing - - <0.001 - 0.039 - Anaemia 0.013 - - - <0.001 0.001 more frequent in GPST and ≥21 years Psychological wellbeing - - <0.001 - 0.032 - Clinical examination of: Signs of possible VTE 0.004 - - - <0.001 - more frequent in GPST and ≥21 years Blood pressure - - - 0.024 <0.001 <0.001 Vaginal problems - - <0.001 - - - Caesarean section wound (when applicable) - - - - - - Perineal wound (when applicable) 0.049 0.019 <0.001 0.001 0.032 - more frequent in GPST
more frequent in GPSTs and locumsReview and plan follow-up for: Pregnancy complications, for example, diabetes, hypertension - - 0.025 - 0.002 0.015 GPST = general practice specialty trainee. NICE = National Institute for Health and Care Excellence. VTE = venous thromboembolism
Supplementary Data
- Mac_BJGPO-2024-0229_supp.pdf -
Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.
Content and timing of the 6–8 week maternal postnatal check: a mixed-methods study
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