The maternal six week postnatal checkBMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6482 (Published 02 December 2019) Cite this as: BMJ 2019;367:l6482
- Adam D Jakes, academic clinical fellow in obstetrics and gynaecology1,
- Pippa Oakeshott, professor of general practice2,
- Debra Bick, professor of maternal health3
- 1Guy’s & St Thomas’ Hospital NHS Trust, London, UK
- 2Population Health Research Institute, St George’s University of London, London, UK
- 3Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry UK
- Correspondence to A Jakes
What you need to know
The maternal six week postnatal check is an opportunity to review a woman’s physical, emotional, and social wellbeing, discuss contraception, and offer lifestyle advice
Conditions specific to pregnancy, such as gestational hypertension, pre-eclampsia, and gestational diabetes, require postnatal follow-up and education regarding the long term risks and the risk of recurrence in future pregnancies
One iron tablet daily for three months, combined with an iron rich diet, can be a practical way to manage postpartum anaemia, especially where side effects of iron supplementation are a problem
A 29 year old woman is seeing her general practitioner for a six week postnatal check after having her first baby. Her labour was induced at 41+0 weeks’ gestation for post-dates and she had a vaginal birth with a second degree tear. Her baby is well, exclusively breastfed, and gaining weight. Her partner has returned to work after parental leave and she has no family who live in the area.
The maternal six week postnatal check is a long established part of routine postnatal care. It typically includes a review of the woman’s physical and mental health, the events of her pregnancy and birth, and discussion of future health considerations.1 It is also an opportunity to identify the 10-15% of women who may develop postnatal depression,234 provide ongoing management of medical complications of pregnancy such as gestational hypertension or gestational diabetes,56 and discuss postpartum contraception. This article offers an approach to the maternal six week (or 6-8 week) postnatal check.
What you should cover
If possible, check the woman’s maternity care discharge summary before the consultation so that you are aware of her medical and previous pregnancy history, the circumstances surrounding the birth, and the health of her baby.
A 10 or 15 minute consultation is a short time to cover everything, …