Article Text
PDF
Abstract
Background A maternal postpartum 6-week check (SWC) with a general practitioner (GP) is now considered an essential service in England, a recent policy change intended to improve women’s health. We aimed to provide an up-to-date snapshot of the prevalence of SWC prior to the policy change as a baseline, and to explore factors associated with having a late or no check.
Methods We conducted a cohort study using primary care records in England (Clinical Practice Research Datalink (CPRD)). 34 337 women who gave birth between 1 July 2015 and 30 June 2018 and had ≥12 weeks of follow-up post partum were identified in the CPRD Pregnancy Register. The proportion who had evidence of an SWC with a GP was calculated, and regression analysis was used to assess the association between women’s characteristics and risks of a late or no check.
Results Sixty-two per cent (95% CI 58% to 67%) of women had an SWC recorded at their GP practice within 12 weeks post partum, another 27% had other consultations. Forty per cent had an SWC at the recommended 6–8 weeks, 2% earlier and 20% later. A late or no check was more common among younger women, mothers of preterm babies or those registered in more deprived areas.
Conclusions Nearly 40% of women did not have a postpartum SWC recorded. Provision or uptake was not equitable; younger women and those in more deprived areas were less likely to have a record of such check, suggesting postpartum care in general practice may be missing some women who need it most.
- cohort studies
- health services
- maternal health
- perinatal epidemiology
- primary care
Data availability statement
Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from Clinical Practice Research Datalink (CPRD). Restrictions apply to the availability of these data, which were used under licence for this study. The data were provided by the CPRD under a contractual agreement that does not permit the sharing of data. Study documentation is available on request from the corresponding author. The data that support the findings of this study are available from Clinical Practice Research Datalink (CPRD). Restrictions apply to the availability of these data, which were used under license for this study. The data were provided by the CPRD under a contractual agreement that does not permit the sharing of data. Study documentation is available on request from the corresponding author.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Statistics from Altmetric.com
Data availability statement
Data may be obtained from a third party and are not publicly available. The data that support the findings of this study are available from Clinical Practice Research Datalink (CPRD). Restrictions apply to the availability of these data, which were used under licence for this study. The data were provided by the CPRD under a contractual agreement that does not permit the sharing of data. Study documentation is available on request from the corresponding author. The data that support the findings of this study are available from Clinical Practice Research Datalink (CPRD). Restrictions apply to the availability of these data, which were used under license for this study. The data were provided by the CPRD under a contractual agreement that does not permit the sharing of data. Study documentation is available on request from the corresponding author.
Supplementary materials
Supplementary Data
This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.
Footnotes
Twitter @d.siassakos
Contributors CC and JK developed the protocol with input from all the other authors. YL and CC developed the analysis plan with input from all the other authors. YL cleaned, prepared and managed the data and conducted the statistical analysis with input from all the other authors. YL and CC drafted the article with input from all the other authors. All authors were involved in interpretation of the findings, revised the manuscript critically for important intellectual content and approved the final version.
Funding This research is part-funded by the National Institute for Health Research (NIHR) Policy Research Programme, conducted through the NIHR Policy Research Unit in Maternal and Neonatal Health and Care, PR-PRU-1217-21202. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. A further small grant from NHS England funded the data extraction from the Clinical Practice Research Datalink (CPRD). CC was supported by a Medical Research Council Career Development Award (MR/L019671/1).
Disclaimer The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.