Postnatal checks and primary care consultations in the year following childbirth: an observational cohort study of 309 573 women in the UK, 2006–2016
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Authors
Smith, Holly Christina
Saxena, Sonia
Petersen, Irene
Issue Date
2020-11-23
Type
Article
Language
en_US
Keywords
Maternal Medicine , Primary Care , Epidemiology , Reproductive Medicine
Alternative Title
Abstract
Objective:
To describe women’s uptake of postnatal checks and primary care consultations in the year following childbirth.
Design:
Observational cohort study using electronic health records.
Setting:
UK primary care.
Participants:
Women aged 16–49 years who had given birth to a single live infant recorded in The Health Improvement Network (THIN) primary care database in 2006–2016.
Main outcome measures:
Postnatal checks and direct consultations in the year following childbirth.
Results:
We examined 1 427 710 consultations in 309 573 women who gave birth to 241 662 children in 2006–2016. Of these women, 78.7% (243 516) had a consultation at the time of the postnatal check, but only 56.2% (174 061) had a structured postnatal check documented. Teenage women (aged 16–19 years) were 12% less likely to have a postnatal check compared with those aged 30–35 years (incidence rate ratio (IRR) 0.88, 95% CI 0.85 to 0.91) and those living in the most deprived versus least deprived areas were 10% less likely (IRR 0.90, 95% CI 0.88 to 0.92). Women consulted on average 4.8 times per woman per year and 293 049 women (94.7%) had at least one direct consultation in the year after childbirth. Consultation rates were higher for those with a caesarean delivery (7.7 per woman per year, 95% CI 7.7 to 7.8). Consultation rates peaked during weeks 5–10 following birth (11.8 consultations/100 women) coinciding with the postnatal check.
Conclusions:
Two in 10 women did not have a consultation at the time of the postnatal check and four in 10 women have no record of receiving a structured postnatal check within the first 10 weeks after giving birth. Teenagers and those from the most deprived areas are among the least likely to have a check. We estimate up to 350 400 women per year in the UK may be missing these opportunities for timely health promotion and to have important health needs identified following childbirth.
Description
Citation
Smith, H. C., Saxena, S., & Petersen, I. (2020). Postnatal checks and primary care consultations in the year following childbirth: an observational cohort study of 309 573 women in the UK, 2006-2016. BMJ open, 10(11), e036835. https://doi.org/10.1136/bmjopen-2020-036835
Publisher
BMJ Open