Healthwatch England research: Six-week postnatal checks are failing many new mothers
Healthwatch England warns that the six-week postnatal checks mandated for GPs in England are failing new mothers. They reviewed maternal mental health care based on feedback from 2,693 new mothers and parents, including 43 from Dorset. The analysis reveals that not all GP practices comply with the requirement for postnatal checks, and those that do may not be fully aware of the NICE guidance on identifying and assisting with mental health issues. Healthwatch advocates for better consistency, monitoring, and support to ensure quality mental health care for new mothers.
- 16% of new mothers and birthing parents did not receive the recommended six to eight-week postnatal check.
- Only 22% of those who received the check were satisfied with the time their GP spent discussing mental health.
- 44% felt that their GP did not dedicate enough time to discussing mental health.
- 30% reported that their GP did not mention mental health during the check.
- 15% had their six-week check over the phone, which made it difficult for them to express their mental health struggles.
- Some respondents felt that the discussion of their mental health during the check was inappropriate and potentially harmful.
Although the survey participants were self-selected, their views likely represent a significant group of recently pregnant individuals. The Government implemented a six to eight-week postnatal check in April 2020 after Healthwatch England shared the mental health experiences of nearly 1,800 women during their journey to parenthood. General practitioners in England are now contractually obligated and compensated for assessing new mothers' mental health and wellbeing, offering referral options to specialist services and additional support. It is important that these checks are conducted separately from postnatal checks focused on the baby's health. Healthwatch England conducted this research from October to December 2022 to evaluate the extent of mental health support improvement during and after pregnancy.
Analysis revealed the following findings:
- 66% (1800 individuals) of women and birthing parents faced mental health challenges during and after pregnancy.
- 41% of those individuals did not receive any support for their mental health during and after pregnancy.
- Delayed access to mental health support can negatively affect new parents, resulting in difficulties leaving the house, forming bonds with their child, and maintaining relationships.
- First-time mothers are especially susceptible to developing mental health issues and are less likely to seek timely care.
The Care Quality Commission recently reported a decline in women's experiences with maternity services due to staff shortages. Additionally, a 2020 MBRRACE report revealed a threefold increase in the rate of women dying by suicide during or shortly after pregnancy compared to the previous three years, with 1.5 women per 100,000 births affected.
One Dorset resident commented: "Nobody did any kind of mood questionnaire etc. I had quite severe postnatal anxiety and OCD and it wasn’t picked up by any professionals. Eventually at around 12 weeks I reached a kind of crisis point and called the GP and asked to be put on anti-depressants and asked to be referred to the perinatal mental health team. After that things started improving but I still resent that I had to advocate for myself to sort things out, it could’ve been sorted earlier and I might not have got so unwell."
Louise Ansari, National Director at Healthwatch England, said: "With mental ill health affecting up to a third of new and expectant mums, six-week postnatal checks are key to assessing their wellbeing after the birth. If left untreated, poor mental health can have a devasting impact on new parents and their families.
"Unfortunately, our findings show that although most new mothers and birthing parents are likely to be invited to a postnatal consultation, these are frequently carried out as a tick-box exercise, where mental health is not treated as a priority or not assessed at all.
"Monitoring the delivery of six-week checks should be the first step to ensuring there’s a consistent approach to offering quality mental health support to all new mothers. NHS England should consider what additional support and guidance it can provide to GPs so that the help new parents get is of the best quality.
"We also need to ensure that maternal mental health and peri-natal services continue to remain on the government’s agenda and a priority in workforce planning and funding budgets."
Healthwatch England has made five recommendations for improving the six-week postnatal check for new mothers and birthing parents:
1. Integrated Care Systems should monitor the delivery of these consultations.
2. NHS England should update the GP contract to include mental health reviews as part of an open-ended discussion.
3. NHS England should update the GP contract to include signposting to specialist and community mental health support services.
4. NHS England should provide additional support and guidance for GPs to have quality conversations about mental health.
5. Deliver on the Long-Term Plan commitments to improve access to perinatal mental health services, including through more outreach clinics.
This news story has been produced by Chesil Radio's News Team, for more information please visit: https://www.chesilradio.com