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Ep 69 – Postnatal care: the maternal 6-week check

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Posted 24 Mar 2023

Dr Hannah Rosa MBBS DFSRH MRCGP 

In this episode, Dr Hannah Rosa looks in detail at the maternal side of the postnatal 6-week check. NICE’s quality standard on postnatal care is explored and topics, such as contraception after childbirth, are delved into in further detail. Thereafter, there is an exploration of conditions that can arise during or after pregnancy which require management postpartum, such as gestational diabetes, hypertensive disorders in pregnancy and postpartum thyroiditis.

 


Key references discussed in this episode:

  1. Saving Babies’ Lives. 2016. A care bundle for reducing stillbirth.
  2. NICE. 2022. Postnatal care (QS37).
  3. NPEU. 2023. MBRRACE-UK: Mothers and babies: reducing risk through audits and confidential enquiries across the UK.
  4. FRSH. 2020. Contraception after pregnancy.
  5. NICE CKS. 2021. Anaemia – iron deficiency.
  6. NHS Greater Glasgow and Clyde. 2021. Iron deficiency management during pregnancy and the puerperium.
  7. NICE CKS. 2021. Hypothyroidism: Scenario: Postpartum.
  8. NICE. 2020. Diabetes in pregnancy: management from preconception to the postnatal period (NG3).
  9. NICE. 2019. Hypertension in pregnancy: diagnosis and management (NG133).


Key take-home points:

  • In 2013 (updated in 2022), NICE published a quality standard on postnatal care, of which statement 6 pertains specifically to the GP postnatal check for women. This check should be carried out 6–8 weeks after giving birth and should focus on the following four main areas:
    • A review of the mother's mental health and general wellbeing using open questioning.
    • The return to physical health following childbirth and early identification of pelvic health issues.
    • Family planning and contraception issues.
    • To consider any pre-existing diseases or conditions that have arisen during pregnancy that may require ongoing management. This can include anaemia, thyroid dysfunction, gestational diabetes and hypertensive disorders of pregnancy.

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