A recent study conducted by Christine Agdestein, a PhD candidate at the Norwegian University of Science and Technology (NTNU), has uncovered significant insights into the postnatal check-up practices among Norwegian mothers. Despite the critical nature of these consultations, a notable number of women are not attending their scheduled appointments. The research highlights the reasons behind this trend and suggests potential improvements to enhance postnatal care.
Agdestein, who specializes in general practice, emphasizes the importance of the six-week postnatal check-up conducted by general practitioners (GPs). “An important finding is that the majority are satisfied with the 6-week check-up with their GP. This is an important offer for those who have recently given birth. GPs have an important role in postnatal care,” she states. The study, which is part of Agdestein’s PhD project, was conducted in collaboration with researchers from NTNU and the Nord-Trøndelag Regional Health Authority.
Key Findings and Women’s Feedback
The study reveals that satisfaction with postnatal check-ups is closely linked to the ability to discuss the birth experience, address relevant topics, and receive a gynecological examination. According to the survey, the most important topics for women during these consultations include:
- The birth experience (61%)
- Contraception (55%)
- Breastfeeding (53%)
- Birth-related pelvic injuries (52%)
- Mental health (40%)
While these topics are frequently discussed, the study found that one in four women do not attend their postnatal check-up. The reasons for this include a lack of a GP, perceived irrelevance of the check-up, dissatisfaction with previous visits, and unawareness of the service.
Barriers to Attendance and Information Gaps
The study highlights a concerning trend: women with chronic diseases, high-risk pregnancies, and childbirth complications do not attend postnatal check-ups more often than those with uncomplicated births. This is particularly worrying given their increased risk of health issues. Agdestein notes, “Women with chronic diseases, high-risk pregnancies and complications during childbirth did not participate more often in the follow-up check-up than women with good health and uncomplicated births. This is worrying considering that these women have an increased risk of disease and mortality.”
Information dissemination appears to be a significant barrier. Only 44% of women reported receiving information about the postnatal check-up from the maternity ward, while 52% were informed by a municipal midwife. A smaller percentage learned about the service from their GP, friends, or social media. Moreover, 32% of women were unaware that the postnatal consultation is free, a factor that could increase attendance if communicated effectively.
The Importance of Gynecological Examinations
A gynecological examination is a critical component of the postnatal check-up, yet not all women are offered this service. The study indicates a strong correlation between satisfaction and the inclusion of a gynecological exam. Agdestein suggests that GPs should proactively offer these examinations. “The study showed that some women find it difficult to ask to have their genitals examined. The findings show that it is important that they are offered a gynaecological examination, and then the women can decide for themselves whether they want and need it,” she explains.
Mental Health and Postpartum Depression
Mental health is another crucial aspect of postnatal care. The study found that 40% of women consider discussing mental health important, and the topic was addressed in 60% of consultations. Agdestein points out, “This may indicate that GPs are focusing on mental health, and that is good. We see from other studies that the prevalence of postpartum depression has increased in Norway in recent years, so mental health is an important topic to talk about at the postnatal check-up.”
Ongoing Improvement Efforts
In response to the study’s findings, Agdestein is leading a follow-up project aimed at developing tools to improve postnatal care. “We have developed a tool and a prototype that is ready for testing. It is a tool that will be used by GPs and women in collaboration,” she says. This tool is designed to provide comprehensive information about the check-up and help women prioritize their needs, thereby enhancing the quality and effectiveness of the consultation.
The study was conducted through a questionnaire survey targeting women who gave birth in the Nord-Trøndelag Regional Health Authority over one year. Out of 1,119 women, 351 responded, providing a representative sample of the broader Norwegian population. Agdestein concludes, “Our survey includes insight into the content of the consultations, and an analysis of the factors that affect whether the women are satisfied or not. This means that professionals can quickly address the findings to improve the service.”
As the research continues to unfold, it holds the promise of significant improvements in postnatal care, ensuring that more women receive the support and health-promoting measures they need during this critical period.
