Skip to main content
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1998 Sep;48(434):1570–1574.

The role of the general practitioner in postnatal care: a survey from Australian general practice.

J Gunn 1, J Lumley 1, D Young 1
PMCID: PMC1313219  PMID: 9830181

Abstract

BACKGROUND: Despite the practice of routine postnatal check-ups, many women experience problems in the months after childbirth. General practitioners (GPs) are involved in routine postnatal care, yet little research has been undertaken to explore this role. AIM: To report the views of Australian GPs as to what physical examination and discussion should take place at the routine six week postnatal check-up and to determine the influence of gender on the approach to the check-up. METHOD: Postal survey of 1104 Australian GPs, yielding an eligible sample of 1022. RESULTS: A total of 715/1022 (70%) usable surveys returned. Over 65% of GPs recommend routine examination of the abdomen, blood pressure, perineum, vagina, pelvic floor, and breasts at the six week check-up. Fewer than a half the sample believed that physical problems (urine and bowel symptoms, back problems), sexual issues, relationship and parenting issues should be routinely discussed. After controlling for age, practice location, obstetric practice, and qualifications, the sex of the GP remains an important factor influencing the GP's approach to postnatal care. Female GPs are three times more likely to believe that maternal feelings should be discussed routinely and about twice as likely to believe that infant sleeping/behaviour, maternal sleeping/diet/tiredness, coping with other children, relationship with partner, and household work should form part of the routine discussion with all recent mothers. CONCLUSIONS: Sex of practitioner and older age (60 years or more) are the two most important influences on a GP's approach to postnatal care. This study indicates a need for GPs to shift their focus from routine examination to indicated examination to allow more time to discuss common postnatal problems.

Full Text

The Full Text of this article is available as a PDF (35.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Astbury J., Brown S., Lumley J., Small R. Birth events, birth experiences and social differences in postnatal depression. Aust J Public Health. 1994 Jun;18(2):176–184. doi: 10.1111/j.1753-6405.1994.tb00222.x. [DOI] [PubMed] [Google Scholar]
  2. Bick D. E., MacArthur C. Attendance, content and relevance of the six week postnatal examination. Midwifery. 1995 Jun;11(2):69–73. doi: 10.1016/0266-6138(95)90069-1. [DOI] [PubMed] [Google Scholar]
  3. Bowers J. Is the six-weeks postnatal examination necessary? Practitioner. 1985 Dec;229(1410):1113–1115. [PubMed] [Google Scholar]
  4. Branthwaite A., Ross A. Satisfaction and job stress in general practice. Fam Pract. 1988 Jun;5(2):83–93. doi: 10.1093/fampra/5.2.83. [DOI] [PubMed] [Google Scholar]
  5. Britt H., Bhasale A., Miles D. A., Meza A., Sayer G. P., Angelis M. The sex of the general practitioner: a comparison of characteristics, patients, and medical conditions managed. Med Care. 1996 May;34(5):403–415. doi: 10.1097/00005650-199605000-00003. [DOI] [PubMed] [Google Scholar]
  6. Donner A., Brown K. S., Brasher P. A methodological review of non-therapeutic intervention trials employing cluster randomization, 1979-1989. Int J Epidemiol. 1990 Dec;19(4):795–800. doi: 10.1093/ije/19.4.795. [DOI] [PubMed] [Google Scholar]
  7. Drife J. O. Assessing the consequences of changing childbirth. BMJ. 1995 Jan 21;310(6973):144–144. doi: 10.1136/bmj.310.6973.144. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Halloran J., Gunn J., Young D. Shared obstetric care: the general practitioner's perspective. Aust N Z J Obstet Gynaecol. 1992 Nov;32(4):301–305. doi: 10.1111/j.1479-828x.1992.tb02838.x. [DOI] [PubMed] [Google Scholar]
  9. Holden J. M., Sagovsky R., Cox J. L. Counselling in a general practice setting: controlled study of health visitor intervention in treatment of postnatal depression. BMJ. 1989 Jan 28;298(6668):223–226. doi: 10.1136/bmj.298.6668.223. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Liao J. F., Change H. T., Chen C. F. Characterization of agonist-induced internalization and down-regulation of beta-adrenergic receptors in isolated rat lung and heart preparations. Proc Natl Sci Counc Repub China B. 1993 Oct;17(4):123–130. [PubMed] [Google Scholar]
  11. Mabray C. R. Postpartum examination: a reevaluation. South Med J. 1979 Nov;72(11):1433–1435. doi: 10.1097/00007611-197911000-00026. [DOI] [PubMed] [Google Scholar]
  12. Noble T. The routine six week postnatal vaginal examination. BMJ. 1993 Sep 18;307(6906):698–698. doi: 10.1136/bmj.307.6906.698. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. van den Brink-Muinen A., de Bakker D. H., Bensing J. M. Consultations for women's health problems: factors influencing women's choice of sex of general practitioner. Br J Gen Pract. 1994 May;44(382):205–210. [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES