New mums aren’t being asked about their mental health at their six-week check, new research reveals, directly contradicting guidelines given to GPs.
A quarter of new mums who’ve given birth in the past 12 months say they were not asked about their emotional or mental health at their six-week GP check-up, according to the survey of nearly 1,000 mothers by the National Childbirth Trust (NCT). This is a huge figure – and could be up to 150,000 new mums in the last year.
In addition, the majority of mums (85%) said the appointment was focused on the baby’s health, despite a policy change in 2020 that stipulated all new mums should receive an appointment to check their own physical and mental health.
Kate Silverton, a 32-year-old first-time mum from Poole in Dorset, had a traumatic birth and says she was offered “no help with recovery in lockdown”.
“I didn’t have my usual support system, so I thought my health checks would be longer to see if everything was okay, but they felt so rushed,” she tells HuffPost UK. “We didn’t really get the normal things a new family gets because of the pandemic – no family or friends around to help. It was heartbreaking, really.”
Silverton describes the early days of being a new mum as “very emotional,” and says she’s been struggling with anxiety. However, the only question she’s been asked regarding her mental health is: “You’re alright, aren’t you?”
“I did want to discuss mental health but didn’t feel able to do so in the circumstances,” she says. “I think it would have been hugely positive to have been asked about my mental health at that stage. It would have helped me to open up and discuss the concerns I was having.”
The NCT findings follow an exclusive report from HuffPost UK in June 2020 that revealed six-week checks for mums were cancelled, cut short or conducted over the phone last year, meaning mums did not receive adequate care.
“It would have helped me to open up and discuss the concerns I was having.”
At the time, a spokesperson for the NHS told HuffPost UK staff were working “around the clock” to respond to the Covid-19 pandemic, “while also ensuring vital services like six to eight week checks can still take place in a safe way”.
Nana-Adwoa Mbeutcha, who gave birth in March 2020, said she was “feeling a bit low” and would have benefitted from talking to a professional, but her telephone appointment was cancelled. When she did eventually see someone face-to-face, she wasn’t given the chance to talk about her mental health.
“I was not seen at all or spoken to at all about how I am – it was all to do with the baby,” she said. “He had his checks and his vaccinations, but it was all done quickly – not in a rushed way that wasn’t taking care, but there was no dilly-dallying. It was a case of ‘let’s get you in and get you out as soon as possible.’”
Sherica, a 30-year-old second-time mum based in Harlow, Essex, told us how her baby’s six-week appointment was postponed and rolled into his 10-week immunisations. She didn’t receive a physical examination to see if she had healed after birth and was not asked about her own wellbeing.
“I know they normally check in on people’s mental health and how they are doing, but it was nothing like that,” said Sherica, who chose not to share her surname. “In terms of how my body is physically, I was not seen, I was not given an examination, I was not asked any questions.”
The experiences reflected by the women HuffPost UK interviewed, plus the NCT survey, contradict the system GPs are supposed to follow.
Previously, six-week checks for new mums were subject to a postcode lottery, but in February 2020, the government announced GP postnatal checks would be funded in England. This means every new mother is entitled to a dedicated appointment with her GP practice to discuss her own health and mental health at around 6-8 weeks after she has a baby, as well as a check-up for the baby.
Contrary to the terms of the GP contract, only 15% of the mothers surveyed by NCT had an appointment that was focused on their own health and wellbeing.
“We realise GPs and other services have been working under immense pressure recently but the pandemic has had a huge impact on the wellbeing of many new mothers,” commented Angela McConville, chief executive of NCT.
“This makes it even more important that mums’ postnatal health checks are prioritised. We urgently call on GPs to provide dedicated time and space for this crucial appointment.”
Responding to the NCT survey, Dr Victoria Tzortziou Brown, joint honorary secretary of the Royal College of GPs, told HuffPost UK: “GPs and our teams have been working incredibly hard throughout the pandemic to deliver the care and services our patients rely on us for – including maternal post-natal checks – in as safe a way as possible. It’s encouraging that a similar number of new mothers are being offered, and are coming forward for, their six-week post-natal check as before the pandemic.
“The mental, as well as the physical health of both mother and baby are both equally important. Having conversations about physical and mental health can be daunting for some patients, but general practice is a confidential and non-judgemental space in which new mothers can discuss their concerns openly and without fear of stigma, and receive the advice and care they need.
“The College has also produced relevant guidance for GPs on Postnatal Maternal and Infant Care during the pandemic, to help support GPs continue to deliver important post-natal services throughout the pandemic.”
Earlier this month, NHS England announced the launch of 26 mental health hubs, for new, expectant and bereaved mums, that would open by the end of 2022, with more by 2024. But the hubs have been labelled a “sticking plaster” by some, who say instead, better training is needed for GPs and health visitors, to ensure mental health check-ups aren’t simply a “box ticking” exercise.
Commenting on the NCT findings, Dr Nikki Kanani, NHS England medical director of primary care, said: “The introduction of six-week post-natal health checks on the NHS for new mums was a significant and step, and all GP teams are expected to have these important discussions with new mothers.
“The pregnancy and the birth of a new child are a special time for families and that is why, as part of our Long Term Plan, we are helping tens of thousands of women with our specialist perinatal mental health services which are now available across the country and which are continuing to expand, despite the pandemic, with help for around 6,000 new, expectant or bereaved mothers being set up in 26 new mental health hubs.”
A department of health and social care spokesperson added: “We understand the challenges new and expectant mothers, and their families, face during these difficult times.
“Specialist and inpatient perinatal mental health services have remained open throughout the pandemic – offering digital and remote support – and all GP practices are required to deliver Maternity Medical Services including post-natal checks for new mothers in person, by phone or by video consultation.
“We are committed to creating a health and care system that works for all women and urge everyone to share their experiences in our call for evidence so we can create the first government-led Women’s Health Strategy to improve the health and wellbeing of all women across England.”