GPAtlas🧭 When to offer the maternal postnatal check
The 6–8 week postnatal check is a universal, scheduled review offered to every woman after birth. NICE NG194 specifies, for the first time, that the maternal check should be carried out by a GP, and in England it is a contractual requirement – a separate consultation from the baby’s newborn and infant physical examination (NIPE) at the same age.
It is a genuine screening opportunity, not a formality. Most maternal deaths in the UK occur after birth, with mental illness a leading cause, and postnatal depression and anxiety affect 15–20% of women in the first year. Much postnatal morbidity – low mood, incontinence, painful sex, domestic abuse – is under-reported, so the skill is to ask proactively across every domain and never miss a time-critical complication.
| Domain | What the check should cover |
|---|---|
| Mental health | Mood, anxiety, sleep and bonding; case-find with the two depression-identification (Whooley) questions and GAD-2 (the 2-item generalised anxiety scale); stay alert for postpartum psychosis. |
| Physical recovery | Vaginal bleeding (lochia), perineal or Caesarean wound healing, bladder and bowel function, fatigue and possible anaemia, and blood pressure after any hypertensive disorder. |
| Pelvic health | Urinary or faecal incontinence, prolapse symptoms and dyspareunia; reinforce pelvic floor exercises. |
| Contraception | Fertility can return from about day 21 – discuss and offer an effective method (see Contraception after birth). |
| Ongoing conditions | Close the loop on pregnancy-related disease: gestational diabetes (GDM), hypertension, venous thromboembolism, thyroid and complex social factors. |
Source: NICE NG194 · NHS England GP contract
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