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Background Since 2020, GP maternal postnatal consultations 6–8 weeks after birth have been mandatory under England’s General Medical Services contract. Previously, provision and quality of these consultations was inconsistent, often inadequate. The impact of the mandate is unknown.
Aim To develop an understanding of facilitators and barriers to GPs providing high quality 6–8-week maternal postnatal checks through exploration of views and experiences of women and GPs.
Method Mixed methods study focus groups of GPs and women, and an online survey of GPs in England. Qualitative data collection was via focus groups exploring GPs’ and women’s experiences of postnatal consultations, and an online survey of GPs. Thematic framework analysis was used, with the Capability, Opportunity, Motivation – Behaviour (COM-B) model as an overarching thematic structure. Inductively developed subthemes were mapped to relevant constructs of the COM-B model.
Results Focus groups included 18 women and 14 GPs, the GP survey received 671 responses. Twelve subthemes mapped to six domains of the COM-B model, comprising influences that could be facilitators or barriers to good care. Some influences related to both GPs and women. Some were specific to GPs, such as ‘GPs’ knowledge’, or to women, such as ‘Women’s social context’. GPs’ lived experience impacted their knowledge and motivation.
Conclusion GPs and women experienced barriers to good postnatal consultations. Organisational interventions could address; for example, adequate appointment duration, and improved information transfer. Application of the Behaviour Change Wheel to prioritise and develop interventions based on findings could improve women’s experience and outcomes.
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British Journal of General Practice
