It was found that one in four women in Norway missed postpartum check-ups

It was found that one in four women in Norway missed postpartum check-ups

Christine Agdestein examined several aspects of the follow-up examination in a new study. Agdestein is a general practitioner and general practitioner and is currently a doctoral student at the Norwegian University of Science and Technology (NTNU). The research project is part of her doctoral thesis.

"An important finding is that the majority are satisfied with the 6-week check-up with their family doctor. This is an important offer for women who have recently given birth. Family doctors play an important role in aftercare," says Christine Agdestein.

"Not much research has been done on postnatal screening, and that's why it's all the more gratifying that we can offer new knowledge. These are findings that can quickly be used to improve work related to postnatal care," she says.

The study was carried out together with four other researchers from NTNU and the regional health authority Nord-Trøndelag.

Feedback from women

The study shows that satisfaction is strongly related to the opportunity to talk about the birth experience, that many relevant topics were addressed during the consultation and that a gynecological examination was included.

The topics that were most often consideredimportantorvery important:

• das Geburtserlebnis (61 Prozent)
• Empfängnisverhütung (55 Prozent)
• Stillen (53 Prozent)
• geburtsbedingte Beckenverletzungen (52 Prozent)
• psychische Gesundheit (40 Prozent)

The most important topics were also discussed most frequently.

One in four doesn't show up

Although the offer is perceived as positive and important, many women do not take advantage of the opportunity. The researchers found four main reasons:

• Fehlen eines Hausarztes
• hielt es nicht für notwendig, eine postnatale Untersuchung durchführen zu lassen
• War mit früheren Besuchen nicht zufrieden
• Wusste nichts von dem Angebot

Women who did not show up for a follow-up examination after giving birth missed an important opportunity for support and health-promoting measures.

Women with chronic illnesses, high-risk pregnancies, and complications during birth were no more likely to attend follow-up visits than women with good health and uncomplicated births. This is concerning given that these women have an increased risk of illness and death.”

Christine Agdestein, PhD student, Norwegian University of Science and Technology

The consultation is free

It is important to provide information about postnatal screening. In principle, women should receive information both during pregnancy and in the maternity ward. Only 44 percent said they had received information from the maternity ward.

52 per cent had received information about the service from a midwife in the community, some from their GP. 18 percent received information from friends and 11 percent through social media.

“We definitely see potential for improvement here,” says Agdestein. It also takes into account that some of the new births do not remember all the information given. Therefore, Agdestein believes it may be important to develop written information for women.

It also found that 32 percent of women did not know the service was free, which is important to make clear in the information provided.

“The chances of participation increase if you know that the advice is free,” the study shows.

Wants a gynecological exam

A gynecological examination was at the top of the women's wish list during the follow-up visit. This wasn't offered to everyone. The study shows a strong connection between satisfaction with follow-up visits and having a gynecological exam.

The women recommended that family doctors be more proactive in offering gynecological examinations.

"The study showed that some women find it difficult to request an examination of their genitals. The results show that it is important that they are offered a gynecological examination, and then women can decide for themselves whether they want and need it. Many people can have pain and tears after childbirth and suffer from incontinence, so it is important that they are offered a gynecological examination," says Agdestein.

Mental health and increased postpartum depression

40 percent of women responded that it was important to talk about mental health, and the topic was raised in up to 60 percent of consultations.

"This may indicate that GPs are focusing on mental health, and that is a good thing. From other studies we see that the prevalence of postpartum depression has increased in Norway in recent years, so mental health is an important topic of conversation during postnatal check-ups," emphasizes Agdestein.

Improvement work is already underway

Building on the study, Christine Agdestein is working on a follow-up project together with some of those who worked on the first study. The follow-up is specifically about tools to improve postnatal control.

"We have developed a tool and a prototype that are ready for testing. It is a tool that will be used by family doctors and women in collaboration," says Christine Agdestein.

It gives women good information about what topics can be addressed during the 6-week checkup and helps the woman prioritize what is most important to her. In this way, the family doctor can adapt the examination individually.

“With this measure we want to improve both the information and the quality, which in turn can contribute to higher participation and better use of the postnatal examination.”

"I started looking into this because, as a general practitioner, I cared for many women during pregnancy and the postpartum period. Then I saw that there was a great need for knowledge about postnatal care in the primary health service. I moved from clinical practice to research and now to improving practice," says Christine Agdestein.

How the study was conducted

The study was conducted as a questionnaire survey, with the target group being all women who gave birth in the Nord-Trøndelag Regional Health Authority for one year. 1119 women were part of the target group, 351 responded.

"The age, education and number of births of the respondents are comparable to those of women who gave birth in Norway in the same year. Therefore, the results are also relevant in the rest of the country," says Agdestein.

She summarizes that the key findings are that one in four do not attend, that there is a need for better information, that it is important that counseling covers many and relevant topics, including the experience of childbirth, and that women should be offered a gynecological examination.

"Our survey includes insights into the content of consultations and an analysis of the factors that influence whether women are satisfied or not. This means that professionals can quickly implement the results to improve the service," concludes Christine Agdestein.

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