10MC postnatal review fn - BMJ 10-minute consultation: The maternal six week postnatal check

Sep 1, 2026

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Guidance for primary care clinicians conducting a maternal 6-week (or 6–8 week) postnatal check, emphasizing structured review within a short 10–15 minute consultation. The approach prioritizes identifying urgent needs by reviewing the maternity discharge summary, exploring psychosocial factors (support, mood screening for postnatal depression, lifestyle, and sleep), assessing physical recovery (breastfeeding, wound healing, lochia, bladder and bowel function, and venous thromboembolism risk), and addressing sexual health, contraception, smear timing, and vaccination follow-up.

LanguageEnglish

CategoryGeneral

FormatDOCX

Pages9

Reading Time3 min

AccessFree to download

What you should cover

Psychosocial symptoms

Physical symptoms

Sexual intercourse and contraception

BMJ 10-minute consultation: The maternal six week postnatal check Adam D. Jakes1, Pippa Oakeshott2, Debra Bick3 1Academic Clinical Fellow in Obstetrics and Gynaecology, Guy’s & St Thomas’ Hospital NHS Trust, London, UK. 2Professor of General Practice, Population Health Research Institute, St George's, University of London, London, UK. 3Professor of Maternal Health, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry UK. Word count: 1586 Key words: childbirth, general practice, maternal morbidity, postnatal review A 29-year-old woman is seeing her GP for a 6-week postnatal check after her first baby. Her labour was induced at 41+0 weeks gestation for post-dates and she had a vaginal birth with a second-degree tear. Her baby is well, exclusively breastfed and gaining weight. Her partner has returned to work and she has no family who live in the area. The maternal 6-week postnatal check is a long-established part of routine postnatal care. It typically includes a review of the mother’s physical and mental health, the events of her pregnancy and birth, and discussion of future health considerations.[1] It is also an opportunity to identify the 10-15% of women who may develop postnatal depression [2-4], provide ongoing management of medical complications of pregnancy such as gestational hypertension or gestational diabetes [5, 6] and discuss post-partum contraception. This article offers an approach to the maternal 6 week (or 6-8 week) postnatal check. What you should cover If available, check the woman’s maternity care discharge summary before the consultation so that you are aware of her medical and previous pregnancy history, the circumstances surrounding the birth, and the health of her baby. Although there is a lot to get through in a short 10 or 15 minute consultation it is important to identify the most pressing needs of the woman. Start by asking some open-ended questions: how is she finding parenthood? Has she any worries about her own or her baby’s health? Suggested answers to some common questions are given in Box 1. Psychosocial symptoms Social – Explore her home circumstances and support. Does she have any family in the area, or friends with babies? Are there other children at home? Ask sensitively what support she is getting from their partner, family or friends. Mood – Ask about her emotional wellbeing and screen for postnatal depression using the following questions recommended by NICE[2]: During the past month, have you often been bothered by feeling down, depressed or hopeless? During the past month, have you often been bothered by having little interest or pleasure in doing things? Take a more detailed history for possible postnatal depression if she says yes to either question, or if she is at risk of mental health problems due to personal or family history, does not seem to be bonding with her baby, or you have other clinical concerns. Consider using the Edinburgh Postnatal Depression Scale, as this is a validated tool for assessing post-partum depression [2-3]. GP and health visitor follow-up and/or referral to mental health services should be considered as appropriate.[2] Lifestyle – Ask about smoking, alcohol or illicit drugs. Sleep – Is she getting any daytime sleep to supplement loss of nighttime sleep? Sleep disturbance is, of course, normal for new parents, but can precipitate or exacerbate post-partum depression and/or anxiety. If she is struggling to cope, explore practical solutions such as whether there are family members who can help with nighttime infant care? Labour and birth – Is there anything she would like to discuss about her labour and birth?[1] If she has concerns, would it be helpful to arrange a consultation with her midwife or obstetrician? Physical symptoms Breastfeeding – Ask if she is breast or bottle feeding, and if so, how it is going? Consider signposting to the health visitor/lactation consultant or observing lactation and latching if the woman ha

FAQs

Why is the 6-week postnatal check clinically important?

It reviews the mother’s physical and mental health, pregnancy and birth events, supports identification of women at risk of postnatal depression, helps manage pregnancy-related complications, and allows discussion of postpartum contraception.

How should postnatal depression be screened during the consultation?

Use NICE-recommended questions about feeling down, depressed or hopeless and loss of interest or pleasure. If positive, or if risk factors or bonding concerns exist, take a more detailed history and consider the Edinburgh Postnatal Depression Scale.

What physical concerns should be assessed at the 6-week review?

Assess breastfeeding issues and possible mastitis, perineal wound healing, bleeding/lochia, bladder and bowel function, and venous thromboembolism risk, including evaluation for dyspnoea or calf pain/swelling.

Sep 1, 2026

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