My Postnatal Check and why it was Substandard

A few weeks ago I had my postnatal check – just over 6 weeks since having Oscar. Every new mother is entitled to and should have a check around 6 to 8 weeks following the birth of their baby (or babies). Whether you had a stillbirth or living baby, the postnatal check helps your GP to check in with your mental health and wellbeing, physical health following delivery and ensure things like stitches etc have healed correctly. They discuss with you weight, blood pressure, contraception and vaginal disharge/return of periods. It is a very important appointment to ensure you are recovering well after birth and if any referrals need to be made to help your physical or mental health and wellbeing.

It is a seperate appointment to the babies 8 week check and solely for the mothers wellbeing. I have had one with each of my deliveries and so was quite aware of the protocol and the things I wanted to raise or ask my doctor, as well as what they would discuss with me. Only this time round, I found my postnatal check to be no other than substandard.

I don’t know if it is this area or perhaps it is more an issue of Covid restrictions still very much at play within the NHS, but this time it was done over the phone (over the phone?). Whilst I suppose convenient, there were a host of things that seemed both pointless and even risky with this approach but over the phone it was nonetheless.

Physical checks?

With all of my other babies, the postnatal check with the GP has been an opportunity for them to check you physically. With my 4 other deliveries they have checked my uterus at this appotintment to ensure that it felt like it had returned to normal and discussed if my periods have returned. I have also had any stitces checked and raised other physical concerns that I have felt needed checking with a doctor – both for reassurance and also their awareness.

This time however, with my GP on the end of a phone, a physical check was obviously impossible. I wanted my stitches checking just to make sure it was “normal” and I also raised serious concerns of a possible prolapse – I was told to give it 4 months and see how I felt then! I suppose if it really bothers me I could absolutely make a seperate appointment, but to be put in such a position shouldn’t happen for any new mum. A physical check should have been priority and it should have taken place at the surgery. Then, if they feel it should wait 4 months, you are confident that that decision was made based on an examination, not words crossed over a phone. Plus, I don’t know 100% that my stitches are fine and nor do I know 100% that my uterus is back to its usual spot either.

Contraception

To me contraception is such a personal choice and numbers of children is individual to the couple. I understand the need to discuss this and that education is also important on the topic, however in the past, my doctors have always been very respectful in how they have asked about this and certainly haven’t pushed anything.

My postnatal check this time felt far from respectful and also very assuming when it came to asking (or telling) me about contraception. My doctor didn’t ask what my preffered choice was or if we even used it, rather he said he could have a prescription waiting for me by the end of the day at the surgery or make an appointment for the coil!

EXCUSE ME – WHAT?

To me this just felt so pressured and a little judgy (and very assuming). I declined and said I would be in touch should I need anything – but also felt pretty awkward, which no patient should be made to feel. He didn’t ask me my feelings or what I wanted, he assumed that as I had had my 5th baby, I must want some pills or a longterm coil fitting ASAP!

Lack of emotion

As mentioned postnatal checks also offer new mothers an opportunity to share any concerns regarding their emotional wellbeing and generally how they may be feeling. Whilst often things like PND are detected through the health visitor, a new mother may feel more confident in expressing these concerns to her GP.  However, if the GP is on the other end of a phone and rushing through a check list of things to tick some boxes, do you really feel able to share something like that?

Thankfully my mental health has been fine this time round, though after how my physical concerns were fobbed off (or so it felt at the time), I am not sure I would have felt able to raise mental health concerns over the phone.

For me there was a lack of emotion here which was manifest by a flippant comment of “so you had a live birth on the 9th of March?”. The wording of “Live birth” and this whole statement shocked me a bit and caught me off guard. It showed me that either they hadn’t read my notes or that they didn’t see a need to reword this. Hearing the term “live birth” following the experience of a stillbirth (even several years ago) instantly triggers a whole host of memories and emotions, that made me feel a level of anxiety. Yes of course I had a live birth, but highlighting that also highlights that some babies (like Poppy in 2014) aren’t born living and that is always a hard thing to remember.

It’s safe to say that my postnatal check was far from the care and consideration that I have previously experienced. I was left feeling no better off with my physical health and triggered with my emotional health. I felt more like I was a quick check list and that the main focus was pushing contraception at me. I wish I could say that with it being my 5th that perhaps it was one off, and that of course knowing the expectation of these appointments, I can always contact a different doctor for an inperson check. But sadly I have since seen on Instagram that this isn’t a unique experience and first time mums as well as mums with a few more like me have also had very sumilar phone consulatations as their 6 week check. Like me, these women are still striggling weeks on with varying things as result of delivering their children.

Despite covid, I wonder how is this okay in this day and age and part of the world; to be offering new mothers such substandard care? I worry for those with real emotional struggles who have fallen by the wayside or physical issues which have been missed, which otherwise would have been picked up on if the appointment had have been in person. To me it’s just not okay!

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