Evidence suggests there are gaps in postpartum care in women with specific health conditions in pregnancy

Published on Monday, 14 April 2025 Post

A new study by Rema Ramakrishnan, Diane Korb, Yangmei Li, Marian Knight and Claire Carson published in Acta obstetricia et gynecologica scandinavica provides evidence of disparities in six-week postnatal checks in women with specific health conditions in pregnancy that suggest gaps in postpartum care in this high-risk population.

This study describes the provision of the maternal postpartum six-week check among women with hypertensive disorders of pregnancy, and compares short-term postpartum outcomes in those who did and did not have a six-week check.

Clinical Practice Research Datalink GOLD holds anonymised patient data from general practices throughout the UK. This was used to study 30,483 women who gave birth from 2000 to 2018 and had hypertensive disorders of pregnancy. Of these women:

• More than 2 in 5 had no record of a maternal postpartum check by their general practitioner (GP) at 6-8 weeks
• Younger women, women from more deprived areas, who experienced more severe disease, and those who had a more difficult pregnancy or birth were less likely to have a six week check record in their GP notes.
• About 44% of these high-risk women did not have a blood pressure measurement recorded in primary care notes in the first 4 to 12 weeks postpartum
• Postpartum depression was identified in about 13% of women. This was more commonly recorded in those who had had a six week check, suggesting that the SWC may aid in detection or encourage subsequent consultations for this condition.

The emphasis on postpartum care by the Women's Health Strategy for England, clearer guidance for GPs regarding the content and conduct of the six-week check, and the introduction of six-week check as an essential service under the GP contract in 2020 are all favourable to enable provision of more standardized and equitable care. There is an opportunity to improve postpartum care for all women, and it is important that those with coexisting health conditions are not overlooked.