Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Recommended routine postnatal checks for mothers in primary care include:
- Asking about the birth experience and mode of delivery, support available, any concerns including domestic abuse or safeguarding, and the mother's mood, emotional wellbeing, sleep, fatigue, and bonding with the baby NICE CKS,NICE NG194.
- Assessment of infant care and feeding, including any breastfeeding problems NICE CKS,NICE NG194.
- Enquiring about ongoing vaginal bleeding, lochia, bladder and bowel function, perineal or caesarean wound healing, sexual function, and any long-term conditions or lifestyle issues such as smoking, alcohol use, and obesity NICE CKS,NICE NG194.
- Physical examination including blood pressure, body mass index (BMI), mood and mental state, perineal or wound inspection, and abdominal or pelvic examination if indicated by symptoms such as bleeding or pain NICE CKS,NICE NG194.
- Screening for signs of infection or sepsis, thromboembolism, anaemia, and postnatal mental health problems, with appropriate referral or emergency admission if serious conditions are suspected NICE CKS,NICE NG194.
- Offering support and advice on pain relief for perineal or wound pain, vitamin D supplementation if breastfeeding, lifestyle modifications, contraception options, and preconception care if planning future pregnancy NICE CKS,NICE NG194.
- Arranging further investigations as clinically indicated, including blood tests for glucose regulation if gestational diabetes history exists, renal function if pre-eclampsia history, full blood count and ferritin for suspected anemia, urinary dipstick testing for proteinuria, and vaginal swabs if infection suspected NICE CKS.
- Assessment of psychological and emotional wellbeing at each contact, with referral for further investigation and support as needed NICE NG194.
- Providing timely postnatal support visits: first midwife contact within 36 hours of transfer from birth, and first health visitor visit between 7 and 14 days after transfer NICE NG194.
Recommended routine postnatal checks for babies in primary care include:
- At each postnatal contact, asking about parents’ concerns regarding the baby’s wellbeing, feeding, and development, with physical inspection and observation NICE NG194.
- A complete newborn examination within 72 hours after birth and again at 6 to 8 weeks, in line with the newborn and infant physical examination screening programme NICE NG194.
- Awareness of warning signs such as failure to pass meconium within 24 hours of birth, which requires urgent medical evaluation NICE NG194.