THE ROLE OF THE GENERAL-PRACTITIONER IN POSTNATAL CARE - A SURVEY FROM AUSTRALIAN GENERAL-PRACTICE

Background. Despite the practice of routine postnatal check-ups, many women experience problems in the months after childbirth. General prac titioners (GPs) are involved in routine postnatal care, yet little res earch has been undertaken to explore this role. Aim. To report the vie ws of Australian GPs as to what physical examination and discussion sh ould take place at the routine six week postnatal check-up and to dete rmine the influence of gender on the approach to the check-up. Method. Postal survey of 1104 Australian GPs, yielding an eligible sample of 1022. Results. A total of 715/1022 (70%) usable surveys returned. Over 65% of GPs recommend routine examination of the abdomen, blood pressu re, perineum, vagina, pelvic floor, and breasts at the six week check- up. Fewer than a half the sample believed that physical problems (urin e and bower symptoms, back problems), sexual issues, relationship and parenting issues should be routinely discussed. After con trolling for age, practice location, obstetric practice, and qualifications, the s ex of the GP remains an important factor influencing the GP's approach to postnatal care. Female GPs are three times more likely to believe that maternal feelings should be discussed routinely and about twice a s likely to believe that infant sleeping/behaviour, maternal sleeping/ diet/tiredness, coping with other children, relationship with partner, and household work should form part of the routine discussion with al l recent mothers. Conclusions. Sex of practitioner and older age (60 y ears or more) are the two most important influences on a GP's approach to postnatal care. This study indicates a need for GPs to shift their focus from routine examination to indicated examination to allow more time to discuss common postnatal problems.