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25 May 2022

Many Laois mums not asked about their mental wellbeing at checkup soon after birth

Some 6,000 women from Laois and other counties surveyed as part of maternity services review

Birth and pregnancy

Mums survey by HIQA

A survey on maternity care of new mums in Laois and other counties has found that many women are not asked about their mental health at check-ups after having their babies.

The finding is contained in a new Health Information and Quality Authority (HIQA) Report into Maternity Care provided in the Community.

The survey of 6,000 women in Laois and all other counties was conducted as part of the National Maternity Experience Survey 2020. 

It found that the GP was the first port of call for 92.4% of Laois women when they thought they were pregnant.

Every women who is pregnant and ordinarily resident in Ireland is entitled to maternity care under the Maternity and Infant Scheme. This scheme allows for two visits to the general practitioner at 2 weeks and 6 weeks after childbirth. 

86.1% of Laois women attended a 2 week check-up after birth. Of those who did not attend the biggest proportion said they knew about the check-up but did not attend. Unlike a substantial number of counties, very few women in Laois said they did not know that they were supposed to attend.

When asked if sufficient time was spent discussing their physical health at the 6-week post natal check-up, just 41.8% of Laois women said yes definitely. About 10% said no. A small number said they had not had a postnatal check-up.

When asked whether sufficient time was spent discussing mental health at the 6-week check-up just 35.4% of Laois women answered that there definitely had been. A similar percentage said yes to some extent but about a third said no.

On this point, HIQA says greater care must be taken by medical practitioners to make sure that women know what mental health supports are available.

Another question asked if a woman's GP, practice nurse or midwife had answered their questions in a way that they could understand. About three-quarters of Laois women said yes this was always the case. A small percentage said no.

Nationally, the survey shows that for almost 90% of women who responded, their GP was the first point of contact once they became pregnant.

HIQA said most respondents around the country were positive about the care and support they received, saying they were treated with respect and dignity, were spoken to in a clear, understandable way and had confidence and trust in their healthcare professional.

However, it also revealed that some women felt that more information was needed on changes they would experience to their mental and physical health, as well as their nutritional needs during pregnancy.

HIQA said the survey also identified significant variation in attendance at the 2-week postnatal check-up. Most women attend this check-up but the numbers were notably lower for women living in counties in the northwest of Ireland.

Respondents also provided detailed information on their experiences with their GPs, practice nurses and midwives. These comments identified the caring and helpful attitudes of GPs, but also highlighted the requirement for more personalised care, particularly in the postnatal period.

 HIQA’s Director of Health Information and Standards Rachel Flynn spoke about the findings.

“Care begins in the community and to that end, it is crucial that pregnant women can trust and have confidence in the treatment and advice they receive from their GP or family doctor.

"It is hugely encouraging to see that a majority of women have reported positive experiences as they prepare for one of life’s major milestones.

"More concerning, however, is the correlation between geographical location and the provision of post-natal services. It is important that women in Donegal, Leitrim and Sligo are afforded the same opportunities and can have the same expectation of care provision as those in Ireland’s urban centres.

"It is clear that there is still work to be done to ensure women and babies across Ireland have access to the care and support they need,” she said.

The survey found that most women said that their GP, practice nurse or midwife answered their postnatal questions in a way they could understand. However, it was evident that a significant number felt that insufficient time was spent discussing their physical and mental health at the 6-week postnatal check-up.

“Pregnancy is a demanding experience, both physically and mentally. It is concerning that a significant number of women who took part in this survey felt that they did not receive enough information about potential changes to their mental health during pregnancy.

"Greater care must be taken by medical practitioners to make sure that women are made aware of the mental health supports that are available to them while expecting,” she said.

 The report on the maternity care provided in the community by general practitioners, practice nurses and midwives, as part of the 2020 National Maternity Experience Survey, can be found at www.yourexperience.ie.

The National Maternity Experience Survey is part of the National Care Experience Programme, a joint initiative by the Health Information and Quality Authority (HIQA), the HSE and the Department of Health.

The survey asked over 6,000 new mums about their maternity experience in February and March 2020.  

KEY FINDINGS

- For 87.4% of the women who responded, their GP was the first healthcare professional they saw when they thought they were pregnant, with 3.7% receiving care from a midwife first and 8.9% answering ‘other.’ 

- Women who saw a midwife first were slightly more likely to say they were offered a choice of care than those who saw GP first or ‘other.’

- Nationally, 84.7% of women attended their 2-week post-natal check-up with their GP; however, the numbers were significantly lower for women living in Donegal (44.4%), Leitrim (46.3%) and Sligo (47.1%). Of those who did not attend, most said it was because they did not know about it.


- When asked if sufficient time was spent discussing their physical health at the 6-week check-up, Monaghan had the highest proportion of women who answered ‘yes, definitely’ with 64.1%, while Longford had the lowest with 35.9%. Nationally, 1,458 women (45.5%) answered ‘yes, definitely’.

-When asked whether sufficient time was spent discussing mental health at the 6-week check-up, Monaghan again had the highest proportion of women who answered ‘yes definitely’ with 51.3%, Clare had the lowest with 28.6%. Nationally, 1,251 women (39.1%) answered ‘yes, definitely’.

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