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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

‘You’re more likely to tell the GP if you’re asked’: women’s views of care from general practitioners in the first postpartum year

Stefanie Hartley A , Georgina Sutherland A , Stephanie Brown A B and Jane Yelland A C
+ Author Affiliations
- Author Affiliations

A Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, Vic. 3052, Australia.

B General Practice and Primary Health Care Academic Centre and Melbourne School of Population Health, University of Melbourne, Melbourne, Vic. 3053, Australia.

C Corresponding author. Email: jane.yelland@mcri.edu.au

Australian Journal of Primary Health 18(4) 308-312 https://doi.org/10.1071/PY11111
Submitted: 6 September 2011  Accepted: 16 November 2011   Published: 23 December 2011

Abstract

New mothers and their infants are high frequency users of primary health care services in Australia providing opportunities for GPs to engage with women about common postnatal morbidities. This study aimed to explore women’s views of GP care in the first year following birth. We used semistructured interviews with a subsample of women who had participated in a population-based survey of women who gave birth in two Australian states (Victoria and South Australia) in 2007. Twenty-nine women were interviewed. Prominent themes that emerged were around issues of disclosure, including women’s views on ways practitioner interactions and systems of care facilitate or hinder disclosure and subsequent discussion of health problems. Women reflected on the role GPs played in their health and wellbeing after childbirth, the importance of enquiry, communication style and the way access to, and time in, consultations impact on disclosure, perceived support and discussions. To improve care for women after childbirth we need to know the contexts that facilitate disclosure. Findings from this qualitative study deliver an important message to clinicians: women value primary care, identify issues that facilitate and hinder disclosure and describe ‘good’ encounters as ones where they feel understood, supported and reassured.

Additional keywords: postnatal care, qualitative research.


References

Australian Bureau of Statistics (2010) ‘Births Australia, 2010.’ Cat. no. 3301.0. Available at http://www.abs.gov.au/ausstats/abs@.nsf/mf/3301.0 [Verified 25 October 2011]

Beake S, Rose V, Bick D, Weavers A, Wray J (2010) A qualitative study of the experiences and expectations of women receiving in-patient postnatal care in one English maternity unit. BMC Pregnancy and Childbirth 10, 70
A qualitative study of the experiences and expectations of women receiving in-patient postnatal care in one English maternity unit.Crossref | GoogleScholarGoogle Scholar | 20979605PubMed |

Brown S, Lumley J (1998) Maternal health after childbirth: results of an Australian population-based survey. British Journal of Obstetrics and Gynecology 105, 156–161.

Brown SJ, Donath S, MacArthur C, McDonald EA, Krastev AH (2010) Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence and associated risk factors. International Urogynecology Journal 21, 193–202.
Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence and associated risk factors.Crossref | GoogleScholarGoogle Scholar | 19834637PubMed |

Cape J, McCulloch Y (1999) Patients’ reasons for not presenting emotional problems in general practice consultations. British Journal of General Practice 49, 875–879.

Chew-Graham CA, Sharp D, Chamberlain E, Folkes L, Turner KM (2009) Disclosure of symptoms of postnatal depression, the perspectives of health professionals and women: a qualitative study. BMC Family Practice 10, 7
Disclosure of symptoms of postnatal depression, the perspectives of health professionals and women: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 19159478PubMed |

Del Piccolo L, Saltini A, Zimmerman C (1998) Which patients talk about stressful life events and social problems to the general practitioner? Psychological Medicine 28, 1289–1299.
Which patients talk about stressful life events and social problems to the general practitioner?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M%2FntFCgtg%3D%3D&md5=429467ef846803ea991d0b396749a4a3CAS | 9854270PubMed |

Gartland D, Hemphill S, Hegarty K, Brown S (2011) Intimate partner violence during pregnancy and the first year postpartum in an Australian pregnancy cohort study. Maternal and Child Health Journal 15, 570–578.
Intimate partner violence during pregnancy and the first year postpartum in an Australian pregnancy cohort study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3Mrmt1Gkug%3D%3D&md5=96ba01da2af72ebcbbdf8e71de5033c8CAS | 20628799PubMed |

Gerard K, Salisbury C, Street D, Opo C, Baxter H (2008) Is fast access to general practice all that should matter? A discrete choice experiment of patients’ preferences. Journal of Health Services Research & Policy 13, 3–10.
Is fast access to general practice all that should matter? A discrete choice experiment of patients’ preferences.Crossref | GoogleScholarGoogle Scholar |

Gill N, Freeman G (2007) Continuity of care and rapid access: the potential impact of appointment systems. Primary Health Care Research and Development 8, 235–242.
Continuity of care and rapid access: the potential impact of appointment systems.Crossref | GoogleScholarGoogle Scholar |

Goldfeld SR, Wright M, Oberklaid F (2003) Parents, infants and health care: utilization of health services in the first 12 months of life. Journal of Paediatrics and Child Health 39, 249–253.
Parents, infants and health care: utilization of health services in the first 12 months of life.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3szgt1equw%3D%3D&md5=42b4198dcea51e7bd801bb5fd4d09ea7CAS | 12755928PubMed |

Gunn J, Lumley J, Young D (1996) Visits to medical practitioners in the first 6 months of life. Journal of Paediatrics and Child Health 32, 162–166.
Visits to medical practitioners in the first 6 months of life.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s%2FhtlGmtQ%3D%3D&md5=16d6a3db4be85765ded79f560966d23dCAS | 9156528PubMed |

Gunn J, Lumley J, Young D (1998) The role of the general practitioner in postnatal care: a survey from Australian general practice. The British Journal of General Practice 48, 1570–1574.

Gunn J, Southern D, Chondros P, Thomson P, Robertson K (2003) Guidelines for assessing postnatal problems: introducing evidence-based guidelines in Australian general practice. Family Practice 20, 382–389.
Guidelines for assessing postnatal problems: introducing evidence-based guidelines in Australian general practice.Crossref | GoogleScholarGoogle Scholar | 12876107PubMed |

Hatem M, Pasquier JC, Fraser W, Lepire E (2007) Factors associated with postpartum urinary/anal incontinence in primiparous women in Quebec. Journal of Obstetrics and Gynaecology Canada 29, 232–239.

Robinson M, Mattes E, Oddy WH, Pennel CE, Van Eekelen A, McLean NJ, Jacoby P, Li J, De Klerk NH, Zubrick SR, Stanley FJ, Newnham JP (2011) Prenatal stress and risk of behavioural morbidity from age 2 to 14 years: The influence of the number, type and timing of stressful life events. Development and Psychopathology 23, 507–520.
Prenatal stress and risk of behavioural morbidity from age 2 to 14 years: The influence of the number, type and timing of stressful life events.Crossref | GoogleScholarGoogle Scholar |

Rogers A, May C, Oliver D (2001) Experiencing depression, experiencing the depressed: The separate worlds of patients and doctors. Journal of Mental Health 10, 317–333.
Experiencing depression, experiencing the depressed: The separate worlds of patients and doctors.Crossref | GoogleScholarGoogle Scholar |

Woolhouse H, Brown S, Krastev AH, Gunn J (2009) Seeking help for anxiety and depression after childbirth: results of the Maternal Health Study. Archives of Women’s Mental Health 12, 75–83.
Seeking help for anxiety and depression after childbirth: results of the Maternal Health Study.Crossref | GoogleScholarGoogle Scholar | 19214705PubMed |

Yelland J, Sutherland G, Brown S (2010) Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women. BMC Public Health 10, 771
Postpartum anxiety, depression and social health: findings from a population-based survey of Australian women.Crossref | GoogleScholarGoogle Scholar | 21167078PubMed |