Influences on the 6–8 week maternal postnatal consultation in primary care: a mixed methods study using the Capability, Opportunity, Motivation – Behaviour model
Clare Macdonald, Fiona Cross-Sudworth, Christine MacArthur, Ellie Jones, Debra Bick, Beck TaylorBackground
GPs in England are required to invite women to a maternal postnatal consultation 6–8 weeks after birth. Provision, quality and women's experiences of these consultations are often poor.
Aims
To understand what influences consultations for women and GPs and consider potential improvement strategies.
Methods
Mixed methods study in England using focus groups of women and GPs, and a survey of GPs. Qualitative data were analysed thematically, underpinned by the ‘Capability, Opportunity, Motivation – Behaviour’ (COM-B) model. Descriptive statistics of survey data relating to improvement strategies were mapped to relevant COM-B domains.
Results
Participants were 18 women and 14 GPs in focus groups, and 671 GP survey respondents. Twelve subthemes mapped to all COM-B domains, describing influences on GPs and women. More challenges than enablers were raised. ‘Opportunity’ factors were prominent, and there was an interdependency between capability, opportunity and motivation. Of 16 proposed improvement strategies, 8 were highly rated (>70% agreed/strongly agreed).
Conclusion
Women and GPs valued postnatal consultations, but multiple interrelated factors limited their capacity to achieve effective consultations.
Implications for practice
Many strategies could improve consultations, maximising opportunities to identify and address issues that have lifelong consequences. Future research and policy should prioritise interventions across all COM-B domains.