For decades, health care costs have been a political topic in America. Advocates argue it is the best in the world, wealthy people from countries where it is nationalized travel to the United States for elite care, while critics argue it is too expensive and that creates socioeconomic barriers.

Political advocates on both sides always want to be reductionist - X causes Y - but a recent analysis shows it is never that simple. Norway has universal health care and yet 25 percent of new mothers do not attend a postnatal checkup. Even women with with co-morbidities or who endured high-risk pregnancies complications didn't go. The sample was 1,119 women in Nord-Trøndelag Regional Health Authority who gave birth within a year, of whom 351 responded.

The top reason was that they did not have a physician. Even in a country where health care is universal.

Also in the mix was they did not know about it, which means doctors may have been told not to promote that service to ease the burden on the health care infrastructure.

If they instead saw no reason to go because things are fine, that's a win, of course, but the concern by the authors is that only 44 percent were told about it. That means the government is not making women aware of it. Of those who knew, 18 percent were told by friends and 11 percent only learned of it on social media. The majority, 52 percent, were told by local midwives they knew rather than their maternity ward.

On the plus side, 60 percent of women surveyed who did get a check-up said mental health was discussed. Postpartum depression is more prevalent now, but it is hard to discern if that is because of a real effect or more diagnoses, the way Democrats believed vaccines caused autism from 1998-2021 or Republicans believe it now.


N = 211

In any case, it is good to have the discussion. They don't seem to be over-medicated.

You can never make the perfect the enemy of the good. Trying to have 'zero risk' is why NASA needs longer to go back to the moon than it took from the time the Wright brothers first flew a plane than us landing on the moon the first time. Yet it is what we do in America about health care. We had 700,000 people who were uninsurable due to pre-existing conditions and that needed fixed. Yet in 2024 we actually had 50,000,000 in the Obamacare program and a political party shut down the government because their opposition didn't want to continue to give health care free to illegal immigrants. The perfect should not be the enemy of the good but the bad certainly is. Norway shows that if you do the best you can, and people still choose not to use a service, that is good enough.

Citation: Agdestein, C., Vie, G.Å., Baasland, I. et al. Postpartum check-ups with general practitioners in Norway: a cross-sectional survey of attendance, content and patient satisfaction. BMC Prim. Care 26, 306 (2025). https://link.springer.com/article/10.1186/s12875-025-02992-x