In contrast,there has been limited consideration given to the role that poor physical health may play in women’s mental health in the year after childbirth,with the result that interventions to promote maternal mental health rarely identify physical health problems as a major focus of intervention.A notable exception is the trial of redesigned postnatal care evaluated by MacArthur and colleagues in the UK (MacArthur et al.,2002).Community midwives in the intervention sites in this study used symptom checkliste and the Edinburgh postnatal Depression Scale to identify maternal health problems, and then provided care for physical and psychological problems in accord with evidence based guidelines. Maternal mental health was improved in the intervention sites compared with sites providing usual care (MacArthur et al., 2002). Other trials of universal strategies for improving maternal mental and physical health have failed to show benefits.(Morrell et al.,2000;Lumley et al.,2006