to not understand what the purpose of health visitors is?

[RevoltingPeasant]

Okay, this is not intended to be another one of those HV threads. This is a serious question. I did not grow up in this country and this is a really weird concept to me.

So, are they:

a. nurses who effectively act as social workers, and are basically checking up on people's parenting?
b. nurses whose job is to make sure new parents are supported?
c. ?? something else?

Because I always assumed it was b, which seemed fair enough, but since joining MN the general consensus seems to be that it's much closer to a. On another thread today someone was joking that 'luckily' her HV didn't notice what a slattern she was in wearing dirty clothes. I've seen other people comment that their HVs ask them questions about their sex life or comment on their housekeeping.

If this is right, is this really a great idea? Can one refuse this or is it a mandatory thing?

Nigella brilliant name btw - it is possible she did exaggerate, it was a social situation and fairly brief convo - she didn't actually there was no right of appeal, it just seemed so from the way she told it.

This has actually made me feel lots better about HVs, because stupid as it sounds, it's been slightly worrying me. I think there is an MN caricature of an old witchie who comes in, tells you to wean at 6 weeks and criticises your hoovering and then lies about you to SS.... It's hard to know how far to believe that!

Do they ask about your sex life? Cos I would be quite uncomfortable with someone I hadn't invited coming to my house and asking personal questions like that.... despite the fact that I am shameless on here

That would have been decided by a court. I assume the HV was there to ensure the welfare of the child.

That has got to be the worst part of their job :(

It's always been b in my case.

They will ask you about your contraception yes. Thay said, 'what are you using?' I said 'the word no'

It used to be more b) but they have had to take a larger role in child protection now so perhaps moving towards a).

The can be very good when your child starts to show developmental problems as well. My HV had a lot of contact with us when ds1 was going through dx and then dxed.

Thanks Revolting its my rollerderby name

On a more personal note, my HV is absolutely lovely. I had a really difficult time breast feeding and she was incredibley supportive and fabulously none judgemental about my eventual decision to FF.

My HV has also been really helpful in getting my DS a really speedy physiotherapy referal (she got that sorted off the back of one phone call and I had already seen the physio by the time I got to see the GP about it).

I can't remember her asking about contraception, but all the flippin midwives did (I saw about 5 different ones in the two weeks after my DS was born) and my GP has twice (this annoys me greatly as I managed to get to 31 years of age without accidentally getting pregnant, so really don't need their advice now ).

Ours was definitely b - she even arranged for DS2 to be weighed at home, instead of trawling out to the clinic with DS1 who was an absolute handful - she also made the referral I'd been wanting to get him assessed (and subsequently diagnosed with ASD). Having had far more contact with him than his GP, she was in a much better position to make a referral with meaningful comment. She also referred DS2 for me and helped me to secure an early nursery place for him when pilot funding became available.

"Pediatricians across America have witnessed countless similar tragedies. A new BBC documentary has investigated why the US, one of the most prosperous nations on earth, has the worst child abuse record in the industrialised world. America's child maltreatment death rate is triple Canada's and 11 times that of Italy. Over the past decade, more than 20,000 American children have been killed their own family members ? that is nearly four times the number of US soldiers killed in Iraq and Afghanistan" The Guardian 2012

I'm sorry, OP, but maybe the US needs HV? The UK child mortality rate is poor for violent deaths caused by family members, but the US rate is far far worse. Yup, HVs can provide support, refer to outside agencies (say, PND or suspected SN in the child etc) but, if at the same time, they are looking out for children at risk then long may they continue...

NonnoMum thanks for that, do you have a link? It is really interesting but also terrifying and tragic. I have often wondered how preschool aged children suffering abuse and neglect are identified in countries that have no equivalent to HVs, perhaps the answer is that they simply aren't.

b) with a bit of a) when necessary.

One thing I had a problem with though is all the other workers in baby clinics who acted as if they were HVs, but as I eventually found out, weren't qualified to do anything other than weigh your baby, if that. However as people tended to get their baby weighed at each visit and then you could have a more in-depth conversation if necessary, many people I knew only ever talked to the baby-weighers, like me under the impression they were HV, and god these women spouted a load of crap!

The actual HVs were pretty good, just overloaded with a workload of about 1000 babies each (hence getting babies to come to clinic rather than doing home visits except when really needed).

i have encountered both kinds, my health visitor is fantastic, she has helped us more than any other service, if im honest i like the comfort there is someone there for us, especially as quite often i feel quite lost as a parent, everything she has done for us as made up for the rotten cows i've seen previously.

i'm glad i got a good one in the end though because the actions of one particularly horrid health visitor will stick with me forever. i had pretty bad PND caused by family situaton at the time and i took ds to the weigh in clinic and the hv there decided ds's eczema was contagious?? i had spread it to all the babies in the village bringing him to "well baby clinic" i had to take him to the drs right away if i didnt they'd put it on file i'd refused advice... the cow, took ds to the drs and told them what happened, she'd diagnosed the eczema the week before so wasn't amused, she rung them and something must have been said because they rung me back to make a "support visit"

there was a temporary one once that came for the initial visit when ds was a newborn and she was rude, gave me condoms and said "they'll stop you catching anything"

here

TBH I don't think I've ever met a bad one. All the ones I have encountered have been kind, thoughtful, supportive and very professional. They have even stepped in later on when our kids were older, in the absence of school nurses and the like.

I am actually wondering if the role should be extended to cover all families with kids of school age. But with perhaps some more training and specialisation to raise standards overall.

salad

Why do they ask you about contraception though? Surely that's nothing to do with the health of your current child - ?

I suppose that is the kind of thing I worry about - that they'd write it up that you 'refused advice' - wtf does that mean? Are they keeping some kind of CP record? So if you refuse to BF (for example) in contradiction to their advice, are you refusing advice? If you make a slightly controversial parenting choice like not having your baby in the room with you for the first 6 mos or raising your child vegan or something, are they going to start making notes?

nonno don't know what that quote is about and the stats you quote do sound shocking. HVs would never happen in the US, though. It's just a different culture. My sister still lives in the US and I can imagine the reaction of her ILs if someone suggested that a govt-employed nurse came to check on them in their homes - they'd think it was some type of conspiracy theory!!

xpost nonno. I'm not enough of a statistician to dispute those figures but I think it's interesting she is primarily talking about Texas. I think the US is too big to generalise like that and the article seems quite sloppy really. I don't think HVs are the answer there.

in my case it was d) nurses who keep an eye on the baby and keep pointing out a serious problem despite the mother sticking her fingers in her ears and going lalalaIcan'thearyou

I think they may well have saved dd's life

I guess they ask about contraception just to make sure you have access to advice if you need it.
There are a lot of myths about BF being suitable contraception etc and it's not really a great idea to get pregnant when your little one is very tiny.

The HV isn't just there to make sure your child is healthy and meeting developmental milestones, but also to support parents if they need it. They are ideally placed to identify possible PND for example.

Although they offer advice, if you choose not to take it, I doubt they make notes unless they think the child is at risk.

RevoltingPeasant you are overthinking it all! HV are incredibley short staffed and have massive case loads. They walk into houses where there is no heating or electricity in the middle of winter, where there is animal excrement all over the carpet, where people are taking class A drugs, where children are stealing food from the freezer as they are so infrequently fed by their parents, where babies have multiple broken bones, where 3 year olds are left home alone to look after the baby over night... I could go on and on

Believe me, some of them may get a bit high horsey about breastfeeding and weaning but as long as your child is safe they really have far more important things to concern themselves with. And since its SWs who would be expected to act on any concerns raised by HVs I can assure you that should a HV contact a SW with concerns that a chid wasn't breastfed, was weaned at 4 months and was sleeping in their own bedroom (but was otherwise well cared for) they would be sworn laughed at and told to stop wasting time.

I had really good health visitors! :o First time round - First baby, no family, no friendship network, and ex-dh working all hours, I was worried I might get PND, having had depression in the past - like ECT depression.

As it turned out, I was fine! but my HV was lovely - she came out once a week for 6 weeks for a listening visit, (cos of high risk) and helped me to sort out one morning a week of childcare, so I could go to the loo in peace. I never felt she was judging me, or nosing round my house - sometimes she would have to shift babystuff off chairs so she could sit down, and when I apologised, she said " If I came round here and it was pristine - then I might worry!" We had a really good laugh! and if I ever needed advice, or was unsure, she was on hand... She also ran a postnatal group that did things like baby massage, resus, weaning etc - I met my best friend there, and we are still friends 14 years later...

With ds2, I DID get PND - but she picked up on it, got me referred, and helped me through it..

Without the element of depression, I would still have found them useful though - I never felt like they were being intrusive or checking up on me, and they made some really useful suggestions.

You don't HAVE to have a HV.

So, revolting peasant - as they walked into my immaculate, gentile and clearly very affluent home - the little bitch highly skilled professional could then have said "we are here if you need us", I understand you are having problems with b/f, either we can help or here are the names of lactation counsellors, I don't have too many concerns about you - but here's my number. Wouldn't that have been better than behaving like a patronising moron "it's my job to make sure you are helping your baby develop properly" "breastfeeding mothers put their babies first, ff mothers put themselves first" . And then insisting I sat in her stinking clinic for hours to have a baby unnecessarily weighed.

married that sounds really unpleasant!

Nigella sorry was responding to salad's post where she said the HV told her they would write her up for refusing advice.

If they are just asking if you need contraception that is okay, I guess.

I know I probably seem like a loon to you all, but it's just so weird to me, that idea that a HCP comes out to your house, uninvited, and comes in and starts saying, 'So do you have a diaphragm or what?'

Sometimes the UK feels like home, and sometimes like a parallel universe!

Midwife handed care over to my HV when me and DS had been home for 10 days. I imagined some nosy parker coming in to my home and judging me for either being too messy and unhygienic or the opposite, far too neat and tidy (ie not enough time spent with DS).

HV never once asked to use the loo (idea opportunity to snoop) and if I offered her a cup of tea, she'd get up to make it for us. She gave me great support re breast feeding and she was the only one to notice DS's tongue tie.

I do recall being asked to fill in a form (assessing risk of PND), being given information re different contraception and being questioned endlessly about my bowel movements (didn't poo for ages after having DS and have just remembered how traumatic it was )

Here it is definitely more a. Because sadly that's where the greatest need is. No danger of being given any parenting advice here, unwanted or otherwise, if you have been rated as "good enough" in the first few weeks. The drop in clinic was withdrawn here when DD was a few months old to allow the HVs to concentrate on the neediest families.