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?

When DS was born with severe disabilities, we got a visit from a lovely, lovely HV who had herself been the mum of a disabled child (who died). She spilled right over and told us all about her child and it was - luckily - incredibly helpful.

Unfortunately though, through nurse training and through being a parent, I have come across some really dreadful, lazy and and plain bonkers HV's. It seemed to be a job that noone could define - a sort of make-it-up-as-you-go-along role. A creative, intelligent practitioner will make the most of that, but I did feel that when I did a placement with HV's, they were, in the main, ex-midwives and nurses who had been put out to grass because they couldn't cope. A bit like people who can't teach become educational psychologists and SW's who are burnt out in Child Protection join the children's disability team. Or am i being unfair?

My original HV only ever came into my living room, never asked to see any other area of the house. We co-slept and I was reluctant to tell her for fear of a lecture, but she just asked "Is baby in your room?" so I said yes - she then mentioned something about a moses basket and I never corrected her, so it's not like she went up to check (we never had a moses basket).

Quick in and out, weigh the baby, do you know these cot death recommendations, do you have any worries or concerns? No? Okay, clinic is at these times, see you then! (Implication being you're supposed to go to clinic, but they won't chase you up if you don't.)

The only other time I had HV contact was for the 9 month developmental check, and after I had taken DS to A&E they automatically follow up, I'm not really sure why... mine just asked if I was okay, sympathised that I was shaken up (we had a minor car accident) and then hung up. Didn't even check I was replacing the car seat!

It was just when I moved that things got a bit hairy and then, TBH, I think it was more because I was a young, newly single mum and I was struggling a lot bit.

The HV will be triggered by your GP though
Not necessarily. AFAIK, it's by the issuing of a NHS number/notification of birth which happens regardless of your GP. I had an independent midwife so GP not involved at all and she had the forms to make the notification - whether you give birth privately (at home or in hospital) or through NHS, your baby will be issued with an NHS number.

Oh I see, I wonder how they decide who to send though (as HV's are attached to particular surgeries - maybe private GP's have HV's attached to them as well).

I had my first baby in the US and think a good HV would have done me the world of good.

I was bent double after an EMCS, at risk of PND, no milk coming in and generally feeling like I'd been hit by a truck. Luckily I was referred to some amazing BF counsellors and I would say half of what they did was about BF and half just lovely reassurance about any questions I had about being a new mum.

A good HV would have been wonderful but a bad one would have tipped me over the edge. A lot of people I knew, the ones that could afford it, paid for a postnatal doula for just this reason.

I'm from the US, too, Revolting Peasant, and I actually really liked the HV thing...much better than in the US where you are sent home, not to be seen again until your 6 week check up! Without my HV, I may not have had proper help for my PND after DC2...she caught it straight away and got me the help I needed. As some others have said, some HVs are rubbish, but I had good ones for both my DCs, and they seemed truly lovely and concerned.

I think it's a) and b)

first hv was fab, full of good advice and reassurance.
second hv is ok, but a bit intimmidating, i.e. recording all bruises in the red book, even the typical toddler ones on the legs.

recent experience: dc had an accident needing stitches in a&e, reception there said they report every patient to ss. next day got a call from hv announcing a home visit saying if I don't agree ss will come for a visit...

I think the interesting thing about the US, at least where I was from, is that mother and child's health is delta with separately. We had a pediatrician vs a GP for DS and then my OB GYN for me. The pediatricians were fab and I really miss the preventive care they provided, the OB however was a quick scar check and smear at six weeks and that was it.

Thank god for the BF counsellors is all I can say :)

And looking back I remember them whipping out my c section staples less than 48 hours after surgery, steri stripping me up and sending me home. Guess they have to do that when you won't e seen again for six weeks!

Mousy - the hv are informed of every under 5 who attends a and e. after an accident they have to follow it up just to make sure there is nothing untoward going on.

Saintly- that was the original idea of Surestart or Children's Centre's, HV's are 'attached' to them as well as GP's , under the remit of the post codes served by the Centre's, so would always be available under 'working together to safeguard children' and multi-professional working. The system didn't go exactly to plan.

I don't think its any of those definitions. They are supposed to support as set out in your definition b), and parents look to them in the hope they provide that support. In actual fact they cause unnecessary worry and distress because they are at best incompetent, at worst negligent and so fulfil no useful purpose at all. Just a complete waste of money. Have formally complained about the HV in my area.

There may be good HVs somewhere, but having been a mother for 6+ years and having had 3 children, I am yet to come across one.

My HV is fantastic. She was full of great (but unpatronising) advice when DS was a newborn and I had no idea what I was doing.

She organised and ran a series of new parent classes at GP surgery. These were a lifeline where I met other new mums and realised I was not the only one struggling . We learned about things like first aid, weaning, immunisations, massage etc in a friendly supportive environment.

She picked up that my relationship with DP had taken a battering after becoming new parents. She offered to come round for a chat, turned up the next day and was truly wonderful- she listened to me, dried my tears and gave good practical advice. She helped us to turn things around for us.

As DS has got older she has helped with a health scare that he had, and provided an assessment and support when he developed a stammer.

I think I've made my point! She is brilliant, dragged me (and others I know) back from the brink of PND. I would give her a medal if I could!!

For anyone worrying about scrubbing your home before the MW / HV arrives. My HV picked up on my over enthusiastic cleaning as a sign of PND- she was right and I had got things out of perspective.

I think someone has already asked this question but didn't get an answer as far as I could see - how do the HVs know your child needs attention if they never actually come to your home?!

We've never had a HV visit, I don't know who my HV is! There is a clinic down the road for weigh-ins and the staff present for weighing are different each time. AFAIK there is no record of us attending these clinics apart from in my red book (which I have heard others talk about losing, so that's not a sure-fore record either). I imagine that the bit where you have to strip your baby completely for weighing is not only about an accurate measurement; they get a chance to scan baby's body for any obvious problems. Although having said that they don't examine baby's back, so there could be any number of scratches/scars there that wouldn't be spotted.

I am always asked if I want to speak to a HV at these clinics and usually say no because I don't think there are any problems. However, that does seem to be putting the onus on the mum to be very observant of baby - what about the mums who need help but don't realise? They could quite easily refuse and end up with a child in real trouble.

The last time a medical professional (midwife) entered our house was when DS was 5 days old and it could be reasonably expected to be a bit messy. Despite my past history of depression (meds for 2 years) I had no PND questionnaire and absolutely no follow-up. As it happens I was ok, but what if I hadn't been?

So in summary: it seems like HVs can be a valuable resource, totally useless or somewhere in the middle. However some of us will never find out as we never see one!!

I think it is unreasonable to call the profession as a whole useless because some, or even most, women don't need them. There is no way of knowing who will be at risk of PND or struggle to cope, so it is good there is someone to check in. If you are ridiculously over-sensitive and think anyone cares less about your house being a bit messy, then that is your problem. The threads on here don't suggest that constantly thinking people care less and are judging you is something specific to HVs.

All mine did was say "that's normal" to all the little things I didn't know about like milk spots, or changes in baby poo. I would never have gone the the GP about things like that, so it was nice to have someone to check with. She was also really good at BF advice and didn't give two hoots that I was still in my dressing gown when she came round. She obviously thought I might be at risk from PND, following bad birth, but handled it subtly, and believed me when I reassured her. She didn't believe me when I said I felt fine, writing "very pale" in my notes - but the photos prove she was right, so I can hardly be annoyed.

Oh, I wouldn't have cared if they thought house was messy or not! It just seems from the experiences listed here that some people get loads of attention from HVs (more than they'd like!) and some don't get any. Surely the system shouldn't have holes in it like that? I mean, I think we're ok (well I would, wouldn't I) but it makes me worry about other families who might not be.

I had a couple of health visitors who were lovely, very supportive and made me feel better about my inability to breastfeed, offering to refer me to get help, but pushing it too far when I explained that I had already tried everything to no avail. They were also happy to answer questions and give advice when it was asked for but not otherwise.

I have heard some stories about horrible HV's who criticised my friends care of their DC's, but they were just told that they weren't welcome to come back and that seems to have stopped them from coming round.

I do like taking the boy to the clinic once a month or so to get him weighed, just so I know that he is growing properly and to give me reassurance that I am doing things the right way for us, first baby and no family or friends close by, its just comforting really.

Had a friend who had her babies in the US and she couldn't believe the support that HVs gave...
Not having to get dressed, get the baby dressed and drive to the paeds office just to get a bit of support/feeding/sleeping advice in the first few weeks seemed like a godsend. HVs calling round to you is fabulous... and if they are casting a bit of a glance around to see if mum is at risk of DV/PND or baby at risk of DV/malnutrition/neglect then that's fine by me.

I'd love a decent health visitor. When DS was born I had a great one, she did more home visits than normal due to my Edinburgh score being thought the roof but it was only when I spoke to some other mums that I realised how far above and beyond she'd gone for me. If I'd realised the norm was one home visit then off to clinic I'd have resisted the additional home visits that I really did need so I didn't appear to be not coping IYSWIM. Sadly she moved areas and they never allocated a permanent replacement to my surgery. :(

Six months ago when DS started preschool at just turned 3 I got myself into a right tizz when the SENCO (although she never introduced herself as such ) on 2 weeks acquaintance with the boy took it upon herself to pull me aside and raise some concerns about his balance (and enquired if it would improve after his squint surgery ), how he played with others and his hearing. I rang the HV office and left a message that day, and twice more the following week and I've still not heard back from them. I'm currently at my wits end over potty training (I have a very stubborn boy who would apparently rather be constipated than use a potty or toilet!) and I just don't know who to get advice/support from. The GPs receptionist booked me in with a dr but that wasn't exactly helpful since it doesn't seem to be a medical issue. When I had DD 12 13 years ago this is exactly the sort of thing I used them for and they were fab.

Sorry OP, I seem to have gone off on a tangent

When DD was born it coincided with the time that DS started to become a concern behaviour wise. I saw my HV at the time of DD's birth and filled in the questionnaire with the 'correct' answers, not the real ones..(I have a good memory and remember what i answered when DS was born when I WAS OK). I then poddled to clinic because it was an 'outing'...... DS kicked off, I ended up in tears, the HV swept me off to a private room, made me tea and encouraged me to go the the BF group at the local sure start centre. She even met me there. Then she got me funding for DS to go to nursery 2 afternoons a week and she came with me to several groups at the surestart centre. She KNEW I had PND despite me teliing fibs on the form and she quite possibly saved my life...... (over dramatic I know, I wasn't suicidal, just going quietly mad...)