How do I go about declining a health visitor?

[HomeIsWhereTheGinIs]

I'm 33 weeks pregnant with my first DC and was just wondering if anyone might be able to give me some advice about HVs. I'm having the baby in the private wing of a hospital that is outside of local authority and so far I haven't heard anything about a health visitor. I'll get a couple of home visits from a midwife after the birth and don't wish to have a health visitor. I have heard too many horror stories about their ignorance in very basic baby matters (the most recent being a friend of mine being told to google her baby's wind problem) and resent the idea that the government has taken such a nanny state role in parenting.

So my query is, does anyone know who assigns the HVs? Is it the local authority or the hospital? How do I opt out?

Thank you!

I second all the positive stories. If she visits and you don't like her then cancel any future appointments. It's really not a big deal.

I'm not sure you understand what a health visitor is.

They are qualified nurses/midwives with additional training, who do a whole range of work out in the community and at health centres/GP clinics. One of their roles is to visit new mums/babies and offer a check - up, advice, and let you know where local services such as baby clinic are. That's it, really. They aren't some kind of government control/domestic spy service!

Actually OP I think you raise a very valid point.

The HV's are attached to your GP practice and are allocated in relation to that. I would suggest you make an appointment to see your GP and discuss your concerns with your GP and see if you can meet the HV in advance.

The HVs legally have to offer you the service but legally you are not obliged to accept it. Unless you make arrangements to have mile stone checks (6 weeks, 8 months, 2 years) conducted privately and similar arrangements for immunisations, you may have difficulty accessing these services via the NHS.

In my experience the HV service is extremely variable and too often it isn't fit for purpose with HVs providing out of date of inappropriate advice. It might be worth, however, asking to meet one who is associated with your GP practice and reserving judgement until you have and until you have some direct experience with them.

My issue was their inability to provide appointments expecting to dictate that one would attend their clinics and then sit and queue in them. I won't go into the poor advice I received.

For DC1&2 my HV was rubbish but after the initial home visit where she did the heel prick test and weighed the babies I only saw her if I chose to go to clinic. There a couple of developmental check ups and that was it.

With my younger two I have had a fantastic HV, I had early symptoms of PND and she came round once a fortnight to chat and really supported me, has helped me through DC3's medical issues, advised on tantrums and fussy eating and helped me 'get over' my shock of DC4's unassisted birth.

They also give your baby's red book on the first visit which all weights, vaccinations and developmental checks are recorded. Plus some parents being them into hospital with their children so we can continue recording any information.

You may find you need their support. Babies do not fit a formula.

Gosh, I'm surprised at the amount of irritation this has generated. We have an excellent paediatrician so why on earth would I want a less qualified woman hanging about when I can take any concerns directly to said consultant? What an odd thought.

I'm also not really in need of more friends so even if they are "lovely", I see no requirement for them. It's not just a case of having heard about useless HV's peddling myths, it's that I just don't think that I'll need one. And on an abstract level, I resent the insinuation that the government will be checking my parenting.

I suppose I'll just wait and see if anyone writes to me about this before I take action. Perhaps they'll skip me altogether? Hope so!

Mine were always lovely. Even though they were older women they were not old-fashioned or ill-informed, and on occasion I got more accurate advice about my children from them (as it turned out) than from the GP. They didn't make me feel intruded on or "nannied" but that I had someone to ask who had a lot of experience. If they had been ignorant or stupid, well, I could have ignored them and there are always other HCPs you can consult.

I don't mean to sound rude OP but you don't know it all. There may be childhood illnesses or conditions that you know nothing about, that a good HV would be on the alert for. HVs also look out for PND which it's well known people often don't realise they have or can be in denial about. An HV could literally save your or your child's life by spotting something before you would go to the GP yourself.

As Ginger says, you're being a bit ignorant to write them all off, and the truth is, as a first-time mum is you probably are more ignorant about many things, as were most of us, than a medical professional who has seen and helped thousands of new mums and pfbs.

I've only had very good health visitors who, whilst not particularly needed at the newborn stage, were bloody brilliant when dc2 got RSV 6 months later and I needed a bit of support when he got out of hospital.

They may come and see you after the birth give you the red book and tell you about local services. Smile and nod, they will see you are well supported and educated so they will go away and never bother you again.

Simples.

Once you are discharged from hospital will you still be under a paediatrician? Not usually the case!

I think you offer a very dim and ignorant view of health visiting , you have formulated a judgment on opinion if others and not your own!

My health visitor is lovely she's told me about her history she is a former neonatal nurse which is valuable considering ds was on nicu! She offered the information which was valuable and relevant to us! She is coming back Friday to weigh him and then we will see her in the community!

I think if I was a health visitor I wouldn't want to be visiting you! Make your own opinion !!

In my limited experience, they are a vital part of the NHS.

Believe it or not your paediatrician won't know everything either. A lot of them don't believe in reflux, did you know that? I bet they can't teach you to bf either. Oh and I doubt they know how to wean.

If you've got the money to phone your paed every five minutes with questions that they don't need to answer them go for your life.

Just be open minded OP. The next few months; year; years will push your comfort zone more than you ever thought it could be pushed.

why on earth would I want a less qualified woman hanging about when I can take any concerns directly to said consultant? What an odd thought

Because sometimes, particularly with a first baby, you may have concerns that are in between "not even remotely worried" and "book an appointment with a consultant". But certainly, if you want to run to your excellent paediatrician every time, knock yourself out.

Maybe just wait and see how it all pans out after your baby is born? You might find what your health visitor has to offer is helpful, in which case great, or you might find it not-so-helpful, in which case it's not an issue as you don't have to have much to do with them.

And would the paediatrician appreciate you ringing them every time you have a problem? Can you guarantee getting to see them? Just because you have private post natal care doesn't mean you will get private after care?? Usual channels suggest... Health visitor, gp and then any referrals! So the question is: will the paediatrician be bothered about general health questions/queries as opposed to their speciality?

I had so-so HVs and fantastic HVs. All of them were better than all the frankly lousy, ill-informed, judgemental, disinterested, rude midwives I had!

Also- you may have planned to give birth in a private hospital, but please be aware, should anything begin to go wrong, you will be whooshed into nhs care quicker than you can say "baby's in distress and meconium is present"

Of far more use was the breast-feeding counsellor, who realised DS had tongue-tie, and sorted that out within 5 days.

Good luck with your baby, and whichever professionals are involved - hide that gin!

Also being non compliant with certain aspects of care can trigger a referral to social services whether your intentions are good or not

OP unfortunately you have upset the braying herd by sharing that you are having your baby privately. MNet does not view such things positively. Look up a few HV threads on here, I have never seen one go well due to people's dire experiences of the service. Alternatively, post again and phrase your post differently - make it about how do you find out who your HV will be and how to get the best out of the service or whether anybody else found alternatives.

Good luck - I don't think you are wrong or deserve the flaming you have had on here.

Paediatricians can be imperfect too. I know from professional experience (I'm a lactation consultant) that their knowledge of breastfeeding, infant sleep patterns and starting solids can be extremely limited for starters. Not to mention reflux, tongue tie and colic. You simply won't know until you are in certain situations.

As with most aspects of parenting, you gather knowledge from different sources, assess the evidence-base and make a judgement.

HV contact is usually extremely limited if that's what you prefer but there are advantages to making initial contact and getting local information.

OP, I feel the same as you. I would like to opt out. I will have a private mw to check we're ok after the birth and I don't have any desire to be visited in my home by someone who is somewhere between a healthcare professional and a social worker. I have also not heard a single good thing about any of our local ones from friends (but most have been too scared of being reported to SS to decline their pointless visits). However for an easy life, I intend to let them in once for the initial visit and then opt out so I don't look like an "avoider" although frankly I resent feeling like I have to do this.

why on earth would I want a less qualified woman hanging about

Bloody hell! You have spectacularly missed the point of what they do.

I found it great to have an experienced friendly face come and spend time talking with me. The issues I had would have been a waste of time for the Doctor and he wouldn't have been able to answer them as he did not have the experience she had.

I particularly valued her because I was massively unprepared as to how insecure I would feel suddenly out of my normal experiences. You will have a huge learning curve to suddenly come to terms with.

I think people are sounding irritable because you are being very dissmissive and condescending about something you have no direct experience of.

My health visitor was rubbish, but I smiled sweetly and kept her onside, attended enough weigh ins to keep her happy etc.

She left and was replaced by a bossy one. I did the same. She took over my referral to speech therapy from my doctor, moved it on and was incredibly supportive. When there was a problem, she knew where to go and how to get it moving. Well worth keeping.

I have found that you get rubbish consultants, doctors, or just a rubbish consultation where it does not work out. The good ones are good, regardless of qualifications. The same is true of the school system.

Also health visitors will be much better informed on the non-medical but still really important things compared to your GP or paediatrician e.g when to refer to speech therapy (just an example)

Oh, are you French? (paed comment)

Once my babies were out, I never saw my consultant again...