Antenatal Health Visitor - home appointment - early September

[ShootingStar71]

Can someone help me please regarding health visitors? I've received a letter today advising that one would like to visit my home in early September (baby due early October & I'm in the West Sussex area). The letter implies that this is normal procedure however I'm not so sure - it mentions in my notes that I will receive 'targeted pn care' as I've a history of mild anxiety which made me worry even more. Is anyone able to tell me if this is normal procedure for every new ftm I this area (or others) & what I can expect from this visit please? I'm slightly nervous having googled & seen some of the things that they seem to ask...does this sound silly? Not sure why I'm so concerned, our house is always spotless (despite our gorgeous black labrador puppy & two mogs). OH is doing a great job trying to reassure me that this is normal procedure. Any advice/thoughts would be most gratefully received. Thank you

Hi, I'm a HV. We are currently paid to do 50% antenatal visits in my trust by our commissioners. Don't worry at all, by March 2015 we will have to visit every pregnant mum by 32wks.

Contrary to popular belief, we're not all dragons in twin sets and pearls!! I love antenatal visits, they are my favourite visit type.

Thank you for the reassurance I'm such a worry wort??you must think I'm bonkers

I don't think you're bonkers at all!! It's totally natural to be anxious. Hopefully your HV will be lovely and be able to put your mind more at ease.

My GV did an ante-natal visit. We chatted over coffee and got to know each other. She is brilliant and has been a godsend regarding DD1's silent reflux.

I was also offered an antenatal HV visit. Letter said to introduce me to the HV so I knew what their role was etc. I declined as ds is only 14m and they have been useless so far so I don't expect them to be any different with this pregnancy/child!

I had mine last week - we filled in the medical records for the baby. It was so much better than doing it with a newborn!

I had this too, jumped to conclusions about them 'checking me out' couldn't be more wrong, the hv that came to see me was just lovely and explained it was more about meeting each other and knowing who was coming to see you antenatally so it's not just a stranger on the doorstep when they do arrive

I'm amazed that mild anxiety would be enough to cause them to visit you - I think it might be more likely that they are just making lots of visits to pregnant women. It wasn't standard in our area when I had DD a few years ago. They probably are more interested in explaining what they do and getting you interested in using their support when your baby arrives than checking out your home.

It's a little odd though. I'm planning to work until 37+3 if all goes well, full time. Finish 2.5 weeks before Christmas. It'd be tricky enough to fit in yet another appointment then, let alone before 32weeks.

That time of year gets full fast. Can it not be joint with a midwife appointment instead, or like postnatal visits is it a wait in all day job?

Mcdog, what info are you getting at that appointment?

Knotty I must say I was just thinking the same thing.

I am under consultant care and right now they are looking to see me about every 4 weeks plus MW appointments at that stage are, in my area, about every fortnight according to the leaflet we got given. My diary at work is pretty rigid and fills up fast; I wouldn't really want to take a morning off work just to sit about chatting to someone over coffee.

Obviously I wouldn't want to be difficult but I can see that being so stressful. Presumably you can decline if you want without starting some type of red flag situation?

Crikey, if it's a wait in all day deal no way could I do that that's awful, do they just assume women don't work?

It wasn't a case of waiting in for them to turn up, she made an appointment with me, the 1st one I couldn't make due to work so we rearranged for my first day of mat leave @37 weeks, there wasn't any pressure though and she made it clear wasn't a problem if we couldn't schedule before antenatal care started, I felt it was worth it if nothing else so I know who she is when she turns up after baby is born, hope this helps

Ah yes, that does help, thanks :)

Work is just crazy that time of year, and this year in particular I'll be looking to wind up projects, meet deadlines etc in time for going off, I can't imagine taking a day off - but if they are not difficult about delaying it, fine.

it mentions in my notes that I will receive 'targeted pn care' as I've a history of mild anxiety

If you have have an history of mild anxiety you are statistically at higher risk of developing post natal depression. Hence why you are being 'targeted'. The principle is to start a relationship before the baby is born and to make sure you are aware that they are there to provide support should you need it - and hopefully to try and prevent it.

It does make sense. I know it is currently standard in my area, after years of not doing it - though I am classed as having a history of anxiety too.

I had mine last week. I was dreading it and was very anxious about it. She was actually lovely and it went a lot better than I expected. Though comment has been made about my guinea pigs, which seems 'a little OTT'.

I think the way it is presented though - especially to those who have anxiety - can leave something to be desired.

Thank you for the reassurances ladies although I have to agree that this will mean even more time off work which isn't ideal at the moment...feel like I'm always out for appointments & feel bad for my colleagues who just have to put up with it x

Knotty knitter, the info we gain from the appt isn't as important as the relationship building, does that make sense? In the OP case, because of her elevated anxiety she is at greater risk of developing PND. If the relationship building has already started, then it's one step less in enabling her to seek help/get better.
The info we get is fairly generic, and would be stuff we would ask at a new birth visit anyway (family health history, significant issues in parents own childhood, any previous pregnancies etc etc).
OP, don't feel guilty about time off for antenatal appts (consultant, midwife, HV, whoever!!). You are legally entitled to them for a reason.

Good luck, let us know how it goes

But how is it targeted when you have a quota of 50% by 32/40?

I don't dispute that the HV service is vital for new mums, especially those with PND or other issues, but keen to know a bit more about the setup of this new service as first I've heard of it despite working in healthcare myself.

I assume targeting is on risk factors like pre existing mh issues, and things like primips, no local family, postcode/socioeconomic groups/ qualify for sure start allowance etc, problems in pregnancy, disclosed dv etc? But which of these? And who comes in next if there aren't enough in that group one month? Who's left out when there are too many?

Is changing gp in pregnancy a red flag (we moved house, and I've yet to see anyone at the new surgery other than reception to fill in forms. This to me is a good thing, I've been healthy!)

And it's never about being entitled to the time off so much as that particular bit of pregnancy being when a working mum to be is at her most frantically loose-end-tying ready to go off on mat leave, alongside getting bigger and more shattered, concerns about leaving everything ready, ensuring cover trained and adequate, clients prepped re changing personnel etc. adding another surprise appointment on top of this seems counter intuitive, or are you expecting that mums to be are already sah?

Sounds like the letter is badly worded at best, and perhaps the appt should be discussed and booked face to face at a cmw appt instead.

I think this is a new thing and depends on each local health authority. I have my appointment on Monday when I'll be 39 weeks, she was very happy to wait until I'd finished work to have the appointment. At my NCT class we're from four different counties / health authorities & three of them do pre visits and the other one doesn't. I think it's a good idea as it allows you to get to know your HV before you're sleep deprived and trying to deal with a newborn.

It's definitely a new thing here - DS is 2 and I didn't have an antenatal appt with him but have done this time.

Knotty again agreed, if you are in a professional role it isn't always the case that others can take over your duties so you don't have "time off" for antenatal appts, you just work late that night to make it up! If you have a deadline to meet, saying "it's okay, you're entitled!" Isn't much use.

Mind you, I must admit to feeling quite conflicted about HV so it is possible I have a skewed perspective. I don't have clinically documented anxiety but I am a really anxious person and even the thought of HV visits raises my blood pressure. So wish you could just see them at a clinic, like a normal professional medical appointment, and not have this faux-matey "I'll just pop round for a cup of tea and a natter" approach. I don't want a "relationship" with a HV, just an avenue for advice and check ups for my baby when necessary. I appreciate I'm in a minority though

I agree with RevoltingPeasant, I don't want the HV to either target me or be my friend. I don't want cosy chats over tea and biscuits. You are not my friend. You are a HCP and I would like to keep that you at a distance. If I want help, I will ask for it.

I appreciate I may not be in the majority, but I can't help thinking that if you are told that you are "targeted" and could need more help, then it will be a self fulfilling prophecy as your anxiety levels increase because you are a target!

I was a bit peeved last week as I had to book time out of work (self-employed professional so not 'entitled') to be home for the health visitor antenatal visit and then 5 mins after appt time her office rang to say she was going to be late as she is in a meeting. WTF? schedule a meeting when you have an appt? So I ask how late, they're not sure. I say I have to go back to work in an hour, they ring back to say she will be longer than this!! I took great delight in saying I wouldn't be able to do either of the other appts they offered me as my work rota would mean me cancelling my consulting time!! Not how to win over a new mother me thinks!

Urgh i really hope they havent/wont roll this out in my area. I hated hv visits after ds was born. so bloody doom and gloom - "you will get depression" crap and caused me great upset by telling me how my baby was going to die because he was a medically necessary tummy sleeper (his airways were closed off by a badly positioned artery when flat on his back, it effected him least on his tummy). Also never turned up within an hour of an appointment time - first time didnt even bother to make an appointment, was just angry with me for not being in!

OP dont worry - just smile and nod, they leave quicker that way. I did find one helpful hv at baby clinic (i tried them all in the local area), went there if i actually wanted advice.

I don't know about the targeted bit in your letter, but in our locality that is decided by the midwife. We obviously don't know anything about you prior to what they tell us. The 50% is of all antenatal mums, not just targeted.

Changing GP isn't a red flag where we are, don't really get why it would be anywhere else unless there is prior history of CP etc.

I don't think you are in the minority by not liking HV visits, historically we have been awful about explaining what our job role is. I always make a point of explaining what we are for. The vast majority of my job is sadly child protection, which means for "normal" families we can be elusive creatures. I legally have to prioritise any CP issues (rightly so), so sometimes I have to cancel visits at the last minute. It makes me furious that I can't devote time to universal mums, but I can't split myself in 2

Honestly OP (and anyone else) I (can't speak for other HV's) am not there to catch any mum out.