Stepping out of the system

It can be a lonely and scary place swimming against the tide of opinion. Going out alone and standing up for what you think is right can be a hard thing to do, especially when it brings with it emotional ties such as your children. 

Before you read this post, it is important that I make it clear that this is in no way a rant against Health Visitors per se. I absolutely recognise that in many areas and for many families, the Health Visiting Service provides a really important function and source of information, advice and reassurance.

I sat down to write this post following my own recent experience with my local service since Emma was born. After becoming frustrated I posed a question on twitter and Facebook along the lines of 'Has anyone ever withdrawn from the health visiting service' and was surprised and dismayed with the responses I received.

The responses highlighted wide and varied experiences of the Health Visiting service so I thought it would be useful to blog about my own views and experiences and to explain why this week, I will formally withdraw myself, Emma and Daniel from this system.

Being out on a limb and taking an unusual position is challenging, however one of my favourite sayings in life is 'If you stand for nothing, you'll fall for anything' and for me, my recent experiences have tested my own beliefs in what the service should be doing and has really affected me at home in terms of feeling anxious about the whole thing. This is not a good or healthy place to be in.

This post documents how I have reached this position.

When Daniel was born in 2012 the health visitor made contact and popped in for a chat. She was a bit too touchy feely for my liking, but signposted me in the direction of various places I could go to for advice, gave me details of the local baby clinics and made arrangements to revisit some weeks later. On the second visit we had a chat about how things were going and it was left at that. No more contact.

This is in the context of Daniel being my first child and arriving early due to me having pre-eclampsia. Daniel was also extremely poorly in the first two weeks after birth and ended up back in hospital for for 3.5 days with one to one nursing care (they literally had a nurse staring at him in his incubator for 24 hours whilst they monitored loads of machines etc). It is absolutely not an exaggeration to say that had we not taken him into hospital when we did, both my husband and I believe Daniel would have died.

Following numerous tests it was diagnosed as a mystery virus and his weight plummeted. He was a small baby when born at 5lb 5 and his weight dropped to somewhere around 4lb 10 and took him until he was around seven weeks I think to get back to birth weight. He sat below the bottom centile line for a long time. At 20 months old his weight now sits between the bottom two lines. Even when he started gaining weight it was a slower than average gain.

Emma arrived on her due date, a straight forward birth and I was discharged that same day. There were issues around slow weight gain which I have blogged about and at the time I felt under enormous pressure from midwives and the health visitor. She was fine in all other ways, just gaining weight slowly, as her brother before her had done. I was referred (against mine and my husband's better judgement) to the hospital. However that appointment took six weeks to arrive, by which time her weight gain was fine so we cancelled the appointment.

Here is where things go wrong.

The 'red book' provides a guideline for getting babies and small children weighed. Once a baby has regained his/her birth weight the recommendation up until six months of age is for them to be weighed no more than once a month. After six months it's no more than every two months. There is no minimum guide.

With Daniel I took him to clinic to be weighed as and when I felt like it. He was clearly growing and meeting developmental milestones and frankly spending a morning queueing to get into a clinic didn't seem like the most useful way to spend my day. I did not take him every month.

Now I have Emma taking them both to clinic is challenging. I simply cannot keep a close eye on my boisterous and energetic toddler whilst undressing Emma and getting her ready to be weighed. At clinic there are lots of new babies and whilst Daniel wouldn't purposely hurt them, there is a reality that at 20 months old he doesn't understand how delicate newborns are.

My Health Visitor for Emma is someone new to me. And she is pestering me. She has visited the house three times (the last being around a month ago) and last week has phoned me at least four times, left three messages and sent me a text message. The reason?

I'm a bad mother – I haven't taken Emma to be weighed for six weeks.

I was incensed when the text message I received Thursday afternoon suggested I was avoiding her calls – I wasn't although I am now. With two under two I rarely have my phone to hand, and if I do Daniel usually wanders off with it to call Grandma! And in any case I simply cannot have a proper phone conversation with anyone whilst the children are around. When the kids are in bed, around 7pm that is when generally catch up on text and phone messages. As I'm sure my parents, sister in law, friends and cousins will tell you I am hopeless at replying. Its nothing personal, I just sometimes never seem to get round to it.

The message from the HV also said she would pop in the next day at 12:30 to see me. An awful time to , choose as that's usually lunch time then settling both children for a nap. In any event I already has plans on Friday to sort out my new glasses and couldn't guarantee when I would be home.

I sent a polite message saying I would plan to go the weighing clinic on Tuesday (which is a three minute walk from my house). She then phoned again Friday morning and left a message which politely suggested that whilst I could go to the Tuesday morning clinic it might be better for me to go to the Thursday afternoon clinic in the next village that she was running. In any case she would 'check my file' to make sure I'd been and then she still 'needs' to catch up with me so she'd let me know when you'd be popping in.

I am livid. Despite the issues Daniel had early on, my HV at the time recognised that I was more than capable of looking after him and helping him as he grew and developed. My new HV seems intent on making me engage with the health profession more than I want to. Emma does not have any medical issues. She does not have any identified developmental issues. At 17 weeks old she is doing all that she should be (and in some cases more). She is streets ahead of where Daniel was at a similar age in many respects. So why do I feel I am being bullied, coerced and harassed into complying with a system?

I took Emma to the clinic on Tuesday and will now be sending a letter to the local HV team and my GP to advise that I wish to withdraw from the local service, and should I have any problems I will access my GP, practice nurse of the HV team at the well baby clinic.

What has been really interesting is that when I have posted stuff about this on Facebook and twitter a lot of people have replied with 'ah, but they're only doing their job'. That may be but it doesn't mean that the job is right.

All too often people comply with these things because they feel compelled too. Society tells us we should do, and not to do so marks you out as a trouble maker.

That's fine. I am already a bit wacky – I 'wear' my children, I don't give them pureed baby foods,. Emma will be weaned as and when she shows signs of readiness and we will follow a 'baby led weaning' process, as we did with Daniel. I do not recognise the notion of baby foods; only food that we all, as a family enjoy together. This is contrary to the information the local HV team provide. I have even offered to speak at weaning sessions about my own very recent experiences of weaning and how and why we chose the approach we did with Daniel, and will follow with Emma. This was declined.

I use cloth nappies and wipes (despite one GP I saw saying Daniel would be much better off in disposables) and I routinely question what they are telling me.

I do not believe that my family Doctor or health Visitor knows me or my children better than I do.

When I am told I have to see my GP because my son and daughter do not match a chart in a book I lose all respect for the process. In my family there are four females (my mum, auntie, me and my cousin). We all look different, different height, weight, skills and abilities. I would love to see the chart we all sit on. Same in my husbands family. Aside from physical facial features and hair colouring etc he and his siblings are all different builds, weights and heights and have very varied personalities. What charts do they fit on?

From my tweets on twitter I had comments such as

'Gosh, I can't get to see a health visitor for love nor money'.

'that's such a shame, my health visitor is brilliant'

'aren't you worried you will be referred to Social Services'

It also seems that in some areas parents are told that it is mandatory to have their child weighed once a month. My response to that was what if I had returned to work after the mandatory two weeks of maternity leave? How would they MAKE me take Emma for weighing?

Interestingly in some areas mums talk about a four month check – this doesn't exist in my area. Importantly the NHS website describes the health visitor role as:

A health visitor will usually visit you for the first time around 10 days after your baby is born. After that, you will see your health visitor at the child health clinic, although you can ask to see them at any time. If you're bringing up a child on your own or struggling, your health visitor will probably come to see whether you need any help.

A health visitor is a qualified nurse who has had extra training. Part of their role is to help families avoid illness and stay healthy, especially families with babies and young children. Health visitors are members of a team that offers screening and developmental checks as part of the Healthy Child Programme.

Talk to your health visitor or a member of the team if you feel anxious, depressed or worried. They can give you advice and suggest where to find help. They may also be able to put you in touch with groups where you can meet other mothers.

Your health visitor can visit you at home, or you can see them at your child health clinic, GP surgery or health centre, depending on where they're based. Your health visitor will make sure you've got their phone number.

My HV is going way above the role outlined by the NHS and forcing me to engage with the team is causing me undue stresses and hassle.

Am I worried about the repercussions of formally withdrawing from the service? Perhaps but I'm confident in our parenting techniques and abilities. Until any welfare or developmental issues are raised to us then I absolutely refuse to continue to engage in the charade.

If I stand for nothing I will fall for anything. The time when my children are small is so fleeting that I do not, and will not, have that time marred and taken up by adhering to charts, tick lists and other peoples systems.

I'd be really interested to know what has been your experience of Health visitors? Have you decided to opt of the system? How did it make you feel?