Should public health nurses visit every family with a new baby?

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  • Devina Shackleford says:

    Very telling that there is NO information whatsoever on how to opt out of these home visits. I don’t need domestic violence counseling, birth control counseling, don’t need or want a stranger other than our family doctors examining me or my child, and don’t want or need any of these other services. If I do, I will get them on my own. I understand why the services are offered, and that many women need them, but when I know I don’t I find the questions about domestic violence, my private life, etc., nosy and intrusive. My doctor already knows I will say OPT OUT when she starts on them. I have searched endlessly for a way to opt out, and all I find are sites with glowing reviews from happy mothers, gushing about how worthwhile this is and EVERYBODY NEEDS TO DO IT!!! without information on how to say a polite NO THANK YOU, WE ARE FINE, SO PLEASE SAVE YOUR TIME FOR SOMEBODY WHO DOES NEED AND WANT IT.

    Nearly all the mothers on the sites I asked told me it’s required by law, that I cannot decline any of the services (including exams and tests on me!), and some even said Child Protection caseworkers would come and take away my baby if I even let up so much as a peep to object “because it’s a big red flag!” THIS IS JUST WRONG.

    Some of us have had more than one baby already, some of us have hired home nannies, others have plenty of support and prefer to keep their privacy – like me.


    • Devina Shackleford says:

      Please note that I am asking for instructions to opt out. I am NOT asking for a discussion about how worthwhile this is or why you think I need to comply. Thank you.

  • Alicia says:

    Do we get the choice to refuse visits if we do not want them. Im not comfortable with people I don’t know in my home. I would feel much MUCH more comfortable going to a clinic instead of feeling intruded upon

    • PHN/RN Nurse Home Visitor says:

      @Alicia, the answer is yes. Most maternal child home visiting programs are voluntary and a mother, parent, caregiver who is a referral has to agree to be seen by the home visiting program. Also, consent forms must be signed prior to being enrolled in these type of nurse home visitor programs. Maternal and infant death doesn’t discriminate. Which means wealthy, highly educated, normal relationship mothers/ families have experienced Loss of a loved one in this “status quo class” during their pregnancy, postpartum as well as this same group of people have experienced the death an infant before its 1st birthday.

      • Shayla says:

        I am SO grateful I had a visit from the public health nurse after my daughter was born. If it wasn’t for her, I would not have known my daughter was even tongue tied. The “lactation consultant” I saw in the hospital didn’t even bother to check when I was having problems nursing. The public health nurse also directed me to a breastfeeding moms support group, with nurses and a lactation consultant in attendance every week. Without that group, I would have given up on nursing after a week probably, and they were able to answer so many other questions I had as a new mom. The public health nurse was so kind and helpful, and followed up with me 2 more times after that initial visit. Every mom should have access to this if they choose.

  • Romel says:

    Do public health nurse visits moms and babies from out of country that were discharged from postpartum?

  • Vickie Boechler RN, MN says:

    Bringing a new baby home is a majorlife event even though it has been anticipated for many months. As a former PHN and IBCLC I can cite many many examples of the value of that home visit witin the first 24 hrs. We started the Early Discharge program with the knowledge that mother and baby would be supported by a home vist. This made the early discharge program possible. If we stop doing the home visits then early discharge is no longer safe for the mother and baby. The many reasons for designing the post part/newborn program with an early home bisit are too numerous to cite. It is all about health promotion and prevention rather than waiting for illness to occur with a re admission to hospital. The burden on the new family is too great.

  • Ann GTA says:

    Such a circular argument. Huge self selection bias. Those who are “fine” and “don’t need help” will say no because this isn’t a social norm here like it is in the countries with much better child health outcomes. (Nordic countries.) Meanwhile many of these same moms are in their doctors office or talking with their friends about how hard it all is – how they never learned emotional self regulation but now have a screaming baby, or a baby not sleeping, or tantrums, or, or, or. And they are trying to figure out how to cope, how to not yell or hit because they know they feel terrible after and they know there is a better way. Is home visiting all figured out yet? no. Is it imperative that we figure it out and get it right? Only if we care about the future, the roots of violence, and healthy brain, body and life development. Public programs are phenomenal, even quality child care under age 2 is impactful. But NOTHING has as much impact as the home environment, the family relationships, and the dynamics at home.

  • Adam Smith says:

    Yet another example of public health busybodies wanting to interfere with peoples lives and wag their fingers saying “we know best”. Plus the self-interest they have in seeking to expand their budgets, their importance and their salaries through some form of universal program.

    A good friend of mine (well educated, wealthy, in a stable relationship) said yes to a home visit from a public health nurse after my friend had her baby. That nurse commented about everything that was wrong, wrote up a report and did follow up visits without asking permission. My friend felt like she was being judged by the public health police and now there is a file about her held by the government.

    it is time we learned in health care that more “care” for everyone may not make sense. It is perhaps better to target the care to those who need/want it, more vulnerable etc and leave it all well alone. Plus we need better coordination of care across silos – no point having public health home visits if there’s no coordination with primary care physicians/providers or other providers to the family.

    • Kristy says:

      So Adam, would your friend be able to identify if her baby had jaundice? Or some other condition her baby could DIE from? Just because some one is well educated, wealthy and in a stable relationship doesn’t mean they can identity issues with their baby. Further more is your friend able to assess herself for post Partum depression? Is she able to understand the hormone imbalances her body will go through? Maybe your friend is well educated, wealthy and in a stable relationship but she is not a public health nurse who had been trained for years to identify problems which mothers and babies died from even as little as 10 years ago. If you are okay with babies dying than yes you are right public health officials should mind their own business

    • SHELBIE RADOM says:

      It is unfortunate that your friend had that experience because her in Northern Colorado we have a program that is very successful. The two nurses use a very non-judgemental approach and are truly there to help these moms be successful. They assist with getting resources if needed, sign up for Medicaid, sustain breastfeeding if that is their goal, and so much more. They build a relationship that it motivated by the mother’s goals and needs. The only priority of the program is to have the mothers feels supported and to succeed.

      • Carla says:

        My niece just had a baby 3 weeks ago and she is going through hell how do we go about getting someone in to help her


Wendy Glauser


Wendy is a freelance health and science journalist and a former staff reporter with Healthy Debate.

Michael Nolan


Michael Nolan has served Canadians through many facets of Paramedic Services.  He is currently the Director and Chief of the Paramedic Service for the County of Renfrew and strategic advisor to Healthy Debate

Jeremy Petch


Jeremy is an Assistant Professor at the University of Toronto’s Institute of Health Policy, Management and Evaluation, and has a PhD in Philosophy (Health Policy Ethics) from York University. He is the former managing editor of Healthy Debate and co-founded Faces of Healthcare

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