Rethinking vulnerability
Could broadening out how we think about vulnerability benefit all families with young children?
'I was so sort of frazzled and upset … it is the hardest thing … there was a lot of guilt tied up … I felt really self-conscious … I just started crying I was kind of confused by it all'.
These are some of the emotions expressed by women talking about caring for their babies and young children as part of a recently-completed study. The study explored mothering and health visiting practices following the implementation of Health for All Children (fourth edition, often referred to as Hall 4). The policy shift of Hall 4 meant that, although health visitors would continue to have contact with all families, as they did before Hall 4, the focus of their work would, predominantly, be with families considered the most vulnerable, who are often referred to as 'vulnerable families'. The study involved in-depth interviews with and analysis of the accounts of 16 health visitors and 20 women.
The health visitors' accounts revealed that they thought that their knowledge and expertise about the families they were working with, and children's health more broadly, had changed. The changes reported by the health visitors reflect a shifting emphasis in the practices shaping how child health is talked about, understood and enacted, from a focus on normality to a focus on risk. Health visitors identified that observation and relationships, work with families, in homes and clinics, and over time, are central aspects of the work they engage in to understand families, and the relationships between family members, and their needs. Health visitors thought, however, that opportunities for this work with families had diminished.
The women interviewed (the majority of whom had not been categorised as mothers in 'vulnerable families') worked through their research accounts to demonstrate that they were coping as new mothers caring for their babies and young children. However, the detail of their research accounts, and in particular the emotions expressed, suggests that any mother can feel and be vulnerable. Is vulnerability, then, an inherent aspect of human experience? And, if we broaden how we think about vulnerability could this benefit all families with young children, including the most vulnerable?
The concept of vulnerability in the contexts of mothering and health visiting practices is explored in a short film made in collaboration with artist Rosie Gibson (previously CRFR artist in residence), and based on the findings of the research: https://vimeo.com/62327287. This experimental piece considers issues of framing and managing vulnerability. It draws on the narratives of mothers and health visitors to consider the dominant ways in which vulnerability is couched through professional practice. In doing so, it aims to open up discussion about what it means to be vulnerable and how to provide timely and meaningful support.