What Is ‘Normal’, Anyway?

What is normal?

It’s a question I’ve thought a lot about.

Last year I wrote about how growing up I sought to be different, thinking ‘normal’ was boring because it means conforming. After Hugo’s death, however, I would give anything to be a ‘normal’ mum – using the term ‘normal’ loosely, to mean having a baby in my arms to care for.

Besides connotations of conforming to a standard, normal can mean usual, typical, ordinary or expected.

That’s why I’ve been protesting against the concept of ‘normal’ birth – yes it means natural, unassisted, but there is so much diversity in birth experiences such a term can put unreasonable expectations on women.

There are also the cases – like mine! – where events were nothing but normal. Getting HELLP syndrome at 24 weeks’ pregnant, being cared for in two hospitals with a blue-light ambulance ride in between the two, waking up in intensive care after a Caesarean section under general anaesthetic are all extraordinary events, in the truest sense of that word.

But does being unusual mean I am not normal?

Of course not.

We need to be careful about the language we use.

A case in point was at the Women’s Safety Day at the Royal College of Obstetricians and Gynaecologists a few weeks ago. During a break out session, a topic of conversation was the care women need on the post-natal ward. It appears the focus of the discussion was on women whose births had gone to plan, so I piped up promoting the needs of women who had had a complicated or traumatic birth, and/or whose babies were in the neonatal unit.

The consultant obstetrician leading the conversation replied with a dismissive comment along the lines of making a distinction between ‘normal’ women, and the ‘complicated’ ones.

I made the tweet below partly in jest, partly in frustration.

 

Language matters. You have to be so careful when choosing words. It is not heavy handed policing or making health care professionals so paranoid about saying the ‘wrong thing’ they feel they cannot say anything at all.

It is about recognising that every woman in that postnatal ward – whether hypothetical or real – is an individual, with her own hopes, fears, expectations, and needs.

We cannot divide them in to ‘normal’, and ‘complicated’.

We do not fit in to neat little tick boxes.

Another example is when having a recent intimate examination. The nurse was unable to find my cervix even after much jiggery-pokery (literally) with a speculum so she called in a doctor to help. Lying flat on my back on the couch and with legs akimbo it was difficult to see the doctor when she arrived in the room, but thankfully she did introduce herself before getting down to business.

She too had trouble locating the cervix: more poking ensued. Surely it must be there somewhere, I thought; it can’t have gone far. I wouldn’t have blamed it for scarpering though: it has gone through a lot the over past few years with pre-cancerous cells being lasered away, and immediately prior to Hugo’s birth being prodded somewhat painfully to see if it was open (it was shut fast, hence the C-section) as just a couple of examples.

So, I was lying back, thinking of England with two strangers exploring my personal parts, wondering where on earth my cervix had got to, and trying to not worry (surely nothing else could go wrong with my reproductive system…?). The doctor asked whether my periods are normal.

“Well, yes they’re normal for me,” I replied.

“Yes, but are they normal?” the doctor persisted.

Now I really did start to worry. Her response gave me cause to panic – what if the evidence down below suggested otherwise? What if my magic disappearing cervix meant I was deluded in thinking my periods were normal?

The panic thankfully subsided after a few moments because – phew! – the cervix was located. Hurrah!

A better approach would have been an open question: “What are your periods like?” The doctor could have then ascertained from my description whether any alarm bells needed to ring – and without alarming me (especially in my vulnerable position).

The health care professionals I describe weren’t doing anything wrong. They were doing their best to give women in general, and me in particular the best-possible care.

‘Normal’ isn’t scientific, nor can it have an evidence base because it is such a subjective term. What is normal to me is unlikely to be normal for you. As such, it should be used with caution in health care conversations.

Because what is normal anyway?

Normal is an illusion.

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17 Comments on What Is ‘Normal’, Anyway?

  1. Jenny
    November 10, 2015 at 12:28 pm (4 years ago)

    Your posts are always food for thought and inspiring darling. I agree you really need to be careful how you say things or word things. Some people read into it more or differently. Thank you for linking up to Share With Me and I hope to see you again tomorrow for another great round. #sharewithme
    Jenny recently posted…Letters to him & her ~ #35My Profile

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    • Leigh
      November 12, 2015 at 9:42 am (4 years ago)

      Thanks, Jenny, I’m glad my posts are good food for thought! xx

      Reply
  2. Jess Helicopter
    November 4, 2015 at 2:03 pm (4 years ago)

    I HATE the word normal. My brother has severe socialaphobia and we learnt very early on not to use that word to compare his (or anybody else’s) life to. Great post #TheTruthAbout
    Jess Helicopter recently posted…Spread The Christmas LoveMy Profile

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    • Leigh
      November 9, 2015 at 10:29 am (4 years ago)

      Yes – I really think there is no such thing as ‘normal’ – we’re all individual. Thanks for commenting xxx

      Reply
  3. Catie: An imperfect Mum
    November 4, 2015 at 11:50 am (4 years ago)

    I think your question was spot on. I hate the term ‘normal’ as mum to a son with special needs. You are constantly asked, was his development normal, does he eat normally, sleep normally… What is normal. I always find it so difficult to answer these questions too because normal for us may not be normal for someone else. Also what is the alternative? Abnormal? The last thing I want my son to feel is abnormal! very thought provoking post, I really enjoyed it thank you!
    Catie: An imperfect Mum recently posted…Autism & Us: Positive Ways of Working on self confidenceMy Profile

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  4. Sam
    November 3, 2015 at 10:46 pm (4 years ago)

    Ooh the word ‘normal’ is definitely problematical and I think it is one of those ones that you really don’t think about too much up to the point in your life when someone else’s ‘normal’ doesn’t seem right to you. I always used to think that the way my family did things was the normal way (for example, we aren’t in constant contact with one another the family motto being ‘no news is good news’ whereas my husband’s family are the opposite and he thinks it’s weird that we don’t ring each other after every journey of over 30 minutes to say we’re OK!!). I think the talk you went to at the Royal College of Obstetricians and Gynaecologists should have probably made the distinction between ‘complicated’ and ‘uncomplicated’ births and the differing needs of each set of people involved and the word ‘normal’ should never have come into it. Glad to hear they found your cervix in the end! I would have had a problem answering the period question too – irregular is an understatement!! 🙂 thanks for linking up to #thetruthabout this week – nice to see you back! Xx
    Sam recently posted…The Truth about… #50My Profile

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    • Leigh
      November 9, 2015 at 10:28 am (4 years ago)

      That’s it, Sam – normal is so subjective it’s ridiculous to use it in most medical contexts! You’re right, differing needs of women post-birth have nothing to do with how the baby came out. Nice to be back! Thanks for your lovely comment xxx

      Reply
    • Leigh
      November 9, 2015 at 10:26 am (4 years ago)

      Definitely, lovely Mel – it’s one of those words you need to think about context, meaning, and implication xxx

      Reply
  5. Melissa
    November 3, 2015 at 8:25 pm (4 years ago)

    I really like this. I agree wholeheartedly. What a tricky word, you don’t realize how damaging it can be. Our new pediatrician recently told me that my daughters tonsils are “generous” and to be sure to remember and use that word if she came in sick to another doctor or urgent care, as they could misdiagnose them as swollen when in fact her “normal” is apparently huge. So strange that the medical field which is science based still uses this stupid word that petty much means nothing scientific!

    Reply
    • Leigh
      November 9, 2015 at 10:26 am (4 years ago)

      Thank you! Sounds like that doctor gave good advice – we’re all individual and what is ‘unusual’ for one is ‘normal’ for another. xx

      Reply
  6. Ella @ Breaking up with contraception
    November 3, 2015 at 4:21 pm (4 years ago)

    Leigh – this was blimming amazing. You write so beautifully and evocatively about such important issues.

    As you know I couldn’t have been happier when I heard the words ‘it’s normal’ in the context of my ultrasound. But yep, I completely agree that calling certain approaches to, say, birth, normal implicitly suggests that others aren’t (e.g. vaginal vs. C-section delivery). Good point too about normal being relative.

    I’m glad they found your magic disappearing cervix in the end…

    x
    Ella @ Breaking up with contraception recently posted…Our first scan: being probed from the inside outMy Profile

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    • Leigh
      November 9, 2015 at 10:23 am (4 years ago)

      Thank you, Ella. I think you’re right, that context is one of the very few occasions where ‘normal’ is something you definitely want to hear! But absolutely, generally normal is relative. Thanks for your kind comment xxx

      Reply
  7. anon
    November 2, 2015 at 9:27 pm (4 years ago)

    My sister has had terribly heavy periods for years and thought it was normal (doesn’t know anything else). She would have answered yes without a second thought

    Reply
    • Leigh
      November 3, 2015 at 1:25 pm (4 years ago)

      Absolutely – that’s exactly the problem. ‘Normal’ cannot be measured or compared. Thank you for commenting xxx

      Reply
  8. SouthwarkBelle
    November 2, 2015 at 8:16 pm (4 years ago)

    As you know I share your feelings on “normal” sadly I also seem to share your vanishing cervix experience! I remember lying on my back wondering how on earth these people couldn’t find it when it felt like half the bloomin hospital had paid a visit a couple of months earlier (in my case it seems there was some dodgy repair work post emergency CS, the planed CS fixed things up – sorry overshare??!)

    Sad to hear of the consultants comments, though not surprised. there seemed to be no thought at all to postnatal care for us “abnormal” mums when I had MissE, decent care at that point would have made a huge difference even though me and baby were basically physically ok.

    Kx
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    • Leigh
      November 3, 2015 at 1:27 pm (4 years ago)

      Oh no – sorry to hear you have a magic disappearing cervix – bit of a nuisance aren’t they?

      Re the consultants’ comment, exactly that. It’s not for HCPs to decide whether mums need additional support dependent on how baby came out and whether or not you are physically ok – a slippery slope for all sorts of psychological problems. Thanks for commenting xxx

      Reply

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