At some point in her life when thinking about her health, every woman has almost certainly asked herself the question 'is this, and am I, normal?' Pregnancy and motherhood provide even more opportunities for self-doubt when it comes to wondering what is normal; the gamut of experience being almost unknowingly broad.
This week is the Jean Hales Women's Health Week. The theme for 2016 is the question 'Am I Normal?'. The driving point is the reassuring answer that when it comes to women and the vast range of physical and mental health, pretty much everything is. One of the main reasons women may question the normality of something they are experiencing or enduring, is a reluctance to talk about it, hence the Women's Health Week campaign of 'No More Elephants!'.
Pip*, a mum of two, developed vulvar varicosities (think varicose veins in the worst possible place) when pregnant. She says, "It was only diagnosed by a midwife after the birth, when I had lived with them for months, getting gradually worse. I had been told it was just my body getting ready. To me it didn't feel right, but I didn't know what was normal or not so I just got on with it."
Just "getting on with it" is something that we, as women, are exceptionally skilled at, proud of even. When the rest of the family goes down with a bug it is us who soldier on without complaint. Feeling (even knowing) that we are the glue holding the family together can mean we worry that something challenging for us, or seemingly wrong looks like a sign of weakness, of failure.
Midwife Reenie, sees women all the time who feeling as though they are letting their family down, that they are somehow "not normal".
"If I could only sit them all down together and show them how similar they are it might help them all. I think it is changing, but not fast enough. There are still new mums staying at home, too nervous to connect with others, sometimes not even willing to open up to friends," she says.
It was a midwife who finally diagnosed Pip's condition. Pip explains, "She came to check my stitches once we were home. She listened to me describe the pain then got me to stand up while she checked. No one else had done this and when I lay down the pressure eased so they were impossible to feel. By that time (after birth), there was nothing they could do; it was just as case of waiting for the pain to gradually go but it would have been good to have known before then that it was a real thing and there was something I could do about it."
Reenie applauds the midwife for her approach; "sometimes it helps to try something in a different way, there can be so many different presentations and symptoms of things that you always have to keep lots of options open until we work something out or find a treatment or solution. There isn't much we (midwives) haven't seen so we're pretty hard to shock. Women can tell us anything; it's what we're here for."
Mental health care in women, especially during the vulnerable time of pregnancy and motherhood, is an especially important area. The number of women presenting with some kind of depression or anxiety pre and post birth is increasing, though Reenie hopes this is because more women are being diagnosed and asking for help.
"There is a test that we use to determine the mother's risk of PND but it is possible to tweak your answers and so change the outcome. We need to remind mums that there are no right or wrong answers here," she says.
Answering the questions in the test with the aim of manipulating the answers is something that Lizzy knows all about: "I had a traumatic birth with my first born, there wasn't a bed in the maternity ward so I couldn't be induced. After 52 hours and baby being in distress he was born but suffered meconium inhalation so was in the Special Care Baby Unit for a week. When I returned home I felt stressed and like I was in a bubble. I struggled with bonding and breastfeeding my child and guiltily gave up after five weeks. The breastfeeding support group were useless and didn't consider my birthing history.
"I felt abnormal and like I had failed my son by not breastfeeding. I even 'faked' my assessment from the health visitor to ensure she didn't know I was struggling and suffering as I suspected from post-natal depression. Admitting that felt like the ultimate failure as a new mother. I wish I had asked for help, as it's become clear that there are lots of mothers out there who also struggle and I wish I'd have known I wasn't the only 'abnormal' one."
Finding other people in the same situation can offer valuable help, especially when the experience is happening for the first time. Women's Health Week, as well as providing great professional resources, encourages women to talk, to share their stories, concerns and experiences. It is through this, by getting rid of the elephants, that women's health will truly improve.
*Name has been changed.
Julia Cahill is mum to three boys and a freelance writer in between. She writes about the rollercoaster that is life at www.juliacahillswords.com.