Common vs. Normal
These two words are often used interchangeably but let’s break them down to make more sense out of what they mean in the Postpartum Period.
Firstly I like to think to myself what is at the core of the question? To get at the core I reflect on how I will use the information I get in the response to the questions, “is _____ common” or “is _____ normal?” Usually the response I am looking for is one that will answer either or both of two core questions:
How will I know when everything is fine or when I need to seek additional help?
If this is the core, I will use the information from the response to determine if there are additional steps I need to take to address my health concerns. In this scenario, I feel that something is “off” even if I can’t quite identify what specifically is not quite right, I am asking questions to help clarify my options and further my understanding so that I can advocate for myself.
Am I alone in experiencing this or is this something that others experience as well?
If this is the core, I am mostly looking for a response that provides me with reassurance that I am not alone. I am looking for comfort more than resources. In this scenario I feel that my physical health is not in jeopardy but emotionally/mentally I am seeking support, empathy and/or validation.
It is important to reflect on these core questions, the “questions within a question”, because much of what occurs in the postpartum period exists in a sort of gray zone. When discussing concerns with care providers there is often a large gap between what is said and what is heard, often leaving questions unanswered or only partially addressed.
Let’s take the “Baby Blues” for example. By the numbers, baby blues is extremely common. The data suggests that nearly 80% of mothers experience the baby blues at some point within their postpartum journey. That’s a lot of moms, which may answer the core question, “Am I alone in feeling this?”, with a resounding “No.” This may feel reassuring, but sometimes reassurance isn’t enough, which would take us to the next question.
When it comes to the question of “is this normal?” and “do I need to seek additional help?”, things get a bit more complicated. It’s such a grey-zone that the Merriam-Webster dictionary even prefaces their definition with this disclaimer:
“We are of course a dictionary, not arbiters of social matters, and so must restrict our opinions on what is ‘normal’ to lexical matters. What is normal is a fluid sort of thing…In present day, normal is perhaps most often used to mean “conforming to a type, standard, or regular pattern,” or “you know…regular.” But types, standards, and regular patterns (or what is considered “regular”) undoubtedly shift, and even when static are largely subjective things.”
My key take-away from this disclaimer is that last bit: normal is subjective - you get to define it for yourself.
This is important to realize because often in the postpartum period, when we raise a concern we might be met with the response of, “oh that’s normal/common” as a way to reassure us but it may also feel quite dismissive. It’s important to pause here and remember, don’t assume something is normal just because it’s common (don’t assume that every health care provider is aware of this distinction as well, especially if they aren’t specifically trained in postpartum mental health). Listen to your gut, if you feel something is wrong then you have the right to get it fully checked out (see Postpartum Mental Health Resources blog for care options).
Be persistent until you get the true answers you are looking for, understand the gap between what is said and what is heard and keep pushing to close that gap until you get absolute clarity. Communication is a practice, not a one and done transaction, so if the message isn’t getting through, and you’re not getting the answers you need, keep practicing with different approaches until you are satisfied with the results.
So back to the example of the baby blues…
Let’s say you come in for your 6-week appointment. You know, or at least now you know, that the “baby blues” should go away around the 2-3 week postpartum mark. Yet, you feel that your feelings of sadness are persisting, you find that they are frequent and impact your life in ways that aren’t managed by your normal coping techniques. You tell your provider, “I am having a really hard time with the transition to motherhood, I am often sad and cry frequently.” She replies, “I hear lots of mothers say they find this transition to be a rocky road, up to 80% of women experience the baby blues, and the feelings often go away on their own over time.” Your provider is confident, empathetic and caring, you may feel tempted not to burden her further with your questions, you know she has limited time to see each patient, maybe the baby begins to cry, it’s time to eat again. What do you do next?
It can be tricky to gather your thoughts in this situation and advocate for yourself, but it is so important that you do so. Often we think, maybe I’ll just see what happens and if it doesn’t get better I’ll attend to it later, but then later comes and we don’t feel better and we also don’t have extra time to spare and so it just gets pushed to the side.
So rather than wait and leave still wondering what help you could’ve possibly accessed had the communication barriers not existed, I’ve come up with a script you can use as you advocate for the care you need and deserve.
“I appreciate that the baby blues is common, however, over these past 6 weeks things have been (staying the same) or (getting worse).
My usual coping methods aren’t working to improve things. I’ve already tried _____ and ____. I am concerned about_______(postpartum depression, anxiety, OCD, my ability to care for myself/the baby, the impact on my relationships, etc.)
This is not normal for me. Since baby blues usually ends around 2-3 weeks, what other resources can you offer me now?
Specifically I would like to know about ______(therapy, support groups, medication, etc.)”
The key is to be as specific as possible as you communicate why it is not normal, what your concerns are, and what you need from the provider. By being specific, you are getting to the core of the question and this gives your provider more information to work with and more guidance as you work together to uncover possible solutions. Healthcare providers are humans too, sometimes they need a little extra direction to provide us with the best care possible. I hope this blog has shed some light on the difference between “common” and “normal” and helps you navigate these nuances so you can confidently advocate for the care you need and deserve.
*Note: If your provider as screened you for a postpartum mood and anxiety disorder (PMAD) using a survey and you’ve screened negative, meaning that the results from your survey indicate you do not have a PMAD, yet you feel you need additional support, you still have the right to more services! You always have the right to more care when you feel it is necessary, a survey is just a tool that catches most cases, most of the time. Most, not all. So if your provider says, “You’ve screened negative, you are good to go.”, respond with, “I would like to take a more proactive approach, even if the screening is negative now, I would like additional resources to prevent problems from worsening in the future.” Remember, an ounce of prevention is worth a pound of cure, it’s better to go ahead and get connected to the resources and end up not needing them than to need them when you hit rock bottom and are feeling utterly overwhelmed. Don’t let numbers on a piece of paper (survey results) stand in the way of you and the care you deserve.
