I have learned a lot about antenatal care and childbirth in Istanbul over the last few months. Suffice to say, it's fairly different from the UK. Generally, if you can afford it, private doctors and hospitals are preferred. Turkey has a very high caesarean section rate and birth is often quite/very medicalised. Even if you find a doctor here who is 'pro-natural birth', their methods and practices probably differ considerably from what might be considered 'normal' in the UK with the NHS.
Since announcing my pregnancy, various people have asked me if all the 'normal' checks are done here, if there is 'normal' midwife care etc. Now, I have my own opinions on the two different systems and which practices/methods I prefer, and what should be 'normal', but it has got me thinking about how we use the concept of 'normal'. It's such a relative term, based on a mixture of our own experience, what we've heard as being the general way of doing things, and (hopefully) some facts and evidence as well. Yet it's also one we (myself definitely included here) can't help but use, because it's so intrinsic to how we make sense of the world around us - and so this post is most definitely not a criticism of anyone who has ever used the word 'normal' when communicating with us!
What is 'normal' differs from country to country, and you can state what is 'normal' without attaching a value judgement to it. To illustrate this, here's a made-up dialogue between two Turkish women, one of whom is experiencing the NHS antenatal system. Please note, this is in no way a criticism of either the Turkish or British health systems - I just want to try and show that what we think of as 'normal' is very subjective! Also my only experience of the healthcare system here has been private practice, so I am fully aware I am comparing private healthcare in Turkey to state healthcare in the UK.
Ayşe; Hello, how are things going in England? How's the pregnancy?
Havva: Things are going well thanks, I'm still getting my head round how things work here though. It's so different from Turkey.
Ayşe: Really? In what ways? Are they doing all the normal checks?
Havva: Well, if you're considered low-risk, you usually just seen midwives for your antenatal appointments. You might not even see a doctor for the birth!
Ayşe: Wow, that's so strange!
Havva: I know! And you know how at home you see a doctor every month and have a scan at each appointment? Here you might go 6 weeks without seeing a midwife, and if everything is okay, you only have 2 scans during your pregnancy.
Ayşe: That's definitely different to here. What if there's a problem, can you call your midwife?
Havva: Of course, but it's an office number, so it might be a different midwife you speak to. And instead of giving you a list of tests, you choosing a lab or hospital to go and get them done at, and sending the results to the doctor, in the UK they do your tests, get your test results then call you if there's a problem.
Ayşe: Interesting. When my friend had a baby here, if she had a question or needed to send test results to the doctor, she just Whatsapped her doctor. I guess you can't do that in the UK, right?
Havva: I don't think so...
Ayşe: So after the baby's born, will they do all the normal vaccinations?
Havva: Most of them are the same, but generally in the UK babies aren't given the BCG vaccine or the Hepatitis B vaccine. So I'll have to find a way to get them done somehow. And there's a couple of extra ones I hadn't really heard of.
Ayşe: I guess you'll find a way to work it out somehow...
It's a bit over the top, but the point stands - just as what I, coming from the UK and with experience of the NHS, consider 'normal' childbirth practices isn't necessarily 'normal' here, so a Turkish person would probably find that their experience of antenatal care under the NHS isn't what would be considered 'normal' in Turkey.
I see this in all kinds of areas of life here, and it is always challenging me to reconsider what I think is 'normal' and why - and reminds me that there are many types of 'normal'. It also reminds me not to assume that just because something is normal for me it's also normal for someone else.
Clearly, something that is considered 'normal' in a place can also be considered right/wrong/superior/inferior to what is 'normal' in other places (depending of course on your criteria for assessing morality, but that's a whole different post).
But just because something is or isn't normal doesn't imply that it's right or wrong - it might be just plain different.
(And for anyone who was wondering, I am super pleased that I have managed to find a doctor here whose practices and philosophy is much more in-line with what I consider 'normal' than what is usually considered 'normal' here.)
