The words a midwife chooses to use are integral to the care she gives. Changes in the corresponding language mirror the development of medical knowledge. Over time, some phrases become commonplace while others fall out of use. The importance of language usage in midwifery, especially during pregnancy, cannot be overstated.
The Royal College of Midwives began studying the effect language has on females in 2020. The Re: Birth initiative set out to standardize pregnancy-related terminology so that individuals providing and receiving maternity care would all be on the same page.
This was the first study of its type to solicit feedback on the preferred language for describing labor and delivery from the maternity community (including new moms and healthcare providers). The research confirmed that many mothers cared more about having a good experience, being listened to, and feeling secure during childbirth than about the specifics of their delivery.
The results were summarized in a paper released by the Royal College of Midwives last year, and a revised pocket handbook is being distributed to midwives this year.
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Previously, “delivery” was the acceptable phrase, but now “birth” has occurred. Women and medical staff alike preferred detailed accounts of what occurred during labor and delivery, as precise as possible. “Birth with ventouse,” “birth with forceps,” etc.
As an alternative to “low risk,” the term “universal care requirements” is being utilized. While “additional care requirements” is the accepted synonym for “high risk” these days. It is crucial that pregnant women feel safe and secure since the term “risk” connotes unpredictability.
Midwives and other medical personnel have traditionally used the phrase “normal birth” to refer to a vaginal delivery that occurs naturally and physiologically. What, exactly, constitutes “normalcy?” Is it fair to call someone “odd” if they did not have a “normal” delivery?
“Spontaneous vaginal birth” is the favored word now since it encompasses labor that occurs naturally without major medical treatments like induction or oxytocin. It also includes natural vaginal births that don’t involve any medical tools.
In recent years, “cesarean birth” has become the universally accepted phrase for a surgical cesarean section. This is meant to be used instead of the more alarming phrase “emergency.” Rather than “emergency cesarean,” the phrase “unplanned cesarean delivery” is now often used.
The term “incompetent cervix” suggests a lack of ability on the part of the patient. Therefore, “cervical insufficiency” is the current phrase of choice.
Women were eager to talk about how phrases like “failure to advance” might add to emotions of defeat and trauma during the Re: Birth initiative. “slow labor” or “delayed progress in labor” is preferable nowadays.
The same reasoning holds true for phrases like “failed induction” or “failed homebirth.” Both “induction of labor, with delay, and then surgical delivery” and “transfer in during scheduled homebirth” are favored according to the circumstances.
Words like “good girl” or “you are permitted/not allowed to” that have implications of guilt or infantilize pregnant women should also be avoided. Poor maternal effort and denial are two such phrases.
The midwife’s job is to give women agency and respect their right to choose how they are cared for throughout pregnancy and childbirth, two times in life when they are most vulnerable.
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According to the Nursing and Midwifery Council’s criteria of excellence for midwives, midwives must offer care for all pregnant women and newborns. Midwives provide security on several levels, including the physical, mental, social, cultural, and spiritual. As a result, it’s quite evident that psychological care is prioritized, and it’s also clear that language has a major influence on how people feel.
The language used by healthcare providers is an important aspect of patient care. There is a tight relationship between physical safety, good results, and future experiences that promote psychological safety and well-being; what we say matters.
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