Giving birth is, without a doubt, one of the most intense and stressful times in a woman’s life. So is it all just about getting the baby out safely, or does it really matter how midwives and doctors speak to women?
Researchers in the UK are saying it really does matters. The British Medical Journal has published a list of examples of “poor language” used during birth, and suggested alternatives.
Midwives and doctors are being asked not to use phrases that are anxiety-provoking, over-dramatic or violent. That means “fetal distress” should be replaced with “changes in the baby’s heart rate pattern,” and “rupture the membranes” should be “release the waters.” As for “big baby,” that should be “healthy baby”.
Women are to be respected as adults, which is why the phrase “good girl” shouldn’t be used during labour. On top of that, women must not be viewed as just a container for a baby. That’s why “delivered” is out, and so is “she’s 7cm”. Instead, it should be “gave birth” and “[woman’s name]’s cervix is 7cm dilated”.
Phrases that are discouraging or insensitive shouldn’t be used. “Failure to progress” should be replaced with “slow labour” and “painful contractions” with “strong contractions.”
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Women shouldn’t be told they “must have” a caesarean. Instead, it should be recommended, with reasons given.
The authors of the journal article – Natalie Mobbs, Catherine Williams and Professor Andrew Weeks – say if there’s positive communication during the birth, it has a big impact on the woman’s experience, which can affect her mental and physical health and her relationship with her baby.
In Australia, the language used towards women giving birth has changed a lot in the last 10 years, according to Professor Caroline Homer.
“There’s some terrible language in maternity care that we’ve really tried to get rid of,” Professor Homer, who is the director of the Centre for Midwifery, Child and Family Health at UTS, tells Mamamia.
“There’s a lot of failures: failure to progress, failure to get into labour, failure to breastfeed. Those are really terrible things to put on women who are starting off new motherhood.”
She says instead of “failure to progress”, it’s better to talk about “slow progress.”
Professor Homer says they’ve also been trying to get rid of all the “trial” terms, including “trial of forceps” and “trial of scar”.
“It suggests something dreadful’s about to happen,” she says. “A ‘trial of scar’, for a woman who’s had a previous caesarean section and is now in labour, gives horrible connotations of the scar exploding and the baby flying out.”
Professor Homer says she also tries to avoid the term “big baby” because it suggests there’s something wrong.
“When you meet women who are pregnant, people say, ‘Oh God, you’re enormous!’ It’s not very helpful. It makes you feel frightened: are you going to be able to give birth to this baby?”
As for the term “good girl,” Professor Homer believes calling women girls is demeaning.
“It’s small and passive and suggests you can tell them what to do,” she says. “Girls are those small people running around playgrounds with pigtails. If you’re having a baby, you’re not a girl.”
Professor Homer says women remember what was said to them in labour.
“It’s astonishing what women remember, even many years later. They’ll remember the positive things and they’ll definitely remember the things that made them feel bad.”
She says women can have a complex birth – for example, an induction, a caesarean, the baby needing special care – and still feel they had a positive experience “because they were listened to, because they felt in control, because their wishes were adhered to”.