health

Why midwives and doctors are being asked to stop saying, 'Good girl.'

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.”

Listen: On Mamamia Out Loud, millennial Jessie Stephens shares why giving birth is her biggest fear. Post continues after audio.

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”.

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Top Comments

guest 6 years ago

I'll refrain from making a bitchy comment.
It's actually refreshing to see the daughter of a PM keep it simple, no-muss no-fuss, and not a huge designer-brand lavish princess day. Maybe I'll see differently at her other celebration later on though.
Also, her Instagram account, which I just had a look at, keeps it simple and down to earth - none of this inflated boobs/ lips/ face fillers and pounds of make up the fitness models of Instagram have.


Annette 6 years ago

This is unbelievable! Women are getting weaker by the day. Precious petals who are so sensitive they fall apart if a wrong word if .used, if a man looks sideways at them, if they get a wolf whistle.
Women have been having babies for centuries, but it seems now that babies are having babies.
Perhaps they should follow the Victorian women who they so closely resemble, and have the smelling salts on hand.
Thank God for strong women, they are few and far between these days.

TwinMamaManly 6 years ago

Perhaps you'd care to share your birth experiences then? And for the record, Victorian women had the most appallingly painful labours because they were forced into seclusion without exercise and limited movement prior to birth and the smelling salts were because they were stitched into whale bone corsets that cut off their circulation and distorted their skeletons. Everyone is fighting their own battles Annette, societal pressures are very different to how they were even 20 years ago, so in my view, there are strong women everywhere I look - anyone keeping it together for themselves and their kids is strong in my view.

Susie 6 years ago

As someone who trained as a Midwife and was a nurse for many years, I gave the above article some thought. Certainly calling an adult woman 'a good girl' is patronizing and infantalizing. But, substituting medical terms such as 'foetal distress', rupturing membranes' for vague euphanisms borders on silliness and could potentially jeopardize the safe delivery of the baby or the woman's health. I should imagine those women who feel a failure for a less than perfect birth do so because of lack of communication/explanation by labour ward staff, or perhaps unrealistic expectations to begin with. Also, after the BMJ directed doctors to avoid the terms 'expectant mother' and 'pregnant women', but to use the term 'pregnant people instead, it made me think that the 'lunatics had taken oven the asylum' and their latest dictates a perfect example of this.

Zepgirl 6 years ago

What an extraordinary display of lack of empathy.

Your comment really speaks volumes as to the sort of person that you are. And none of it is good.

DP 6 years ago

If you think strong women are few and far between, then you must not know many women. We may not have the hardships Victorian women had, but there are new challenges that Victorian women wouldn't even dream of.