When I joined the maternity services 11 years ago I started on postnatal ward as a Maternity Support Worker (MSW) with dreams of becoming a midwife. An MSW is similar to a healthcare assistant, but on the maternity unit. Having never worked in a medical setting before, and given that there is very little training for MSWs, I set about gleaning as much as I could from the Doctors and Midwives around me. I learnt how to support a breastfeeding mum, how to perform observations on both mum and baby, and later on when I moved to Labour Ward I learnt how to assist in Theatre as well as assisting in obstetric emergencies.
I quickly became fluent in the medical terminology required to communicate on the wards. Later on, when training to be a midwife, I was well versed in the language of maternity services, and never gave it another thought that many of the phrases used portion blame on the woman if something deviates from normal.
If a labour stalls, or contractions stop, the patient is told they have ‘failed to progress’. If an induction does not end with a patient being in labour, they have had a ‘failed induction’. Not only is giving birth a huge physical undertaking it is also hugely emotional. Meeting your baby for the first time should be one of the most magical experiences in a persons life - and absolutely not the time that anyone should be labelled a failure. Regardless of whether the labour and birth went according to ‘plan’ the only objective should be to empower and celebrate how incredible a mother was for bringing life into the world.
It was only when I lived through my own pregnancy journeys, which unfortunately included infertility and baby loss, did I notice that lots of the language used in maternity and obstetrics is no longer fit for purpose.
I was a ‘poor responder’ to IVF treatment, when I did not grow an appropriate number of follicles. I had a ‘late miscarriage’ - implying that I was not even able to miscarry within a normal timeframe - despite the birth of my sons in no way resembling the heavy period notion we are told is a miscarriage. I had ‘incompetent cervix’ when it was discovered that my cervix was the reason that I went into very premature labour.
Each of these phrases implies that I was a failure. Repeatedly. Not only did I already feel terrible about myself, but being labelled in this way, and seeing it on paper in my medical notes did nothing for my self esteem which was already in tatters.
Language, both written and spoken is unique to the humans, and yet medicine seems to forget that language has the power to build up and empower, and at the same time to tear down.
Thankfully there are some phrases that are already beginning to fall by the wayside. Instead of the ever so flattering ‘geriatric pregnancy’ it is more common to hear ‘advanced maternal age’. Nothing does more to diminish the self esteem of a woman than to hear herself being referred to as geriatric!
Although there are some fantastic practitioners who use woman centred language, there needs to be a systemic change, and a review of the language used which means the woman is lifted up and her experience honoured, rather than diminished and belittled. There has been movements for maternity services to use more inclusive language, which is fantastic, however these is a long way to go to ensure that no woman feels blamed for any deviation from normal during her pregnancy, labour, birth and postpartum experience.