Six pregnancy terms that may no longer be used, including ‘high risk’ and ‘failed’.

The Evolution of Language in Midwifery: A Journey of Empathy and Sensitivity

The realm of medical terminology is in a constant state of evolution, mirroring the progress of our comprehension of medicine. Over time, new terms are embraced while others fade away. This evolution is particularly pronounced in the field of midwifery, where the language we employ, especially in the context of pregnancy, holds immense significance.

In the year 2020, the Royal College of Midwives embarked on an innovative initiative named Re:Birth. This endeavor was rooted in recognizing the profound impact that language wields on women. Its primary objective was to discern the vocabulary surrounding pregnancy that could be comprehensible to both maternity care providers and recipients.

Notably, Re:Birth stood as a pioneering endeavor, marking the first instance in which the maternity community – including healthcare professionals and new mothers – was directly consulted regarding their preferred language for describing labor and childbirth. The outcomes of this project strongly reinforced the notion that many women’s concerns were less centered around the specifics of how their baby was born, and more focused on the quality of their experience, feeling secure, valued, and heard.

The culmination of these efforts materialized in a comprehensive report published by the Royal College of Midwives last year. This report encapsulated the findings of their research, shedding light on the preferred language identified through the initiative. Additionally, in a continuous endeavor to empower midwives with this knowledge, a new pocket guide is set to be disseminated among midwives this year.

Terminology Shift: Birth vs. Delivery

A significant shift in medical terminology has occurred, with the term “birth” gaining acceptance over the previously prevalent term “delivery.” This transition reflects the evolving language in the realm of childbirth, responding to the insights and preferences of both women and healthcare professionals.

The desire for accuracy and specificity has driven this change, with a concerted effort to accurately describe the events of labor and childbirth. To achieve this, precise descriptions are favored, such as “birth with forceps” or “birth with ventouse.” This change in approach extends to instances of “caesarean birth,” highlighting the emphasis on accurate language that resonates with the experiences of both mothers and healthcare providers.

Evolving Risk Terminology: Universal Care Needs and Additional Care Needs

The language surrounding risk assessment during pregnancy has undergone a meaningful transformation. The term “universal care needs” has taken precedence over the previous term “low risk,” aiming to foster a more inclusive and considerate approach to care provision. Simultaneously, the term “additional care needs” has emerged as the preferred alternative to “high risk.” This linguistic evolution is rooted in the desire to promote an atmosphere of comfort and confidence for women throughout their pregnancy journey.

Recognizing that the word “risk” may evoke feelings of uncertainty, the shift towards using “universal care needs” and “additional care needs” reflects a commitment to linguistic sensitivity and patient-centric care. This transformation is a testament to the continuous endeavor to enhance women’s experiences during pregnancy while promoting their overall well-being.

Rethinking “Normal”: Embracing Spontaneous Vaginal Birth

The term “normal birth” has been ingrained in the language of midwives and healthcare professionals to describe a spontaneous, physiological vaginal delivery. However, the definition of “normal” prompts introspection. Does this label inadvertently cast those who haven’t experienced what we classify as “normal” birth as “abnormal”?

A shift has taken place, favoring the term “spontaneous vaginal birth.” This encompassing phrase refers to labor that unfolds spontaneously, free from substantial medical interventions like induction or oxytocin administration. Additionally, it encompasses vaginal birth that occurs spontaneously, sans the need for instrumental assistance, such as forceps.

Redefining Caesarean Birth: Embracing Sensitivity

The conventional term “emergency caesarean” is undergoing a transformation. The broader, more sensitive term “caesarean birth” now takes precedence. This shift is rooted in the recognition that the term “emergency” can evoke undue alarm. Furthermore, the term “unplanned caesarean birth” supplants “emergency caesarean,” fostering an environment of understanding and empathy.

A Gentle Shift: Cervical Insufficiency

The term “incompetent cervix” carries connotations of personal failure. A gentler alternative, “cervical insufficiency,” has now emerged as the preferred terminology. This change reflects the intention to adopt language that is respectful, compassionate, and devoid of blame.

A Considerate Lexicon: Acknowledging Progress

During the Re:Birth initiative, it became evident that certain terms such as “failure to progress” can inadvertently contribute to feelings of failure and trauma. In light of this, a more considerate language approach is being embraced. Terms like “delayed progress in labor” or “slow labor” have taken precedence, reflecting a shift towards understanding the nuanced nature of childbirth experiences.

The same empathetic logic extends to terms like “failed induction” or “failed homebirth.” These have evolved into “induction of labor, with delay and followed by operative birth” and “transfer in during planned homebirth,” respectively. This linguistic evolution demonstrates a commitment to fostering an environment where women’s experiences are honored, and language is employed thoughtfully to uplift and support their journey.

Language that belittles or patronizes pregnant women, such as phrases like “good girl” or statements that dictate permission like “you are allowed/not allowed to,” should be avoided. Similarly, language that carries undertones of blame, such as “poor maternal effort” or “refused,” should also be omitted.

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