The term midwife is known to refer to a person, typically a woman, who has trained to assist women in childbirth. It has roots in Middle English, and likely comes from the obsolete preposition mid ‘with’ + wife (in the archaic sense ‘woman’), expressing the sense ‘a woman who is with the mother.
Nice guidance advises that when giving information to women (and their partners) healthcare professionals should use clear language and tailor their timing, content and delivery of information to the needs and preferences of the woman and her stage of pregnancy.
The need for explicit language is demonstrated in a recent You Gov survey, which found that 59% of men and 45% of women were unable to label the vagina and around half of men and women failed to label the labia.
There have been calls, recently, to make the language in maternity accessible and inclusive. This has asked for gender neutral language. Omission of words such as ‘women’ and ‘mother’ in favour of gender neutral terms is a form of communication that aims to be sensitive to the needs of transgender people, those that have an identity that is incongruent with their reproductive biology. This was notable in the controversial Stonewall stance, who advised that institutions who were part of their champion scheme, removed the word “mother” from their maternity policies.
Guidance from the Brighton and Sussex University hospital calls for more inclusive language by changing the wording used when referring to Birthing Parents. These changes include changing ‘breast-feeding’ to ‘breast/chest feeding’ and ‘breast milk’ to ‘human milk’. In contrast, the Royal College of Midwives had to apologise for removing the words ‘women’ and ‘mother’ and replacing with it ‘post-natal people’
But the conflating and changing of the language that we use can have a detrimental impact on women that use maternity services. The influence of language in maternity services is multifaceted. With communication central to high quality care, language can significantly affect both patient safety and experiences.
Another important element to consider is that not all patients that access maternity services will not have English as their first language. Evidence shows that 40% of women from ethnic minorities experience problems with communication, discrimination and poorer care during their maternity journey.
Evidence from the 2020 MBRRACE-UK reports on maternal and perinatal mortality shows that women and babies from ethinic minority backgrounds and those that live in deprived areas have an increased risk of death and need closer monitoring and additional support. The risk of maternal death is 4 times higher in black women and 3 times higher in women with mixed ethinic background. Women living in deprived areas are 2.5 times more likely to die compared to those living in the least deprived areas.
Joyce Harper, an IVF doctor and professor of reproductive science at the institute for Women's Health explained that terms like uterus and vagina may not be totally understandable by the general population and women who don’t have a grasp of health messages are less likely to attend health screenings and as a result are more likely to have unplanned and complicated pregnancies.
It’s much more important to use language that people understand.
Views expressed in submitted works are the views of the author.