Yesterday several student midwives tweeted about their dislike of some of the language used in maternity services.
‘I hate the phrase “failure to progress” it's so disempowering’ was one comment. And "trial of scar”’ was another phrase tweeters disapproved of. Indeed.
It’s an old issue. I remember in the early 1990’s the Head of Midwifery (Pauline Quinn) where I worked saying how she didn’t like the use of the word ‘patient’ as she felt it disempowered women. She also disliked women who used maternity services being called ‘ladies’, as she thought it patronising and it reminded her of ‘ladies’ at the golf club! And in addition to that, could saying ‘she’s one of my ladies’ be an even bigger crime, even though unintentional? The woman doesn’t really belong to anyone, does she?
Mrs Quinn interestingly also changed our midwifery titles, and dropped the use of ‘sister’ and ‘staff midwife’, as she believed it potentially influenced the midwife-mother relationship by establishing a defined hierarchy.
These ideas really made me think. I was always careful from then on to consider the words I used. I listened to others, and read interesting articles on the topic. I became more and more aware, and talked to others about it.
The words ‘Not allowed’ became intolerable. Hearing women saying ‘They wouldn’t let me go over my dates’ started to sadden me.
‘She told me I was only 3cms’ instead of ‘Wow! You are 3cms! Your body is working brilliantly!’
Using the name Labour Ward, or Central Delivery Suite instead of Birth Suite.
The list goes on.
Research carried out into the power of language in relation to infant feeding suggested that midwives used language that influenced decision making to what the midwife wanted rather than words that enabled the woman to make her own choices. Interestingly, the study’s (Furber and Thompson 2000) implications for practice confirmed my managers beliefs from all those years ago:
‘It is important that the language used when interacting with women is considered carefully in order to facilitate an unbiased perspective and to promote partnership. The word ‘women’, rather than ‘girls’ or ‘ladies’, should be used when referring to users of the maternity services.
Working in the same organisation, decades later, things were different. From time to time my colleagues would ask me, ‘does using different words really matter Sheena? We don’t mean harm and what we do is more important than what we say. We have enough to worry about!’ But my answer was (and is) it does matter. Because what we say and how we say it, influences what we do. If we are mindful of the language we use ( i.e. facilitate not teach, share instead of educate) we are thinking about the relationship we have with women and families and our actions will reflect that. Being with, not doing to. It doesn't take much effort, and needs no extra resources.
See the photograph at the beginning of this post? The use of the word ‘BORN’ instead of ‘DELIVERED’ on the Birth Suite board to let staff know the woman has given birth? This is the result of a couple of committed (and strong!) midwives thinking about the language they used and the consequential impact on care. They started the ball rolling and although there was much opposition, years later it’s regular practice. It makes my heart sing.
So maternity care workers. Words do matter. To you and to all in earshot of you.
Lead the shift in your workplace even though it may take years for others to follow. Remember Pauline Quinn OBE, and golf. Make a difference, and
‘Be the change you want to see!’ (Ghandi)
Furber CM, Thomson AM (2010) The power of language: a secondary analysis of a qualitative study exploring English midwives’ support of mother's baby-feeding practice Midwifery Volume 26, Issue 2, April 2010, Pages 232–240