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Why words matter in perinatal services

Updated: Sep 4, 2023

A woman's hands with words written on them

When we communicate with women before, during, and after childbirth, we need to be very sensitive with the words we choose as we put information across, and the tone of voice in which we communicate.

During pregnancy and especially during labour, women are more open, vulnerable and suggestible - I often say that I feel every pregnant woman is walking around in a light state of hypnosis. Pregnancy and labour increases a woman’s oxytocin levels and a side-effect is that she becomes very trusting but also very vulnerable to harsh words and unkind treatment. As oxytocin levels are higher, just like when we fall in love, the critical thinking part of the brain is slightly numbed and we are not always able to process and be aware of logic and evaluation. The words we use when communicating have the power to have a huge impact on women and the way they feel about their bodies and their ability to give birth. This is why words matter in perinatal services. In my view, being mindful of language is one of the most important things that birth workers can do. I have seen my clients devastated over some poor information given unthinkingly and uplifted and motivated after being spoken to kindly. Studies by Penny Simkin show that the way women are treated, especially during labour and birth, stays with them for life. So it’s worth thinking about how we as doulas, midwives, obstetricians and other birth workers treat women during this impressionable time. It might be worth asking yourself how you would like to be remembered so that you can adapt your behaviour accordingly. Words really can make all the difference. Given this, I strongly believe that those working in our maternity services need to rethink some of the language used with pregnant and labouring women. Here are just some of the words and phrases routinely used, which as far as I’m concerned, disempower and implicitly criticise women and their bodies:

  • Caesarean section - Please use Caesarean birth instead! The word section can have unpleasant connotations (those with severe mental illness are sectioned).

  • Delivered / delivery - Pizzas are delivered. Flowers are delivered. Babies are born! It would be so easy to change every “delivery suite” to “birth suite” - already, how much more human would that sound? A woman always births her baby, no matter how that birth takes place.

  • Pain relief - This immediately suggests that pain felt during labour is something which one needs relief from and is negative. I’m not disputing that sometimes women need some help with the intensity of the sensations they feel, but the term pain relief is so loaded. Pain management would be preferable.

  • Failure to progress - This horrible phrase implies that it is the woman’s fault that she is not progressing “fast enough” (and actually, I have a problem with the idea that women should labour to a timetable too, but that’s a whole other blog post!)

  • Contractions - This word just sounds painful, and suggests something is being pulled together - actually, the opposite is true when the cervix is opening! I prefer, surge or rush, giving the idea instead that hormones are surging, causing the uterus to work.

  • Incompetent cervix - Another awful phrase! It just suggests that a woman’s body is not doing its job. How disempowering.

  • Lazy uterus - Ditto. I may not be a doctor, but I’m almost certain that a uterus cannot be “lazy”.

  • Lack of maternal effort - Where do I begin! This makes it sound like the woman just simply cannot be bothered to birth her baby, as if she’s lying there sipping a cocktail, perhaps, or getting her nails done!

A woman’s body never “fails” to birth her baby, but often she doesn’t get the care she needs, or the right support, and is not giving birth in an optimal environment for physiological birth to happen. An environment where she feels safe and with birth supporters who make her feel nurtured. Any phrases referring to a woman’s body as “failing” should perhaps be changed to “unsupportive environment”. Birthing women need empathy and compassion, not harsh words or punishments and threats for not “complying”. It makes me think if Ina May Gaskin’s quote, “If a woman doesn't look like a Goddess in labour then someone isn't treating her right.” All of us who work with women around pregnancy, childbirth, and the postnatal period would do well to remember these words, sung by my children in their school assembly: “Your tongue’s a tiny part of your body, but such enormous harm can be done by it. Every time you open your mouth, you’ve got to think before you speak”. It doesn’t cost anything to be kind and we know kindness and thoughtfulness goes a long way!

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