Registered Nurse and Midwife Frances Green explains why the language of gynaecology and maternal health is changing for the better.

Many of you might have heard horror stories from hospital births in the Baby Boomer era, or even experienced them yourself. Women were expected to grin and bear it, even being told off for moaning too loudly during labour. While those days are thankfully behind us, some of the language used around pregnancy in a medical setting is taking a little longer to fade away.

As medical knowledge and understanding of the patient experience advances, so should our language. In my work as a midwife, I often see the impact that certain words and phrases can have on women during what, for some, is the most vulnerable time of their life.

We know that infantilising women, saying ‘good girl’ or telling them they ‘aren’t allowed’ to do certain things is disempowering. Midwives take care to avoid such language. During pregnancy people need to feel their autonomy is valued and that they can make informed decisions around their care. Advice is offered as a choice rather than a directive.

Also dangerous, is language that suggests blame, like ‘failed induction’, ‘refused’ or ‘poor maternal effort’.

We’re phasing out the term ‘normal birth’ to refer to a spontaneous vaginal birth. Not only does it lack clarity but it implies that any other kind of birth is abnormal, which is not true at all. Similarly, where we used to describe a pregnancy as ‘high risk’, we now refer to the person as needing ‘additional care’. ‘Risk’ implies danger and fear, which is not the message we want pregnant women to carry with them.

A common call from those who become pregnant after the age of 35 is to retire ‘geriatric pregnancy’ as a descriptor – understandable! We tend to use ‘advanced maternal age’ in its place, shortened to AMA in our notes. It’s not that much better, I agree, but there is no judgement implied. It is actually necessary to note from a physiological standpoint as there can be additional factors for specialists to consider.

When talking about gynaecological health, accuracy is key. Using euphemisms or loaded terms doesn’t help anyone. I consistently see women confusing ‘womb’ and ‘uterus’, not to mention the old ‘vulva-vagina’ inaccuracy. I even remember one woman who thought her normal discharge was semen. She simply didn’t have the language to describe it. A clear understanding of the pelvic area and precise language helps women describe what’s happening and to receive the right treatment.

‘Letting it breathe’ after a gynaecological procedure is another hangover of unhelpful language. Going commando is wonderful if it’s your thing, but after surgery wearing underwear actually helps to keep track of the recovery process. In fact, it’s often a good idea to go a step further and wear a high-quality sanitary product to keep inflammation and infection at bay.

After working for 35 years in this world (just call me a geriatric midwife!) I welcome changes to our language. While some may see it as petty, the fact is that words matter. They stick with us and tick over in our minds. Pregnancy can be rife with uncertainty, so we want to make sure birthers feel as healthy and strong as they can throughout.

Frances Green is a registered nurse and midwife committed to helping women understand their extraordinary anatomy. Education is at the heart of her work with COGA’s specialist gynaecology team. coga.org.nz