Being female is painful enough. In any year, one in five of us have a female-specific health problem, according to a study of 25,000 US women. Then, during some of our most emotionally and physically traumatic experiences, doctors talk about our bodies using official terms that are hurtful and disempowering.
Adding pain to pregnancy loss
Occasionally in pregnancy the cervix can’t hold the weight of the growing baby, who can be born too early to survive. It’s already appalling, right? Now let’s call the problem “cervical incompetence”, to rub salt into your heartache.
Alecia Staines, Director of the Maternity Consumer Network, is not a fan of that term. “It’s horrible and it makes women feel absolutely like a failure,” she says. “And I think it perpetuates the grief as well.”
“It’s horrible and it makes women feel absolutely like a failure”
Even a “miscarriage” sounds like the woman was careless in how she carried her baby around.
Then there’s the terrifying diagnosis of “threatened miscarriage”. It’s often given to the one in five women who simply have vaginal bleeding in pregnancy, even when it’s been determined everything is likely to end well.
Other unkind terms in pregnancy loss ignore the little life that won’t be. There’s “blighted ovum” (a fertilised egg that doesn’t develop) and “products of conception” (aka baby and placenta). “Why not talk about it as a baby?” says Staines. “We’re still not even recognising that there’s life involved there.”
Unnecessary burdens in pregnancy
Thank goodness we’ve mostly done away with calling them “geriatric” pregnancies or mothers. But the favoured term, “advanced maternal age”, is still pretty rude. It’s also confusing because there’s no universal definition. Is it over age 35, 40 or 45?
Stating the woman’s actual age would be more helpful. Particularly with “advanced” age increasingly on trend - 22% of mothers giving birth are 35 or older, according to a 2016 government report.
The painful language of labour
When baby is due, your cervix may be inspected and pronounced “favourable” or “unfavourable” (ready for labour or not).
Once labour starts, if you “fail to progress” according to the established criteria, you might have a caesarean section. For the woman who laboured for hours hoping for a vaginal birth, the “failure to progress” label is an extra kick in the guts on top of major surgery.
The “failure to progress” label is an extra kick in the guts on top of major surgery.
Staines says some mothers use a different term. “Women have turned the tables on that one – some would call it ‘care provider’s failure to wait’, rather than ‘failure to progress’.”
And please, can we call it a birth, not a “delivery”. The doctor or midwife isn’t the postie – it’s the woman who gives birth to her baby.
The uterus of poor character
When having trouble conceiving, you might be informed you have a “hostile uterus” or “hostile cervical mucus”, mucus that hampers the sperm. It sounds like you’d have a baby if your body just stopped being so dang rude.
Then, after birth, you can have a “lazy uterus” that isn’t contracting enough to stop bleeding. It is serious, but it’s not your uterus’ fault.
It’s not just what you say but how you say it
Although medical language can change, as in recent decades in the area of disability, in women’s health we’re likely to be stuck with clangers for a while yet. But considering when and how they’re delivered would certainly reduce the sting.
As Director of Program Development at Sydney’s Pam McLean Centre, Dr Renee Lim teaches doctors to communicate. She urges doctors to remember the patient is the expert on themselves, including what language is helpful. “Thinking in that way is something that we haven’t got used to in the health sector.”
“I don’t know many [doctors] who don’t care about how the patients feel.”
Dr Lim says doctors aren’t deliberately oblivious to the emotional impact of words. “They’re so busy giving information they forget what the needs of the patient are. And that’s when that kind of language can come down and be very traumatic.”
How health professionals are improving the way they talk to us
Dr Lim says once they hear patients find some terms are hurtful, most doctors are open to change. “I don’t know many who don’t care about how the patients feel.”
She says the medical community does want to improve how doctors talk to patients. “Pam McLean runs over a hundred [health communication] projects a year, so that means there are a hundred different groups across Australasia that want communication to change."
Staines agrees things are improving, slowly. “[Doctors] really need to get out of that medical bubble…I really do think there is a more conscious effort, but the pace of change just isn’t up to what women are satisfied with.”
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