The language guide midwives should use

An ‘alternative’ language guide has been created for midwives to use in the hope of instilling a ‘culture of respect’ for pregnant women.

Three experts devised the list of suggested phrases for common terms, in the hope it will ensure women are ’empowered to make decisions’.

Medics have been asked to say, ‘you’re doing really well’, to women pushing a baby out – instead of the old-fashioned term, ‘good girl’.

It also stresses that midwives and obstetricians should never address the pregnant woman as a ‘she’ when they are discussing the situation at hand.

The authors accepted that some may think the new recommendations, which are only a suggestion and aren’t from the NHS, are ‘political correctness gone mad’.  

Instead, they should constantly refer to her first name, according to the guide that was published in the British Medical Journal. 

And the authors pointed to evidence that shows positive communication can alter the course of pregnancy for the better.

Reviews of research reveal that clear language can reduce the rates of potentially dangerous Caesarean sections, the medics explained.

Medics have been asked to say, ‘you’re doing really well’, to women pushing a baby out – instead of the old-fashioned term, ‘good girl’

Professor Andrew Weeks, who works at the International Maternal Health Care at the University of Liverpool, was one of the three authors of the guide.

The others included Natalie Mobbs, a medical student at Liverpool, and Catherine Williams, a committee member of National Maternity Voices.

Writing in the BMJ, they said: ‘Language matters as a way of respecting women’s views and ensuring that they are empowered to make decisions

‘The use of insensitive language can be indicative of an underlying malaise, which reveals underlying attitudes and prejudices.

‘It is essential that we achieve respectful practice, ensuring that women have complete understanding and control of their own care.’

The three authors continued: ‘If we can achieve that, then the use of appropriate language will follow on naturally.’ 

The guide also asks midwives to avoid discouraging or insensitive language, such as the phrase 'terminate pregnancy'

The guide also asks midwives to avoid discouraging or insensitive language, such as the phrase ‘terminate pregnancy’

‘Good communication during the birthing process is critical to good maternity care, but achieving a shift in deeply ingrained language, and the thinking it reflects, is difficult. 

‘There is a fine line between changing terminology to integrate language which is more respectful, inclusive, and less intimidating for the mother, and substituting vague, verbose language which hinders the original message.’

WHAT SHOULDN’T MIDWIVES SAY TO PREGNANT WOMEN? 

According to the guide that was published in the British Medical Journal, midwives and obstetricians should avoid certain terms when dealing with pregnant women. 

Professor Andrew Weeks, who works at the International Maternal Health Care at the University of Liverpool, was one of the three authors of the guide.

The other included Natalie Mobbs, a medical student at Liverpool, and Catherine Williams, a committee member of National Maternity Voices.

The list included:

  • Painful contractions
  • High risk
  • Terminate pregnancy
  • Failure to progress
  • Poor maternal effort
  • Codified language
  • Patient refused
  • You must/have/need 
  • Fetal distress
  • Trial of forceps
  • Labour ward
  • Big baby
  • My woman
  • Good girl
  • Delivered
  • The primigravida in room 12 
  • She 

The guide also asks midwives to avoid discouraging or insensitive language, such as the phrase ‘terminate pregnancy’.

Should this distressing situation arise, women should be told it is a ‘compassionate induction’ to ease their feelings. 

And if a medical procedure doesn’t work, midwives should describe the attempt as ‘unsuccessful’, rather than ‘failed’.

In another move, it asked for coded language, frequently used by medics to describe certain situations, to be replaced in plain English.

This includes scraping the medical term SROM, and telling the women her water’s have broken in much simpler language.

Anxiety-provoking phrases have also been slashed in the guide, asking medics to avoid the use of ‘fetal distress’ or ‘big baby’.

Instead, they should announce the two common problems as ‘changes in the baby’s heart rate pattern’ and describe a larger infant as ‘healthy’. 

The latest guidelines issued by Nice emphasise the fundamental importance of clear communication between pregnant women.

Writing in the BMJ, the three authors said: ‘Although eyes may roll at the thought of “political correctness gone mad,” the change is well founded.

‘Firstly, intra-partum care must keep in pace with and reflect changes in societal norms and expectations.’

They said the clinician should ‘ensure that the woman is in control of and involved in what is happening to her’.  

‘The role of birth attendant is no longer “owner” of the situation but “facilitator” of the health services,’ they wrote in the journal. 



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