When what we say really does matter.
What is it about a pregnant person that elicits such free social commentary from strangers? “Are you sure it’s not twins?” the owner of my local bakery (who was also pregnant) asked me as she handed over a medley of pastries. I looked at the box – then back at her – before forcing a laugh. I went home and cried.
These interactions are a dime a dozen for most pregnant folks and if like me, you’re a cis-het woman (named Ashley for crying out loud) they skew more emotionally searing than harmful. When assumptions are made about people like me, they’re generally correct: I identify and present as a woman; my kids call me mama; I have a partner of the opposite sex. This isn’t true for all pregnant people, which is why knowing how to say what we mean is really important. The way reproductive health is rooted in gender is to the detriment of trans, queer, and other folks who identify as and experience life outside of the gender binary and gender constructs.
Give mama a break!
We don’t need to project or assume that every pregnant or birthing person wants to be called mama or uses she/her pronouns. When you don’t know how someone identifies, using terms like pregnant person, birthing people, or gestating parent is more inclusive—and, truly, costs nothing to consider. And while we’re on the subject, unless you’re at a gender reveal party, the assigned sex or gender of a baby is really nobody’s business, so consider why it’s important to you to ask. If you need to fill a conversation void just ask, “how can I support you right now?” See… easy!
There’s also a multitude of ways that people can become parents that don’t involve a heterosexual couple having sex—and, those people don’t have a duty to explain to you their path to parenthood. Instead, you have a duty of care to your community to meet folks where they’re at without thrusting ‘norms’ or assumptions upon them.
Centering adoptees with positive language.
“You would never introduce a biological child as, ‘this is Sally, my bio kid’ or ‘meet baby Henry, born via surrogate,’” my friend who’s two children were adopted tells me. “Centering the adoptee, positively, in the adoption narrative is important and something we’re only starting to see now,” she explains. “The opposite of that would be saying something like ‘your own child’ rather than ‘your child’ or if necessary, ‘your biological child’. That one particularly stings for me.”
Humans are wired to take the path of least resistance, so it’s not surprising to me that the antiquated tropes and narratives we often hear around reproductive health, birth, and parenting remain at the forefront of communication. “‘Give up for adoption,’ puts so much shame and hurt upon birth parents,” my friend offers, “the positive version is to ‘make an adoption plan’.” I think this is a really important nuance of language – the intention to make it positive – and something that all people can apply to every interaction.
Things we say v. what we really mean.
In the UK, the Royal College of Midwives recently published its Re: Birth Report which it describes as “a space for listening and discussion around the language we use around birth that has become increasingly difficult on social media and other platforms.” Almost 8,000 people took part in listening groups and voice surveys to help reach the conclusion that service users and healthcare professionals should use language that’s clear, descriptive, and ambiguous; can be consistently understood by both patients and professionals; avoids judgement; reflects birthing people’s lived experience; and allows for the identification of differences in the mode of labour and birth.
Take ‘natural’ or ‘normal’ birth: both terms are ambiguous, non-descriptive, and tainted with judgement, especially if you’ve experienced birth outside of these prescribed parameters. What most folks mean when they talk about ‘natural birth’ is unmedicated physiological or vaginal birth and it’s useful to name that. This isn’t about diminishing anyone’s birth experience, it’s about expanding to broaden the spectrum on which birth exists.
Know how to use your words.
I polled our Brood birthworkers group text to ask what kind of language folks often hear that’s harmful, unhelpful, and/or judgmental, and the replies came in thick and fast. Whether you’re a birthworker, care provider, parent, birthing person, or someone offering your seat to a pregnant person on the bus, enjoy this (very) non-exhaustive glossary of better ways to say things.
Conception & Pregnancy
‘Failed’ IVF round or transfer. IVF can be unsuccessful for many reasons, so it might be helpful to name those things e.g. my egg didn’t implant or fertilization did not occur. Even using the word ‘unsuccessful’ rather than ‘failed’ is more matter-of-fact and can help remove feelings of shame and/ or guilt. You did not fail.
‘Geriatric pregnancy’: This is a term used when a pregnant person is over 35-years-old. If it really is necessary to reduce a person to how many trips they’ve taken around the sun, advanced maternal age is a less ambiguous way to say this—or even better, just say ‘this person is however-many-years-old’.
‘Terminated pregnancy’. According to the Re: Birth research, where there was a terminal diagnosis for the foetus or baby, the term compassionate induction was preferred by group participants.
‘Abortion’. Abortion can be an empowering – and powerful – word to use when a someone is in choice and has access to ending a pegnancy. For some folks, the word abortion is triggering. International Planned Parenthood Federation speaks to “choosing not to move through a pregnancy” or “deciding to end a pregnancy” as more neutral ways to speak to abortion. Terms like ‘keep the baby’ or ‘get rid of the baby’ are stigmatized ways to discuss abortion and should be avoided.
‘Big baby’ or ‘your baby is too big for your body’. You don’t have to be fat to be served with the ‘big baby’ rhetoric but from my own experience as a pregnant person and birthworker, it’s an easy grab for care providers. Medical conditions aside, your body grows a baby that is the right size for you. If a baby is looking on the deliciously healthy side, just say that.
‘High risk’. There’s nothing like inducing fear from the get-go. Some folks might prefer to hear medically complex as a more encouraging and sensitive alternative.
Labour & Birth
‘Failure to progress.’ Imagine being half way through a marathon and someone yells at you, “ Move faster or I’m taking you out of the race!” Yes, sometimes bodies and babies need support in moving to the next stage of labour or birth, but the pace shouldn’t be outlined by hospital or care provider protocol. Whether your baby is born vaginally or by caesarean, progress has been made. Again, you have not failed.
‘Fetal distress’. The study Humanising Birth: Does the Language We Use Matter? suggests “changes to the baby’s heart rate pattern” is a less anxiety-provoking way of communicating this. From a birthworker point of view, gently guiding clients into different positions rather than yelling at them to move is also optimal behaviour when emergent medical intervention is not necessary.
‘Fake contractions.’ Braxton Hicks has entered the chat. Sometimes Braxton Hicks contractions are a precursor to imminent labour—and sometimes people experience them for a long time before birth. They can be uncomfortable, exhausting, and most importantly, they are very real.
‘Trial of labour after c-section aka TOLAC’. According to medical literature, pregnant people who are hoping to have a vaginal birth after a previous caesarean section (VBAC) can’t call their birth such until they have completed their TOLAC. Is this Game of Thrones? Nope. Skip the trial and go get that VBAC (if you want it).
Written by Ashley Jardine.
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