What better way to start the new year than to consider words that are to do with new beginnings.
Language choice in midwifery isn't a new topic, but it is an important one. It's something members of The Secret Community For Midwives In The Making have been asking me to write about and as a person who loves words, I'm thrilled to do so 🙂
If you've done much midwifery reading, you'll know that many excellent midwives have reflected on the impact that language can have and there's been quite a bit of research on the subject too.
The words we choose are powerful as they carry meaning and context from our society.
I think the difference between the words 'delivery' and 'birth' illustrates this truth perfectly.
The word 'delivery' comes from the Old French 'delivrer' based on the Latin 'de-' meaning 'away' and 'liberare' which means 'to set free'.
The way we use it in everyday speech means 'to hand over' or 'provide something' (as promised and expected).
If you were a Mum in labour, how would you feel about this word and concept? If your caregivers were using the word 'delivery' what might it mean to you?
Would you want to 'hand over' your baby to someone as soon as it's left your body? Or 'set it free'? Are you 'providing' the world with your baby?
Does the word 'delivery' imply your part in things is being overlooked? Or like your baby is going to be taken from you, as you just are the vessel for 'delivery'?
This is where the word BIRTH comes in. Birth is a wonderful word.
The word 'birth' is technically more accurate than 'delivery' as it describes the emergence of a baby or other young from its mother and the start of its life as a physically separate being.
We also use 'birth' in everyday language to describe the origins and ancestry of people, as in, 'she's Scottish by birth'.
This seems fitting when welcoming a new person into the world as it has connotations of a baby's home and place of belonging.
The word 'birth' comes from the old Norse 'byrth' which is related to 'bear'. It's a beautiful word which has nothing to do with anyone providing an item as promised.
Just like when we say a 'tree bears fruit', the tree is acknowledged as the source.
We wouldn't say 'the tree delivered fruit'. It would sound weird as the tree isn't just passing the fruit on to us. The tree has it's own agenda 🙂
And while we're discussing old Norse language, which was the language of the Vikings, it's worth mentioning that women in that ancient society held most of the legal rights of men and were often leaders of clans. The word 'byrth' comes from a culture that was (fairly) respectful of women.
Back to midwifery.
A lot of staff think this distinction is not worth taking time over.
They want to fit in with their colleagues who use the word and not be seen as making a fuss. When I was training, I can remember using the word 'delivery' because I wanted to fit in and be seen as a member of the team. I cared what people thought of me, and there's nothing wrong with that.
But do you see how much power you hand a woman when you opt to say 'birth' instead of 'delivery'?
Using the word 'birth' implies midwifery care that is more patient, respectful, understanding, healthy and wise. To me this is what midwifery is all about. Careful language choice is one of the ways I'd tell between a midwife I'd like to have caring for me and one I wouldn't be so sure of.
Sheena Byrom, who is an amazing UK midwifery leader, has written about this topic and lists many other examples of disempowering obstetric language like:
Patient (childbearing women are usually healthy so why label them as 'patients'?)
Failure to progress
Poor Maternal Effort
Trial of Scar
There are many more examples. It's a huge topic and one I hope I've got you started thinking about.
Do read what Sheena has to say on the subject here.
Now I'd love to hear what you think about midwifery language choice.
Do you think the distinction between 'birth' and 'delivery' is important? What are other midwifery terms that you think are disempowering? What would you say instead?
Please do include detail and context so we can learn from your expertise and insight 🙂
I hope you're already having an amazing 2017. As always, thanks for reading. From the bottom of my heart, it's an honour to write for you and I look forward to doing my weekly Midwife Diaries posts right through the year.
Ellie x
Which is a better term to use, breastfeeding or nursing? I know..hard right?
Amazing post! I truly believe that it makes a huge difference the way we communicate with one another, specially so during childbirth. I may not be an expert (I’m applying to midwifery course this year) but I work with pregnant ladies as an Arvigo practitioner and I’m very mindful of the language I use. I want women to feel empowered with their bodies and comfortable with the physical changes they are going through.
Yes! I’m a very strong believer in the power of words. To be “delivered” implies passive and disempowering as if a woman needs to be rescued and to “birth” implies empowering, flourishing and active. The woman birthing her baby rather than someone else coming to deliver the baby from her.
Another one is “failing” the GDM screen. I prefer to say it was “elevated” rather than telling the woman she failed.
Thank you Ellie, my new Years resolution..to be mindful of these terms that are so easy to slip into. Just about to qualify as a midwife so new start new language but will need mindfullness as a tool to keep this up! Cxc
Interesting article and useful to reflect on for my own practice as a student. I do think that my language differs between when I am speaking to colleagues and speaking to the woman I am caring for, and I think this is part of fitting in with the language that my colleagues use. Although the language I use around the women is clearly thought out and sensitive as I feel women can take what we say very literally and it can really stick in their minds. I use birth around women and I think I will be changing my language around colleagues now too and become more thoughtful about the words I use.
I had a nine year old girl attend an antenatal appointment with her mum. When her mum asked if this was the place she would deliver her baby the girl was shocked and told her mum pizzas get delivered babies were born. I thought how fantastic a nine year old got it, the importance of words
That’s phenomenal Linda! x
This was great, Ellie! Thanks for posting, as I think this topic does commonly get brushed aside even though it is important to and impacts a lot of women (even if they don’t quite recognize how language is impacting them!). A related use of language that really bothers me is when people speak of their care provider as delivering their baby such as “Dr. X is delivering my baby, or care providers themselves make statements such as “I deliver babies”. That drives me nuts! I feel that it takes all the credit and hard work and empowerment away from birthing moms.
I agree 🙂 Much better to be in partnership! Thanks for kind feedback and keep on catching 😉 x
It short and in a very literal sense, No it doesn’t matter whether you say delivery or birth, same as it doesn’t matter whether you say catch or delivered, what matters is that you respect the woman you are caring for and choose language that suits and empowers her.
Words really do have power but only if they are meaningful and contextual to the woman you are caring for. Its no use if they only hold power or context for the midwife.
For example, as a midwife I hate the term ‘catch your baby’ as it implies there is a risk of dropping the catch, equally I have colleagues who hate the term ‘deliver your baby’ as it implies a pizza delivery.
Over the past 25 years I learnt that it really doesn’t matter, because it was never about me or my colleagues.
If a woman wants me to catch her baby, I’ll catch it, if she wants me to deliver it, I’ll deliver it and if she prefers to use the word birth and/or birthing, I’ll support her to birth her baby.
I’ll support whatever she needs in whatever language she prefers. I love caring for strong empowered women and I love caring for women who really couldn’t choose a preference if they tried. My choice of language is driven by them and what they need at the time.
In response to the Kate Middleton reference, the only people who know whether Kate Middleton would have preferred the word birth to delivery are Kate, William and their midwife/health care team and to be honest, it matters only to them xx
What a well thought out and balanced response. I respect where you’re coming from.
I wholeheartedly agree Ellie – on the Nurturing Birth course one of the first group exercises we do is look at a range of phrases used in pregnancy/birth and how empowering or disempowering they can be. Deliver always raises a big debate! That 9 year old girl hit the nail on the head – pizzas are delivered, babies are born!!! Look forward to many more thought-provoking blogs this year. Happy 2017!
Thank Ellie, very well put in what is a very sensitive subject, I am a midwife working in Ireland, I as much as I can try to use the word birth, however its difficult, our unit calls Labour ward ‘Delivery suite’ so term is used routinely…presently on twitter in a campaign aimed at showing the overall wealth of services Obstetricians are providing in difficult circumstances (similar to NHS crisis) they initiated a campaign #wearedelivering. This has #language wise upset quiet a lot of people, triggering in some women thoughts of their own birth which they in some cases was traumatic..its caused a large division between Obs and some women, the actual continuing with the hashtag underpinning a belief of not having felt listened to in their birth and afterwards. The Obs explain they are speaking of delivering a service however there can be no getting away from the fact that the idea came from a catch on the expression ‘delivering babies’. So sad to see that the language around birth can can such discourse and upset in a time where like the UK we have a new Maternity strategy that should see everyone working together, listening to one another and showing some respect for others views. Thanks again and a Happy 2017 to you