In an attempt to reduce anxiety and lower the risk of complications during pregnancy, maternity experts issued new recommendations for midwives in The BMJ on Thursday — and humanizing the birthing experience was the central goal behind their recommendations. Focusing on how physicians' language can affect women during birth, experts suggested that midwives shouldn't say "good girl" to women in labor and suggested several other ways to make giving birth more comfortable.
The recommendations were put together by a maternity care advocate and a maternal health care professor, and supported by the Royal College of Obstetricians and Gynaecologists.
"Improved psychological care of those in the healthcare system is closely linked to improved outcomes," the authors, including a National Maternity Voices committee member, a professor of international maternal health, and a medical student, wrote in The BMJ.
The proof of language's power, the authors wrote, was in the benefits a labor companion provides: it reduces rates of Caesarean sections, use of anesthetics, operative vaginal births, and feelings of negativity surrounding the birth. This is "not due to any clinical intervention, but simply due to the provision of support," the authors wrote.
On top of that, past research has found that a good relationship between a physician and their patient tends to lead to better health outcomes. The way midwives and physicians speak to their patients clearly matters — and it's about time that the language used with patients reflected that impact.
As part of their recommendations, the experts showed examples of poor communication alongside better options. They suggested avoiding any phrases that are "anxiety-provoking, over-dramatic, or violent," as well as any language that's "discouraging or insensitive."
Both of those suggestions seem like they would be good advice in any medical ward, but the guidelines went beyond that, as well, going on to tackle sexism in birthing suites with sections like "Respecting women as autonomous adults," and "Respecting the woman's autonomy as a decision-maker."
Rather than say "good girl," the experts suggested, midwives should say, "You're doing really well." And instead of speaking about the woman giving birth as "she" to everyone but her, the experts suggested using her name — and speaking to her, rather than about her, as often as possible.
"At a time when a woman’s body and resolve are profoundly challenged, a laboring mother needs to feel empowered by her caregivers," Mary Malotky, a certified nurse midwife, told Blooma recently. "The language we use around her really is the thread knitting together her labor and birth experience."
A commitment to meaningful exchange with mothers and co-workers helps avoid dehumanization of the birth experience and our jobs, and fosters meaningful work relationships.
Not only does using the right language help improve women's outcomes, but it helps women learn their rights as patients. With so many women unsure of what their rights are during labor, many of them aren't even certain when their physicians haven't respected basic rights.
"Sadly, some women may not be aware of their human rights during childbirth; rights for respectful care, privacy, and freedom of choice concerning their birth," the authors wrote. "It is therefore the duty of caregivers to use language which will help empower all women."
Personally, being called a "good girl" by absolutely anyone — even with the best of intentions — can make my stress levels spike, so I can't imagine being spoken down to during labor. The language changes suggested by the authors, RCOG vice president Edward Morris told The Telegraph, "highlights the importance of creating a culture of respect for women during pregnancy, labour and after birth."
Here's to making the laboring process a better experience for moms everywhere — and using language that produces a better outcome for everyone involved.