New report from midwives says language used around childbirth should be changed

Midwives have called for the vocabulary used before, during and after childbirth to focus on personalisation of care. The project, led by the Royal College of Midwives (RCM), has developed the advice to support maternity professionals in using a new shared language throughout all stages of childbirth.

The collaborative project, called Re:Birth, began in 2020 but the report into the findings was published today. The aim was to build a new language that reflects the needs and asks of women and families and puts personalisation of care front and centre.

After speaking to women who had given birth and those in the maternity profession, the Re:Birth project found that listening to women and using and respecting the language she chooses helps build trust. For example, during the project women were keen to explain how terms such as ‘failure to progress’ or ‘lack of maternal effort’ can contribute to feelings of failure and trauma. The RCM wanted to encourage those giving birth to be the ones to decide how their labour and birth are described.

Gill Walton, Chief Executive of the Royal College of Midwives, said:

We know that, particularly in England, there has been an increasingly heated debate around the term ‘normal birth’. Whatever your personal perspectives, it’s clear that when describing labour and birth, the term means many different things to different people, which has caused misunderstanding, confusion and upset.

After receiving thousands of input from people, including almost 1,500 who had given birth in the last five years, project Re:Birth was coined as the RCM felt the language used needed to be reviewed and ‘reborn’ in a sense. Re:Birth advises that maternity staff should follow the Five As:

• Acknowledge

If the woman has had a previous birth, acknowledge this as a birth (independently of mode of birth), or if this is her first time. If she has had a previous loss, that should also be acknowledged.

• Ask

How would the woman describe a birth she has had or would like to have? Her feelings are just as important as the technical description, so listen to how she talks about that experience.

• Affirm

Check with the woman the language used in your notes to describe any previous birth. Does that description feel right to her? Is there another term she would prefer to describe it?

• Avoid

Try not to make assumptions about her choices – for example if there was a previous caesarean birth. Don’t make your own interpretation of what you think her experience might have been, or impose terminology on her.

• Annotate

Record the woman’s own description of her previous experience of birth as fully as possible, and her preferences on language and terminology.

Giving birth to a baby and the care received during a woman’s pregnancy is a very personal experience and so the RCM felt that personalising the care received was needed via the language used throughout. Shirley Cramer CBE, the independent chair of the Re:Birth project, said:

In every aspect of our lives, language matters – and in health and care settings, it’s even more important. How we communicate with each other can determine the quality and impact of the care given and received, which is why developing a shared language is so important. How we use language inevitably evolves over time, but we hope that the Re:Birth project will help to embed a shared, respectful way of discussing birth.

The project findings included that those surveyed thought that the term ‘birth’ was preferred to describe all types of birth, rather than, for example, ‘delivery’.  Caesarean birth was chosen as more popular than operative birth or caesarean section. Spontaneous vaginal birth was chosen more frequently than alternative terms such as normal or natural birth, unassisted birth or birth without interventions.

You can read the full report here. 

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