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August 23, 2023

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Medical terminology evolves alongside our understanding of medicine. As time goes by, new terms are adopted while others are abandoned. In midwifery, there should always be a strong emphasis on the language we use, particularly in pregnancy.

In 2020, the Royal College of Midwives launched an initiative to discover the impact language has on women. The aim of the Re:Birth project was to find language around pregnancy that could be understood both by people delivering maternity care and those receiving it.

It was the first project of its kind to consult the maternity community (including new mothers and healthcare professionals) directly on their preferred language to describe labour and birth. The findings of the project supported the fact that many women were less concerned about the way their baby was born but with whether they had a positive experience and felt safe and listened to.

Last year, the Royal College of Midwives published a report outlining their findings and a new pocket guide is being issued to midwives this year.

Here are six maternity terms you are now unlikely to hear:

1. Delivery

The term “birth” has now been accepted, rather than the term “delivery”, which has commonly been used in the past. Women and health professionals also wanted accurate, specific descriptions as far as possible to describe what had happened in the labour and birth. For example, “birth with forceps” or “birth with ventouse”. This also includes “caesarean birth”.

2. Low risk / high risk

“Universal care needs” is being used rather than “low risk”. While “additional care needs” is now the preferred term for “high risk”. The word “risk” is associated with uncertainty and it is vital that women feel comfortable and confident during their pregnancy.

3. Normal

“Normal birth” is a term that has long been used by midwives and other healthcare professionals to describe a spontaneous, physiological vaginal delivery. But what counts as “normal”? Does this label someone as “abnormal” if they did not experience what we classify as “normal” birth?

The new preferred term, “spontaneous vaginal birth”, covers spontaneous labour without significant medical interventions such as induction and oxytocin. It also covers spontaneous vaginal birth without the need for instruments, such as forceps.

4. Emergency caesarean

The new overarching term for an operative caesarean section is “caesarean birth”. This replaces the word “emergency”, which is a term that may cause alarm. The term “unplanned caesarean birth” is now preferred over “emergency caesarean”.

5. Incompetent cervix

“Incompetent cervix” has connotations of personal failure. So, the preferred term is now “cervical insufficiency”.

6. Failure / failed

During the Re:Birth project, women were keen to share how terms such as “failure to progress” can contribute to feelings of failure and trauma. “Delayed progress in labour” or “slow labour” are now preferred terms.

We can apply the same logic to terms such as “failed induction” or “failed homebirth”. “Induction of labour, with delay and followed by operative birth” and “transfer in during planned homebirth” are favoured, respectively.

Language which infantalises pregnant women, such as “good girl” or “you are allowed/not allowed to” should also be avoided, as should language which has connotations of blame. Examples of this include “poor maternal effort” and “refused”.

During pregnancy and birth, which is a vulnerable time for many, the role of the midwife is to empower women and to value their autonomy over their care decisions.

The Nursing and Midwifery Council’s standards of proficiency for midwives document states that midwives provide universal care for all women and new-born infants. Midwives support physical, psychological, social, cultural and spiritual safety. The emphasis on psychological care is clear, therefore, with language having a profound impact on wellbeing.

Healthcare professionals must acknowledge that the language we use is an important part of the care we provide. Improved psychological safety and wellbeing is closely linked to improved safety, positive outcomes and future experiences. Language matters.The Conversation

Sarah Aubrey, Lead Midwife for Education, University of South Wales

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • One word I’ve always found strange was confinement. I work for a GP and I come across this a lot when I’m typing referral letters. I think it harks back to at least 150 years ago when women of a “privileged“ background (those that could afford doctors) were “confined” to their rooms and weren’t seen out socialising when they were thought to be near their due date. This probably could have gone for a couple of weeks at least as they wouldn’t have had ultrasounds or other modern methods of getting an accurate date. Apparently they were also confined to their bed for anything from 5 to 15 days after the birth. Amazingly they still use that term today.

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  • I see the reasoning behind this but changing how things are said won’t change what’s happened

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  • I don’t see why everything has to change & think people will still use the current words for a long time still

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  • These terms have been used for so long, I think it will be generational, or a very long time before they roll off the tongue naturally.

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  • It takes quite a long time for language usage to change, as a general rule. Not sure this will happen as fast as they think.

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  • Somehow I think these terms will only be used by doctors, etc. in the hospital, and most mothers will continue to say it the way they think without any ‘woke’ coming into it.

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  • Spontaneous vaginal birth.. ha! Oh people make me laugh! Who comes up with this? I get that terminology can change over time but overall I’m not seeing much difference.

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  • These new terms are actually a form of positive, empowering speech. Our words have power. Love it.

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  • Why does everything have to change? Women still give birth. I don’t like how some women are treated because they have to have a caesarean. Sometimes it’s not possible to give birth through the vagina. What I think is wrong is women choosing a caesarean because they want their baby earlier because it fits better with their plans. It’s different if there’s a medical reason for the baby to be birthed earlier than thought, that’s different

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  • We over think so much nowadays. It means what it means.

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  • I was fine with the old terms

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  • Sounds like we’re just over thinking and complicating things again…

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  • Goodness gracious, this is political correctness gone mad. Believe it or not spontaneous birth IS natural and normal, but that doesn’t make everything else wrong. And the term emergency ceasarian is important to differentiate it from planned ones.

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  • Although I agree with these changes, I think it will be hard to have them actually take effect.

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  • I guess I was high risk because I had twins. But I didn’t mind the term.

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  • Just after Lucy Letby we get this word change on pregnancy It would seem to me if it has feathers webbed feet and a bill it is a Duck .So what is correct just call a duck a duck and be done with it. I think this story is poorly timed not needed and is an insult

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  • These are good changes. They should change “geriatric” pregnancy while they’re at it..


    • I agree – Yes they should, it makes people sound old when they are not.



      • I was labelled geriatric when I had my daughter and I hated the term. I hope they find a better word to use for this.


      • Yes! This is the one I was going to suggest too. “Advanced maternal age” isn’t really much better though ;)

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  • It’s good to be considerate about the language used and not unnecessary cause alarm and worry.


    • It can help to alleviate the concerns of some people.

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  • An informative and educational article about these terms, thanks.

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  • I like that the term ‘high risk’ is being taken out. It is a worrying term.

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