Midwives told to stop using terms such as 'breastfeeding' and 'breastmilk'

[MissMoped]

because it’s not gender inclusive language, I believe with particular reference to the transexual debate.

This is at Brighton and Sussex nhs trust btw, good to know NHS money is being spent wisely btw, poring over the “incorrect” use of language.

The word “mother” apparently should not be used on its own; instead “mother or birthing parent” (um, isn’t that a mother?).

Breast milk and breastfeeding is to be replace by “breast/chest milk” or “milk from the feeding parent”. “Woman” should be replaced with “woman or person”.

Gobsmacked.

In the UK the woman who carries and gives birth to the baby is the legal mother.

@Floisme

Surely in that situation the woman giving birth is still the mother? Of course the lesbian partner would then have a biological connection to the child and I totally get that they'd want a word to express that, but I would be very uncomfortable about anyone other than the woman giving birth being referred to as the mother. It is a very special word with a specific meaning and I think we dilute that at our peril.

So if you use a surrogate with your own egg and then raise the child, you’re not a mother?

That seems unnecessarily exclusionary, especially in cases like the one I mentioned above.

Have a look at the Better Births documentation. Involving partners more in maternity care is supposed to be an attempt to improve outcomes for women and children, and it makes sense. Maternity is so unlike other areas of medicine in so many ways because pregnancy is not illness, and partners aren’t just support, they are also the parent of one of the people benefiting from the service - maternity care is also about the baby and their outcomes. It’s incredibly complex.

To be honest, the biggest issue in the language wars for maternity is not mother - it’s women. Because there are female partners, sometimes the biological mothers, who are women but not pregnant. There are those who are pregnant who don’t identify as women, there are partners who are biologically male but identify as women. It’s a logistical nightmare, and maternity services telling a load of vocal people - not only trans or homosexual people but female service users too - no, we will not use language that includes you... that simply won’t happen. It can’t happen without justifiable claims of discrimination.

It sucks but this is the catch 22 we are in. Which is why a trust like Brighton saying we will not replace language with gender / sex neutral language is a stand, it’s just not as much of a stand as you want to see, and I get that. I don’t see any other solution at this stage however and it’s very difficult to argue against it without sounding unreasonable. If one were to try to argue against it, a more sophisticated argument would be needed than its alienating, because the response will be that not doing it alienates others.

On the subject of stating services should use language that describes the majority, that’s not a great idea either. There have been and are complaints about imagery that features BAME women, especially in areas where the population is mostly white. Complaints about this would be viewed in the same way by trusts.

The thing is I am on the GC side of this too. I genuinely do understand where you are coming from. But this is not like a corporate entity standing firm on the use of language - this is a public service which must provide an accessible service for those who need it. It’s a very difficult position to be in, in this current climate.

@Whatwouldscullydo

Writing social media content is a bloody nightmare now. I spend at least as much time carefully wording things to try to avoid saying anything contentious as I do on the actual content. If you don’t, the comments get derailed, everyone ends up arguing and offended and the messaging is lost. It’s massively frustrating

I mentioned this earlier. The fact that this policy was publically announced means that every twitter post now has to be worded in a "neutral way" by that it usually means without the word woman in it or they will be piled on and tweet removed. They can now never mention women no matter how relevant. So what started as an internal policy fir maternity will now become their entire theme

That’s not true though - the policy does not state that the existing terms can’t be used. And when someone does use those terms they can point to this policy. What you describe is what’s already been happening.

Have a look at the Better Births documentation. Involving partners more in maternity care is supposed to be an attempt to improve outcomes for women and children, and it makes sense

Do they genuinely believe that ? Or do you think its more because staff rely on partners to be keeping an eye on things even when it's distressing the other patients outside of visiting hours because there's no staff?

Genuinely asking . Not being sarcastic. I had a homebirth with dd1 so had a midwife and a student there just for me. Hospital birth was a shock as was barely even spoken to on admission/over night on the ward ( had ecv and water broke and to complications in pregnancy was admitted )

The only person to.speak to me at one.point was the lady doing the.menu choice

Tammy That's a long post and can't read it in full at the moment - I'll have to come back to it, but on your first point, I would say only the woman who gives birth to the child is the mother. I can see how that might be viewed as exclusionary but that's what words do, and I don't think we should change their meanings because people feel left out. That's how we got into this mess in the first place.

We might be talking at slightly at cross purposes as I'm thinking about wording used in public information and communications, whereas I think your focus is on spoken discourse.

Well I think that is a dangerous route to go down TammySwansonTwo. I believe it is a mistake in maternity services to focus on the anyone but the woman who carries and gives birth to the baby. Looking after the mother you are by default looking after the baby since the baby is dependent on the mother.

The commissioning parents in surrogacy have no legal rights in the UK until the point after birth when the paperwork is done and not should they.

Maternity services must be at the service of the woman who is pregnant and giving birth. She cannot be subject to claims of anyone else over her body and what happens to her. The foetus has no rights whilst in utero and no other person has any rights over the mother’s body nor should they have any rights in her pregnancy, birth or feeding choices.

@TammySwansonTwo I think the point is that it is everywhere. Thank doubt people here would be as upset if this was the only place.

You say that the goal is to make it accessible to everyone.

Take another NHS initiative, cervix havers instead of women. How does this make that service accessible to all the women who don’t know what a cervix is? And the women who would know what it is in their mother tongue? Especially bearing in mind the low current uptake of smear tests?

@Whatwouldscullydo

Have a look at the Better Births documentation. Involving partners more in maternity care is supposed to be an attempt to improve outcomes for women and children, and it makes sense

Do they genuinely believe that ? Or do you think its more because staff rely on partners to be keeping an eye on things even when it's distressing the other patients outside of visiting hours because there's no staff?

You’re talking there specifically about postnatal wards - staff generally dislike having partners staying but there simply aren’t enough staff to provide all the assistance women need. During COVID many have commented on how much more peaceful it is without partners, increased breastfeeding etc but also service users are talking about how difficult it is on postnatal wards with no partners and so few staff. Another impossible situation!

@TammySwansonTwo sorry but there is no justification for a health organisation (any government organisation) to use inaccurate euphemisms to be kind or inclusive, and to be renaming women centred departments when they, by their very nature, will always be women centred departments.
Health organisations need to use biologically accurate, sex centred terminology when this is appropriate, they need to be impartial and objective, it’s not their job to think about feels. It’s their job to save lives and preserve physical and mental well-being. I’m guess this trust like every other, has significant staffing issues in maternity units, and could improve patient outcomes, and that should be their focus.
The idea that they would use a made up term like chest feeding, even if it was just to trans men, is preposterous.

[quote CoffeeTeaChocolate]@TammySwansonTwo I think the point is that it is everywhere. Thank doubt people here would be as upset if this was the only place.

You say that the goal is to make it accessible to everyone.

Take another NHS initiative, cervix havers instead of women. How does this make that service accessible to all the women who don’t know what a cervix is? And the women who would know what it is in their mother tongue? Especially bearing in mind the low current uptake of smear tests?[/quote]
I’ve already made exactly this point so I’m not sure why you think I would disagree with this?

Surely however the energy should go into improving care fir the mother though?

Stuff the partners tbh . They are adults can leave any time for food and just disturb people and make demands on the time of staff and infringe on the privacy and dignity of the women on the wards . Cant they just be called in when it's nearer the time.

You have highlighted the exact problem. Effort going everywhere else but the women. And now women aren't eveb women and there's no problem because there's no definite class of person the problem.is affecting

And with such staffing issues why waste time amd money on rewriting these policies.

The very fact that's where they chose to act shows exactly where priorities don't lie. We cannot for a second let them think.its ok to erase the victims of what is effectively medical neglect

Are trans people actually offended by the term "breastmilk"? Have they asked for the leaflets to be changed? Doubt it. I would imagine that 90% of trans people don't give a sht, and changing the nomenclature is a decision made in a boardroom to appease an angry mob that doesn't exist.*

One member of the rather large review team on this document was F, a very high profile transman who has hit the headlines several times for trying to get the birth of F’s child (for clarity the child came out of F’s vagina) registered with F as the father. This was rejected by the courts. If allowed, it would have left the child without a registered birth mother which would be rather a bizarre (and unacceptable) situation for the child.

Canada are now allowing fathers who transition to retrospectively update their child’s birth certificate to record them as the ‘mother’ regardless of the fact that this is an historical document belonging to the child recording important facts relating to the child. Canada has completely lost the plot.

@DaisiesandButtercups

We are getting into dangerous territory when we consider anyone other than the pregnant/birthing mother has any right to expect anything from maternity services whether or not the other party is married to the mother or provided her with an egg or sperm.

The mother’s chosen birth partner is there only to support her in her process, her journey to motherhood. The mother is the most important person in the room, no one should be there unless she decides that they are helpful in her process. All the power should lie with the mother in her pregnancy, labour, birth and feeding choices. For too many women this will the first time in their lives when they are the absolute centre of any situation.

Yes, yes, yes.

Also

So if you use a surrogate with your own egg and then raise the child, you’re not a mother?

You would become a mother when you start raising the child, but when the surrogate is pregnant, in labour etc SHE would be the one in need of maternity services obviously.
As for involving partners more..why? In the hospital where I had my oldest was the midwives were clearly beyond stretched (is that why? extra pair of hands?) How do they have time to be focusing on partners? Maternity should be focused on the patient, and then the baby. There are good reasons why sometimes it is actively bad for the mother to bring her partner into the equation. Surely you know that Tammy
I had PTSD after my first birth. The negligence and carelessness nearly killed my baby and has left me with lifelong terror of being in hospital, and I am boringly average. Most women I know have at least one bad story abut maternity care, so if women expect to be the centre of their own care when they are pregnant, in labour or post partum they are not being "un-inclusive" FFS.

What I can say is that there is no deliberate attempt to “send a message” by this usage

But coupling it with a threat of disciplinary action for accidental misgendering certainly does that.

Combined with directives to staff to gaslight women whose life experiences or mental capabilities mean they need female bodied care or cannot process malebody=woman its a pattern that sends a very clear message.

Its never about one statement, one message, its the steadily aggregating whole. As Yes Minister would have put it - its the salami slicer model of incursion.

no, we will not use language that includes you... that simply won’t happen. It can’t happen without justifiable claims of discrimination.

This is the crux of the problem.

‘Woman’ when used to refer to sex is inclusive of anyone whose sex is female. It excludes males, but that is the nature of medicine.

I won’t get a Covid vaccine at the moment because I’m not on any priority list, but those lists have nothing to do with my identity. Medicine is necessarily exclusive.

Again, ‘chestfeeding’ is not gender neutral, it is an enforcement of gender.

Of course there is sometimes a tension between words used for the act of parenting, having legal responsibility for a child and roles within the reproductive process. This is not new and also involves adoptive and step parents.

However ‘chestfeeding’ if added to general communication and not just used for individuals is an attempt to add gender and differentiation to existing neutral language.

This is another situation where grouping trans and gay together leads to false equivalences.

You would become a mother when you start raising the child, but when the surrogate is pregnant, in labour etc SHE would be the one in need of maternity services obviously

These partners are gonna hear the words mum/dad screamed at all hours of the day for the next 20.or 30 years until they move out.

Still involving them somehow priority over the actual women

Of course the pregnant woman (or otherwise identifying person) is centred in maternity care and will continue to be so. Trans men / biological women who identify as non binary who get pregnant and need maternity care exist. You can’t deny that this is a fact, whatever your views on trans ideology. They need to access services and messaging needs to be relatable for them as well as the majority. There’s no way a public service can refuse to include all of their service users in their messaging. Maternity is backed into a corner and caught in the crossfire of something we don’t have the resources to resolve.

If you look at Better Births, the language used throughout is “women, babies and families” - the underlying thought is that personalised care centred around womens’ individual circumstances and those of their family is crucial. Involvement of partners improves outcomes because women are not the only parent, and being treated as though they are is a major source of oppression for women. It’s not a covert attempt to remove women from the centre of maternity care or any other kind of ploy. If you’re pregnant you come first, but involving your partner in discussions and care is beneficial to women as well as to their partners.

There needs to be a dialogue and a sharing of experiences and resolutions developed. I am only trying to give some insight into the realities of the service, I am not against anyone here.

But women aren't coming first.

Proven by the fact that they'd rather write about involving partners, or rewriting inclusion policies than improve the care.

Black.women are still 5 times.more likely to die having a baby, and we faff about with this stuff...

You would become a mother when you start raising the child, but when the surrogate is pregnant, in labour etc SHE would be the one in need of maternity services obviously

I disagree. ‘Mother’ also indicates a genetic relationship and as with fathers this starts at conception. Where the egg is carried by someone else both are mothers (even if neither has contact with the child after birth).

And actually tbh there's nothing they can show or tell you in hospital as a partner that cant be found with a quick Google or watching a you tube video.

If a partner wants to learn and be an active Co parent they will. They don't need the hospital to take on that responsibility and Spoon feed them. Just take care of the patients

The pregnant woman herself can decide who she wants to support her and the role of health care providers is to facilitate that choice not to decide for her who should be her birth partner. There are many reasons why the provider of the gamete or the mother’s spouse/partner may not be the best choice and I absolutely disagree that anyone but the mother herself has any rights to be involved in her maternity care. The mother must be the centre of maternity services, they exist entirely for her.

This is another situation where grouping trans and gay together leads to false equivalences.

I’m not grouping them together - they are two groups who, for different reasons, have difficulties with some of the language used within the service. I refuse to agree that a biological mother whose partner carries the baby has no claim to the term mother, I think it’s unnecessary gatekeeping, just as I believe that adoptive parents should be able to use the terms mother and father despite not being biologically related and not having carried the child. I don’t see how men donating genetic material get to claim the label of father and women doing the same don’t. I think everyone is perfectly able to understand that mother encompasses different scenarios. Perhaps if you’d seen the way female couples are spoken to by some HCPs you would get what I’m saying.

Still involving them somehow priority over the actual women

Who said it’s a priority? Where does it say this? It’s this kind of hyperbole that derails discussion and prevents resolution. It’s bloody exhausting.

I think I’m done - you can listen to what I’ve said or not. I’m trying to explain how an objection to additional language will be perceived by the service, by those who work directly with individuals impacted by these issues rather than debating language in general terms. That may help to formulate a position which is actually heard. Again, I am being careful about what I say here because I have to be, but I am not against you.

I disagree. ‘Mother’ also indicates a genetic relationship and as with fathers this starts at conception. Where the egg is carried by someone else both are mothers (even if neither has contact with the child after birth).

Ok. Yes, there is a genetic relationship with the egg/sperm etc. What I am trying to say is that for the purposes of maternity care, during the time when a woman would be using those services, no matter how that baby got there or who supplied the genetic material, she is the woman giving birth A woman giving birth to a baby conceived with her partner's egg is still the mother even if she is not the only mother once the baby is born.
The idea of anyone outside of the pregnant woman somehow having ownership over what is inside her body makes me very uncomfortable I guess. And from a pragmatic standpoint, the woman in labour is the patient and the focus should be on that.