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.

Tammy, thank you for giving your insight and engaging patiently.

the underlying thought is that personalised care centred around womens’ individual circumstances and those of their family is crucial

I completely agree with this, but it’s not clear whether the trust are providing advice for personalised care or are generalising that care to all communication.

As previously posted, this isn’t additive language because it changes the meaning of the existing word by gendering it.

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

That's such a shocking statistic.

And it's only a couple of months since the full horror of the Shrewsbury/Telford scandal was all over the media - women abandoned when they most needed care, women treated with contempt and criminal negligence. Women not listened to. Women and their babies who died.

The attitudes that led to that scandal are far more likely to be the source of distrust in maternity services than whether the wording on a piece of paper is sufficiently 'inclusive'. Surely someone who identifies as transman/non-binary, who's managed to overcome their dysphoria to the extent of having a baby isn't going to snap because they saw the word 'mother' or 'breast'??

@Whatwouldscullydo

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

Sorry but that’s evidently bullshit. Involvement in your partner’s specific maternity care is nothing like looking stuff up on Google. Of course the choice is women’s, but involving the other parent in discussions on care is beneficial to women - I know had to make difficult choices in my pregnancy and would not have wanted to do so without my husband’s input.

And pregnant women are not patients. They are not ill.

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.

What are you even talking about? Where has anyone said anything about birth partners or HCPs deciding anything? This is what I’m talking about - ludicrous statements that have no relation to what’s being discussed.

This is why those working in these services don’t engage in discussion, because so many don’t listen and already believe they know what’s happening and don’t want to hear anything else. I’m obviously wasting my energy here. Which is a shame as it seems there’s nowhere a moderate discussion can be had and no moderate conclusion can be reached, which fills me with dread about how this will progress in future.

IfNot, yes I agree that it’s important to preserve the word ‘mother’ to refer to the person who gives birth.

tammy

I do appreciate you answering the questions.

But what we are trying to explain is that this is something creeping in everywhere and being inclusive is being prioritised over women. Cervical screening another prime example.

Men are not being made to do this.

I also included uptrend a link to a legislation document. The section on.miscarriage being about when a "persons'" pregnancy ends.

@merrymouse

IfNot, yes I agree that it’s important to preserve the word ‘mother’ to refer to the person who gives birth.

But that is not the sole definition of mother. The primary definition of mother is female parent, not one who gave birth.

@Whatwouldscullydo I’ve already explained that I understand this and agree. But services cannot justifiably refuse to use language which is inclusive of all their service users - I would entirely agree if the policy was that existing language would be replaced but that’s not the case and objecting on that basis would not be considered reasonable.

We are drowning in work right now: actions relating to the Ockenden report, addressing the shocking outcomes for BAME women, dealing with high staff absence due to COVID, increased workload due to COVID. The idea that we are ignoring all these things to come up with a language policy is ridiculous and not at all what’s happening (change moves at a snail’s place in the NHS - I know that any policies like this pinball around for months or longer before anything is put out).

We absolutely need to get to a position where we can get back to discussing actual issues rather than every public post creating arguments about language. Additional language is, at this time, the only way to try to do this unless anyone has any other suggestions?

@TammySwansonTwo do you think a National health organisation can use inaccurate euphemisms if this makes people better?

Tammy I'm sorry that you are finding this so frustrating. I agree with all your points about patient care.

I'm find it frustrating that the reporting doesn't make clear whether this is patient specific or instructions for language to be rolled out across all communication. (and I assume that patient specific non-judgemental care is always the ideal for no other reason than I love Call the Midwife - what would Nurse Crane do? )

Again, I disagree that this is simply additive language, but my query about that is not with you, it is with the trust. However, I imagine that their communications department is too busy handling 'political correctness gone mad' media enquires to engage in conversation.

I did ask earlier about what would happen with this language vs insurance/legal action.

How would that affect a staff member who used inclusive language with a patient that was medically incorrect to gain consent and the patient complained when it went wrong . Where does that leave the staff.

@C8H10N4O2

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.

Absolutely! I saw this thread in Twitter and I think it demonstrates perfectly how the ‘salami slicer’ approach functions and is so powerful.

Asking people to make seemingly trivial concessions, a little at a time and encouraged to put it in their own words/write it down or communicate it to someone else. The act of communicating the trivial, ‘harmless’ minor aspects of this concept can help cement them in the persons mind.

Then further little concessions which push the individual further down the road and requiring commitment which then changes how the person views themselves- they start to identify with and buy into the result of the concessions they are making.

The example used here may seem irrelevant but the process and and result are absolutely relevant to this. Please read if you can:

twitter.com/0x49fa98/status/1272180537541656577?s=21

@TammySwansonTwo yes I have several suggestions.
The department name is not changed because maternity accurately describes its function, the term breastfeeding is used for all, as this is the accurate term for the biological function, the term breast milk is retained as this is the accurate term for what is produced from women’s breasts to feed babies.
I would have been ok with ‘mother’s and birthing parents’ if it wasn’t for the fact that elsewhere in NHS information it had replaced the word woman with people or just avoided using it altogether, so I have no reason to believe that ‘birthing parent’ will not replace mother. So in that instance the NHS could roll back its removal of the word woman and then it can justify its ‘additional’ language.

[quote Lifeaintalwaysempty]@TammySwansonTwo do you think a National health organisation can use inaccurate euphemisms if this makes people better?[/quote]
*feel better

But that is not the sole definition of mother. The primary definition of mother is female parent, not one who gave birth.

I feel like you are being deliberately obtuse tbh. You work in maternity services, yes? When a woman comes into one of your wards/birthing suites/whatever they call it now and she is pregnant and about to give birth to a baby, then she is the mother.
Yes, families come in all types, yes, sometimes women use donor eggs, yes some women are lesbians, yes, some children are adopted after their birth has happened, but for the purposes of looking after a pregnancy and helping a woman give birth there is only 1 mother!
I think it is you making this way more complicated than it needs to be and not listening. The language doesn't need changing to fit new and complicated family relationships-the language still means what it has always meant.

I would entirely agree if the policy was that existing language would be replaced

I think the problem is that it has been replaced - existing neutral language has been replaced with gendered language. Breastfeeding is now what you do if you have a feminine identity (assuming this approach is to be used on all communication).

Again, with individual patients, the goal is a healthy baby and mother, not judgement. However, if you widen individual patient appropriate treatment to all patients the effect is different.

Effectively this is the opposite of gender neutral language - it would be like having a separate masculine word for nurse because 'nurse' tends to be associated with women. What would that then say about people who choose to use the word nurse?

@Whatwouldscullydo

I also included uptrend a link to a legislation document. The section on.miscarriage being about when a "persons'" pregnancy ends.

I saw that scully and meant to comment at the time, but the discussion was moving so fast, I lost sight of it. Thanks for linking. Does anyone know if 'person' has always been used in this legislation or is it new?

this is why those working in these services don't engage in discussion..

At least you're prepared to admit that!

Yes scully inhuman and demeaning language

Thanks for that Twitter thread as well

Can see how it works. Small things

The language doesn't need changing to fit new and complicated family relationships-the language still means what it has always meant.

In practice, on a one to one basis it's impossible to provide good care if you can't use the casual terms that your patients are using.

If a man refers to his partner as 'wife' even though they have never married or if a son refers to a stepparent as 'Dad', medical staff will compromise care if they insist that those terms are inaccurate. (I'm thinking about adults - not situations where parents would have to agree to treatment).

On a one to one basis there are very few occasions where this will matter.

The problem is changes to formal language.

Tammy maybe this is one of those conversations that would be better off the internet?

And pregnant women are not patients. They are not ill.

If someone is receiving medical care why shouldn’t they be called a patient? What else could they be called? Clients? Customers? Consumers? People receiving medical care and/or other assistance?
Patient seems as good a term as any, concise and reasonably accurate. (Unless we deny that maternity services supply medical care, in which case what sort of care is it?)

Midwifery is not medical care, midwifery is about supporting women in the normal life process of birth. Pregnancy and birth are not illnesses.

Medical care (from obstetricians)is only required if there complications.

Midwifery is not medical care, midwifery is about supporting women in the normal life process of birth. Pregnancy and birth are not illnesses

I suppose if absolutely no medication nor medical intervention were involved this would be true, to an extent. But the normal term for a person requiring medical care is “patient”.

As for the normal life process argument, think about dying (and sometimes, sadly, a consequence of poorly managed childbirth). That’s not an illness, but a natural and normal life process, a consequence of being alive. It may or may not require support from a medical professional using medical interventions. Would you not call the dying person a patient, if receiving those?

I’ve had two children and when in hospital, I was a patient on the maternity ward.

Oops put my parenthesis in the wrong place. I’ll edit:

As for the normal life process argument, think about dying. That’s not an illness, but a natural and normal life process, a consequence of being alive (and sometimes, sadly, a consequence of poorly managed childbirth). It may or may not require support from a medical professional using medical interventions. Would you not call the dying person a patient, if receiving those?

Those accessing maternity services are service users, have been for a long time. Again another can’t scenario because people complain when you use service users and others complain when you use patients. The arguments around language don’t just revolve around gender related issues - Caesarean section, delivery, etc etc all terms that cause rows. Arguments about language in maternity are nothing new.

Perinatal services is more accurate than maternity services, and a change to reflect this does not necessarily link to gender related issues. Some sections of the service already use this terminology- eg. Perinatal mental health, because maternal mental health is not specific the perinatal period. All maternity services occur within the perinatal period, it’s a good way to refer to services.

I too find the focus on language irritating, there are far more pressing issues to deal with. But if service users tell services that the language used feels actively exclusive to them, it’s naive to think they won’t need to address that.