Language in pregnancy and birth - poster

[organiccarrotcake]

I thought this poster might be useful to give to your midwife, and to also remind all of us that we have rights to our own body during pregnancy and birth!

www.facebook.com/AIMSUK/posts/1446435502092026

You would have to be a right fanny to seriously think handing over that nonsense is acceptable. Due month ffs

I agreed with most of that poster.
I had a horrific birth, where I had internal examinations I did not want, I begged them to stop and take their hand out and they didn't. I ended up with ptsd and still have issues with anything going near my vagina. I have major trust issues and sex is a nightmare.
I felt like I had been assaulted. They didn't ask, they did, and when I said stop, they didn't.

I wouldn't give this to a MW - I think it wouldn't be helpful at that stage. And tbh a few years ago I probably would have thought this was precious.

But having lost a baby largely owing to failures by midwives, some of the words on the left hand side column really struck a chord with me. Like not believing I had progressed (because of the short interval) and subsequently reading how they'd written "woman not compliant" in the notes, and then seeing how shocked they were that I was already 7-8cm dilated at that point. (And the woman not compliant being challenged along with other lies by their own internal investigation following the post mortem).

Of course much of this is down to individual incompetence, but throughout that pregnancy I remember leaving mw appointments in floods of tears, not being listened to, my concerns not being taken seriously, important bits of info being missed, and being continually patronised.

There is an issue with midwives talking down to pregnant women, and not listening to them. No medical professional would talk to men about their bodies in this fashion. Even if this poster isn't the best way to address that misogyny it's important to acknowledge that it exists.

Can’t say I mind any of the ‘dont say’ stuff. I did need to be told to push when I was getting tired. When I’d asked for pethedine I had no objection to my midwife saying ‘I’m just going to clean the area then you’ll feel the needle’.
I want my midwives to be focused on what they’re doing while I’m in labour not worrying about every single word that comes out of their mouth.

I don't know if they need to be given this... we just need to feel empowered to say what we think/feel. A good birth partner is really helpful too. I delayed cord clamping at the behest of my midwife and my consultant said this could be a factor in my (hellish) retained placenta experience. DH has been briefed to explain (if necessary) :

1. Our first child was early with a quick labour. If my wife says she is in labour you must examine her (after being nearly turfed out of the hospital last time and giving birth about 90 mins later)
2. Do not delay clamping the cord at all. This is not ok.

On a lighter hearted note, I remember the midwife saying 'push push push push push' on and on, right next to my ear like it was a chant... through gritted teeth I managed 'I am fucking pushing'

Your labour, your child, your body.

A load of twaddle if you ask me.

I have to agree with others I think this is precious, and can't understand why phrases like 'due date' 'hop up on the bed' or the word 'push' would be an issue. And some of the things on the things they should say list such as 'breast is normal' for example just aren't true as most people ff and it could make people feel worse than 'breast is best'.

Yes the lack of agency some of the language is implying is less than ideal, but a good midwife will be offended and a bad one will take no notice of this poster. They have more important things to be doing than worrying about policing their use of language.

I wanted low intervention for my labour, and I thankfully had an easy birth and my midwives were amazing, but I was totally willing for the midwives to take full control and tell me what to do should anything change, I wanted my baby out safely however it happened. They are the ones with clinical knowledge and experience, they should be deferred to should anything less than ideal occur which could endanger the baby.

There is an issue with midwives talking down to pregnant women, and not listening to them. No medical professional would talk to men about their bodies in this fashion. Even if this poster isn't the best way to address that misogyny it's important to acknowledge that it exists.

I came on to say just this. The way some women treat labouring women is sexist. Belittling women's pain, not asking for consent etc. are misogynistic attitudes. Nothing is going to change unless HCPs realise this.
There will always be a very fine line between respecting a labouring woman's wishes and getting the baby out safely. It will never be possible to avoid all situations in which either party may end up traumatised. However, things really are far from perfect at the moment, I have been present at many births and have witnessed systematic bullying of labouring women. I was subjected to two procedures I explicitly refused during the birth of DS2. I don't have PTSD, but I'm still fucking angry about it!

Having said that, the poster is pretty stupid imo. It assumes all women want an intervention free birth. Many don't! And what's that "breast is normal" crap? That's just replacing one kind of patronising language with another!

Choice and consent is so important in labour and this poster is just highlighting that. Anything that brings this to the forefront of labour unit staff has to be a positive thing.

I was told I was having an episiotomy when the doctor was halfway through cutting me. Almost 2 years on and it's left me pretty traumatised. The same doctor also told me I was basically lying that I could feel every stitch afterwards (I have a high tolerance to LA) despite me screaming in agony. If I saw that doctor again I'd happily hand her a copy of that poster.

IMO they've clouded a valuable message (about seeking consent/making sure women feel empowered to make choices/are informed etc) by adding in a load of fluff and stuff about not saying push or due date. I mean for God's sake.

due date is misleading though, and ends up with women being totally focussed on 1 particular day, when in fact its that date +/- 2 weeks- so a month, in effect
this would be a very useful tool in training, I agree, all the 'hop up', I'll just... business is patronising and infantilising- I frequently heard of MWs saying 'good girl', which would just enrage me so much labour would grind to a halt.

Some of the don't say things are a bit odd, but I really resented being told that I would be booked in for an induction. When I said I didn't want to have an induction she still made the appointment anyway. This was before I'd even reached my due date, and although she said it would be for a check if I didn't want an induction, the appointment was in the ward at the hospital when I was booked for a home birth and all my appointments were in my own home.

I was also offered sweeps from 38 weeks which I kept saying I didn't want and kept being told I needed one or I would definitely have an induction despite there being nothing wrong with me or baby. It was very stressful to have this repeatedly said and I felt stressed whenever I refused.

I didn't have an induction, baby came 4 days late at home and everything went fine, the labour was good and we were all doing very well.

due date is misleading though, and ends up with women being totally focussed on 1 particular day, when in fact its that date +/- 2 weeks- so a month, in effect
What would be more acceptable language, given that there needs to be some "due date" type concept to work towards? It's already referred to as estimated due date in all my notes etc. and no one has ever made a big deal of the date whatsoever.

Why is 'choice' on the do not say list?! It seems very precious to me.

I don't understand why some women want to micromanage every little detail, and dictate to professionals on how they should speak/act.
I think this poster is very offensive, and quite precious.
I've had 3 complicated pregnancies resulting in premature birth and lost my twins in the most recent.
They should count themselves lucky if all they have to worry about are throwaway comments. Load of shit.

I'm just laughing at the Community midwife who delivered my last baby after a full days work, then getting called in to a night shift as they were so desperately understaffed having time to read a poster! she ONLY worked 18 hours that day bless her!!
There was barely time for her to read my notes as they were dashing from room to room! She did however ask me if there were anything I did/ didn't want to happen and constantly check I was ok! That was quite enough for me!

whereisforever

Breast is normal is no better than breast is best. Now I get to feel abnormal that my son wouldn't latch and nobody could tell me why or give me any useful advice.

I get this but 'Breast is normal'? So bottle feeding is 'abnormal' then? Christ if someone had said that to me after the birth of my first I would have punched them! I felt bad enough for 'failing' at breastfeeding in the first place.

**Edgar sorry I've just repeated what you said! Totally agree though. I actually feel the phrase 'breast is normal' much more offensive that 'breast is best'.

I'm confused by some of the examples, but it's definitely an issue that needs addressing. The kind of language used ties in with decent care.
I definitely think "good girl!" should be added to it! I've heard that so many times on OBEM and it makes me absolutely cringe. Can you imagine a grown man in his 30's being told "Good boy, that's it, good boy". Really disrespectful and patronising IMO, there are other choices of language that can be reassuring and encouraging.
I definitely agree with "I'm just going to"...this was said throughout my first birth, including when the midwife was doing the episiotomy. Tbh I think consent during labour and childbirth is an utter joke. My baby went into distress so they decided to take me to theatre, prep me for a section but do three tugs of forceps first in an attempt to get baby out vaginally. Never was I asked whether I actually wanted to try the forceps and whether diverting straight to a C-section would be better, the risks of each option were never discussed. It was just a case of 'Right we're going to do this'. I feel when you get guidance on making birth plans it's all about 'preferences' regarding water births and whether you 'prefer' not to have something 'where possible', nothing is about actually knowing the risks associated with different treatments, your rights and the fact you can refuse consent.

Also 6 years after my DS's birth I still remember some of the sarcastic comments and cutting remarks made when I was in labour. They repeat over and over in my head sometimes.
I was very aware during both labours at everything that was happening and being said, and even if I didn't fully 'care' at the time, I would look back at certain things afterwards and feel very distressed.
I do have friends, however, who claim their labours are big drugged-up or painful blurs with hazy details or complete blank spots. I do wonder whether if all women could remember their births clearly, whether a lot more would feel upset at their treatment. I did feel at times during my labours, the medical staff sort of assume that you're not fully aware and won't remember, and that you aren't bothered about dignity or privacy ect.
It does make me sad how patronising and demeaning midwives can be to other women. I just don't understand why? A lot of the women they deal with are just as intelligent, just as educated (and even if they're not it's not important) and all are an equal adult, why do so many talk down?