1. Section Editor(s): Freda, Margaret Comerford EdD, RN, CHES, FAAN

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I 've been annoyed at some of the bizarre language we use in women's health nursing for a long time. About 20 years ago, I wrote an article for Journal of Obstetric, Gynecologic, and Neonatal Nursing titled "Arrest, Trial and Failure," in which I argued that we needed to change the words we use so they could be more patient-friendly, more easily understood, and (certainly) more accurate for our patients. I was (and still am) particularly incensed by the negative, prison-like terms common to our specialty. We hear that the woman had an "arrest" of labor, or a provider wants to give her a "trial" of labor, or that she "failed" her "trial." Drives me crazy. What in the world are our patients thinking when they hear those terms? One of the terms I complained about was eventually changed, and I applaud those who made it happen. That term was "intrauterine growth retardation." I always tried to avoid using it because I knew the women only heard "retardation," and were frightened by its implications. That term is now "intrauterine growth restriction," a perfectly fine term that says what it means. But that's about the only positive news I can report about terminology lo these two decades.


I particularly dislike the term "incompetent cervix." I've talked about this at many presentations I've given, and I always have a big slide that says "INCOMPETENT???" giving the audience a chance to read that word and consider other less punitive terminology. (I've seen some journals using the term "cervical insufficiency," but that term is just as highly charged and unacceptable, in my view). The best response I ever heard was when I spoke at a media conference to magazine writers. A very important person in the women's magazine business came to me after I spoke and said, "How about 'exhausted' cervix"? I thought, that says it in a nutshell, doesn't it?


And how about "cesarean section"? That term takes away the entire concept that the woman is having a birth!! I also dislike it when providers refer to the "delivery." As a good friend of mine in perinatal nursing says, "Pizzas are delivered; babies are birthed." Yes!


I wonder if our colleagues in medicine agree that the words we use should be re-examined to be woman-friendly and easily understood? How about developing multidisciplinary committees to remove offensive and even misogynistic terms in our vocabulary? I'm sure no one developed these terms with malice, but I'm also sure that the time has come for a complete examination of the vocabulary of women's health, and a willingness to change terms that don't show respect for the women in our care; these terms have outlived their usefulness.


Midwifery has always supported clear communication with their patients, and is concerned about terminology. As an example, the editor of Journal of Midwifery and Women's Health recently wrote that we should not use the term "refuses" for it infers that the patient is not following the clinician's recommendation. She says that we should change it to "declines", for women have a right to make their own choices! (Likis, 2013, p. 123). In that same issue, Lichtman (2013, p. 124) says that the concept of midwives "delivering" babies takes the power away from the woman and that when midwives' work is described as "catching" babies, it demeans what midwives do." Well put. I agree.


Language is important, not trivial. If we hope to provide comprehensive care to our patients (or "clients" if you prefer), we need to speak clearly, using words that cannot be misconstrued and are not degrading. Yes, I still feel passionately about this topic. Even after all these years.




Freda M. C. (1995). Arrest, trial and failure. Journal of Obstetric, Gynecologic and Neonatal Nursing , 24(5), 393-394.


Lichtman R. (2013). Midwives don't deliver or catch: A humble vocabulary suggestion. Journal of Midwifery and Women's Health , 58(2), 124-125. doi:10.1111/j.1542-2011.2012.00253.x [Context Link]


Likis R. E. (2013). The words we choose. Journal of Midwifery and Women's Health , 58(2), 123. doi:10.1111/jmwh.12040 [Context Link]