1. Simpson, Kathleen Rice PhD, RNC, CNS-BS, FAAN

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For the past 25 years as coeditor of five editions of AWHONN's Perinatal Nursing and the last 5 years as editor-in-chief of MCN, I have strived to use appropriate and respectful language when writing about those we care for during pregnancy, labor, birth, and postpartum, as well as newborns, and children. Birth and giving birth are always substituted for delivery and delivered. Cesarean sections are edited to cesarean births. Patients, nulliparas, multiparas, and parturients are always replaced by pregnant women or women in labor. Staff is always clarified to be nurses or other members of the health care team and providers are generally replaced with nurse midwives, nurse practitioners, physicians, as appropriate each time mentioned even if it requires more space. Instead of diabetics and asthmatics and the like, we use women with diabetes and women with asthma, because no one wants to be or should be distilled down to their condition.


Over the past year, I participated as a committee member in development of the report Birth settings in America: Outcomes, Quality, Access, and Choice (National Academies of Sciences, Engineering, and Medicine [NASEM], 2020. Discussions among committee members led to the following statement in the beginning of the report (NASEM, 2020, pp. 1-2).


Gender-neutral language across different fields and in research is ever-evolving... For the purposes of this report, the term "pregnant women" is used to describe pregnant individuals. The committee recognizes that intersex people and people of various gender identities, including transgender, nonbinary, and cisgender individuals, give birth and receive maternity care. Because we understand the term "woman" may be isolating and not reflective of how some individuals choose to identify, we periodically use the terms "pregnant people" or "pregnant individuals" in place of "pregnant women."


A similar discussion was held about how to describe race and ethnicity. "Race" is a socialconstruct that has no biological meaning (NASEM, 2020, pp. 1-3); however, some classifications have been used in various studies including natality data and vital statistics that at times warrant use of race or ethnicity to report findings and understand disparities. Black, White, Native American, and Latino (women) were used throughout the document as appropriate when describing what had been reported by others.


Value-laden words were discussed and should be very important considerations in writing. I have long asked authors to specifically define what they mean by "natural," "normal," or "physiologic" birth as these terms are sometimes used loosely and to imply that anything other is "abnormal" or "unnatural." No one who has labored and given birth, either vaginally or via cesarean needs to feel negative implications, guilt, or shame from reading or hearing these types of descriptions that are imprecise at best and sometimes driven by implicit biases of what the writer believes is ideal for all. As editor-in-chief of MCN, when authors describe race and ethnicity, I will review how they are applied, whether they are needed, in what context, and if study participants used these terms. We welcome your manuscripts and hope you find this information about language useful.




National Academies of Sciences, Engineering, and Medicine. (2020). Birth settings in America: Outcomes, quality, access, and choice. The National Academies Press. in-america-outcomes-quality-access-and-choice [Context Link]