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“It’s time we stopped using archaic medical terms to talk about fertility”

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Phrases like “inhospitable womb” and “lazy uterus” should be scrapped from medical vocabulary, says Dr Ellie Rayner. 

Dr Ellie Rayner, obstetrician, antenatal teacher and founder of The Maternity Collective, believes out-dated terms used to describe parts of the reproductive system should be scrapped. Here, she talks in her own words about why. 

It’s time we stopped using archaic medical terms to talk about fertility, childbirth and parenthood. Phrases like ‘inhospitable womb’, ‘lazy uterus’ and even ‘barren’ should be scrapped from our vocabulary.

Aside from the fact that many of these terms feel incredibly outdated and do not encourage a positive doctor-patient relationship, it would be fair to say the use of these phrases doesn’t exactly make women feel like they are supported and respected as part of the decision-making process, either. (I can only imagine what it must feel like to hear a part of your body described as incompetent, inhospitable or failing.) 

At best, these out-dated terms are inflammatory, moralistic words and, in 2021, there really needn’t be any reason to use them. Just because they are medical terms, doesn’t mean we can’t change them; language is always evolving and we should move on if the current words we use don’t suit. 

As a woman, I know how I would feel if a term like this was directed at me. As an obstetrician and antenatal teacher who specialises in this area, I see on a daily basis the emotional and psychological effect these words can bring to an already upsetting situation.

Pregnant woman holding her bump
Out-dated terms like 'inhospitable womb' should be scrapped, says doctor

That’s why I was so excited and relieved to hear that Peanut – an app that connects women through all stages of pregnancy and motherhood – – is launching a campaign to change these words. They’ve just released a glossary of new terms developed by linguistic and medical experts: they’re calling it the Renaming Revolution and I am totally on board with it.

Change can be so difficult to achieve in healthcare, but campaigns like this are essential in highlighting the importance of providing the right care for patients. We need to protect, inform and empower women, not make them feel awful at an already vulnerable moment. 

Trying to conceive, testing your fertility, giving birth and caring for a child are all difficult enough already, without compounding the problem by using shaming, guilt-ridden words to talk about it all. 

Using derogatory language in an already potentially distressing situation feels so against everything we are working to achieve as doctors and healthcare professionals. 

I will never forget the first time I heard of a surgical management of miscarriage procedure described as “evacuation of retained products of conception”, and thinking to myself how harsh and uncaring this sounded. Furthermore, I was surprised to see it written on the consent form and even on the patient information leaflet.

A recent survey of women by the Birth Trauma Association states that nine out of 10 women with post-traumatic stress disorder report poor communication from staff as contributing to their condition. I know from my own practice when I have met couples for a debrief after pregnancy loss or after birth how hurtful some of the terms they have heard or seen in their notes can be, and how much that has stuck with them days, months or even years later. It can seriously affect a person’s mental health, confidence and sense of self.

The vast majority of obstetricians and gynaecologists are aware of the distress that can be caused by some of the words we use routinely in clinical practice and the way certain medical conditions are described. Many of us actively try to use alternatives and discuss topics in a sensitive and compassionate way, but it can be challenging without more widespread uptake of change. I’d really like us all to start using the updated glossary, and I’d ask women who read about them to tell their doctors and nurses about it too so we can spread the word. 

As doctors, our primary job is to care for our patients, not just physically, but emotionally. If the words and the terms we use are distressing and upsetting to patients then we should do everything in our power to avoid that. Many medical terms have already evolved over time and I see no reason why recognising the importance of language isn’t as important as other, more clinical aspects of our job. We know that improved psychological care can improve outcomes so it should be considered as important as ensuring the right physical and surgical care is provided.

I want to care for my patients as sensitively as possible, but I need the language to be able to do that. In 2021, I would like to see the outdated terms we’ve seen used for so long to be banned from healthcare environments. I want these new, more respectful and still medically accurate terms to be picked up universally, so we can treat women with the respect and tenderness they deserve.

Who’s with me?

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Images: Unsplash

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