If you’re not pregnant, you’re forgiven for thinking that all pregnancy terms are comparisons to baby bumps, bundles of joy, and fruits of varying sizes. The medical lexicon for a mother-to-be can be downright daunting.Case in point: Phrases Elderly Pregnancywas until recently used to refer to someone who became pregnant after their 35th birthday.
The unfortunate term is believed to have originated from a concept dating back to the 1970s, when amniocentesis, a procedure to screen for genetic abnormalities, was becoming routine.That year, the National Institutes of Health Identified Because the age at which the test could harm the fetus was about the same as the chance that the fetus would be born with Down syndrome. More than 40 years later, advances in screening technology have made that calculation essentially obsolete. foolishMoms too, always hated Phrase: Jamila Larson, a 49-year-old mother of two in Hyattville, Maryland, said she “felt like a punch in the gut” when her midwife called her “geriatric” in 2011. she told me.
you still will hear it Occasionally, the term has (thankfully) fallen out of use for some time. One reason is demographic change. By 2020, more and more women are giving birth after the age of 35. 1 in 5 babies In the United States, born to mothers past their birthday. announced The preferred term is now “pregnancy over 35”, and even better, physicians and researchers should indicate the patient’s age in 5-year increments starting at age 35.
This is how progress works. If medical terms don’t last beyond their usefulness, thank them for their service and move on. It may therefore surprise you to learn that dubiously appropriate and medically incorrect terms are still used to describe pregnancy and childbirth. It has been recognized that there is power in: perpetuate prejudice among doctors, scrape off the vocabulary of such terms including schizophrenia (this makes a person a stigmatized disease), drug abuser (which makes people addicted), and sickler (derogatory term for someone with sickle cell disease). Still, doctors say about the female body, hostile womb, incompetent cervix×, and recurrent miscarriage— Words that definitely sound worse than the words that are currently shunned Elderly PregnancyWhile some words claim to haunt mothers’ charts like the ghosts of medicine from the past, why do some words evolve?
Elderly Pregnancy Publicity skyrocketed in 2021 when the makers of fertility and motherhood app Peanut turned their attention to the minefield of pregnancy language.rear video After a distraught woman’s attention on the app after doctors told her she would be “geriatric” if she got pregnant, Peanuts launched a campaign to come up with more neutral-sounding alternatives to existing medical terminology. .That April they Glossary of the proposed replacements. Still, heightened public interest does not always translate into organized action. 20,000 people have downloaded his Peanut glossary, but there has been no official move in the medical community to repeal the original term.
Across America, doctors continue to give diagnoses that not only sound outdated, but downright bizarre. Many of these terms are included in the global catalog of diseases doctors use to report procedures to insurance companies, known as the ICD-11. the latest version of that glossary, release 2022 and still contains the phrase primiparous elderlyare basically synonyms Elderly PregnancyIn 2016, during her second pregnancy, Larson’s note read, “Senior multipregnant.” That means she’s over 35 and she’s been pregnant before.
or consider incompetent cervixterms in both ACOG Dictionary and the ICD-11It actually means that a pregnant person’s cervix has dilated before the pregnancy is complete, which can lead to premature labor or miscarriage. Meena Khandelwal, research director for Obstetrics and Gynecology at University Health Care, told me that she avoids using the phrase in front of her patients (she sometimes Weak cervix Instead, she’s not sure it’s much better).but the reason is incompetent cervix It’s entrenched in insurance codes and her hospital’s record-keeping system, but the phrase is likely to appear in patient notes anyway.
Indeed, it is very important to tell that the cervix has opened prematurely. Doctors are encouraged to use ultrasound to monitor the situation, temporarily suture the cervix, and try other treatments. Healthcare providers need to be able to inform each other about their patients quickly and clearly. It can be argued that it is a much more important function of medical terminology than protecting the patient’s emotions.
But often existing languages are the following Clearer and more precise than the milder alternatives. for example, failure to progress— A common term meaning labor lasted longer than expected —say nothing About why labor is late. Also, calling a patient “elderly” is less informative than simply stating whether he is in his 30s, 40s, or 50s. Outdated language can even worsen patient outcomes. 2018 survey A study of physician bias found that when physicians read stigmatizing words in patient charts, they tended to have more negative attitudes toward patients and less aggressive treatment of pain. rice field. Besides, “incompetence” is a strange way to describe whether the cervix is open or closed.
This strange quality unites many pregnancy-related terms.These sound as if the pregnant person or her body part could have chosen a different path. “It sends the message, ‘You may be normal, but you’re not.'” Language at Rutgers University Associate Professor Kristen Sillett says: Elderly PregnancyDo not apply the accusation explicitly.
For many moms to peanuts, the most devastating label they’ve encountered is recurrent miscarriage. The term is usually refer For women who have had multiple miscarriages before 20 weeks of gestation 1-2% Female. (The cousin spontaneous abortion, which means that such a miscarriage occurred once). From a purely medical point of view, abortion point to Any procedure that terminates pregnancy, which includes a procedure to empty the uterus after a miscarriage. However, in layman’s terms, Was chosen Abortion. In addition to that, it also implies that abortion is a bad habit that is hard to break, so I found the term particularly inappropriate. “It’s really scary when you think about it,” says Somi Javed, an obstetrician-gynecologist and founder of healthcare company HerMD, who consulted for the Peanut Project.
This sense of responsibility is exacerbated by the fact that for many people, the genitalia are closely tied to their identity and self-esteem. At least compared to the kidney. It’s hard to hear that the uterus is “hostile” or the cervix is ”incompetent” in the context of wanting children. When Javaid was in her 20s, her doctor considered her “infertile” due to her “old” uterus. take. “It felt like I got a slap in the face for her,” she told me. “The impact of the word was not at all diminished to my knowledge.”
Medical terminology can and does change. But the field is usually responding to major cultural shifts rather than leading the way.It became like this with the words pregnant womanincluding which organizations ACLUs and the CDC has been phased out gradually pregnant persona term that sparked a lively debate about inclusive language and feminism. announcement It would move “beyond the exclusive use of sexual language” to better encompass the fact that people of all genders can become pregnant.
and Elderly Pregnancy, the change could have been more bottom-up, starting with the doctors themselves. After all, for many, it was personal.The length and intensity of medical training increases the likelihood that doctors will have children later than other women. Monica Lipson, Associate Dean, Columbia University School of Medicine, who studies equity and inclusion. Lypson said she was considered “elderly” when she became pregnant at age 36. This was a “jarring” word choice as a patient.
probably incompetent cervix, recurrent miscarriageetc. refer to less common conditions, and many health care providers do not realize how harmful they can be. Ariel Lefkowitz, a physician who treats patients with pregnancy complications in Toronto, told me he used to think: failure to progress just like he thought kidney failure again heart failureHe didn’t realize the negative connotations until his wife, Sarah Friedlander, started training. childbirth educator and pointed them out. Now I find it “more loaded and more personal.”
That realization prompted him to think more deeply about the prejudices embedded in other fields of medical terminology. Coping failure“We’re very medicalized, maybe neutral, and in this clinical environment,” said Lefkowitz, who co-wrote a 2021 editorial for the journal. Obstetrics about the importance of Inclusive language in obstetrics“It’s so easy to become numb to silly talk.”
The outdated terms that are now plastered on the pages of the ICD-11, doctors’ offices, and medical journals are subject to change. More and more doctors are realizing that how their patients perceive their words can be affected. Real impact on health outcomessays Julia Rainey, an adolescent primary care provider who created a workshop for using mindful language in clinical settings. Towards more person-centred care, such as focusing on significant risks. For example, in her study of her teens, Raney points out that BMI is at her 95th percentile rather than simply calling it “obesity.” Her goal is not to shield patients from reality, but to make their medical needs clearer. Like the ACOG’s move to designate mothers as ’35-39′ or ’40-44′ instead of ‘elderly mother’s age’, this involves both low judgment and medical accuracy. It has heavy advantages.
There is another reason why doctors need to be careful with their wording. Since April 2021, the “open note” law has given patients the right to freely electronically access virtually any information doctors have written about them.The rules are still largely unknown to patients, but open notes can make doctors Increased awareness (and sometimes anxiety) about how what they write affects patients. “I think when we write something, we’re all aware of it,” said Stephen Lapinski, the journal’s editor-in-chief. Obstetrics, said to me. This increased transparency accelerates the pace of language change, incompetent cervix Let’s do this one last time.
