“Mistake” was 15-year-old Heather O’Dwer’s (Lucy Burrows) family nickname. It was not intentional cruelty, but it sent a message to the young girl, leaving her to feel alienated and unloved. “Can you imagine how it feels to be called that?” Trixie (Helen George) comments during the child welfare hearing.

“Nothing” was the very intentional name Sister Monica Joan (Judy Parfitt) gave to her stray dog friend. She also meant no harm with this sly and playful trick of language. Intentional or not, both names were misconstrued.

Everyday words can so easily be manipulated and hurtful. It is not surprising that medical terminology can be a minefield. As society in general becomes more mindful of language biases, so has the world of health care. Women’s health care especially has been left a legacy of terms with patriarchal and sexist implications. Labels that can leave feelings of shame, guilt, and inadequacy. As a young woman, I was told by a physician that I had an “infantile uterus.” Can you imagine how it feels to hear that while grappling with the new functions of an adult body? As it turns out, the diagnosis was subjective and meaningless.

“Habitual Abortion” is the term used for spontaneous, reoccurring pregnancy loss. It sounds cruelly intentional. The heartbreak associated with the loss of pregnancy is not eased by this insensitively termed diagnosis.

Justine van du Leun, a mother and a writer for the Guardian, wonders why a woman has an “incompetent cervix” or a “blighted ovum” while a man has “premature ejaculation” or “erectile dysfunction” rather than “inadequate testicles or “futile penis.” The changes may seem subtle, but focusing on the disease rather than the body part makes a difference.

Early in my career I was cautioned not to say, “I delivered the baby.” It is the hard-working mother who delivers the baby. It is the midwife who attends the delivery. That change in language keeps care focused on the mother, where it needs to be.

Traditionally, “Chief Complaint” heads the record of each visit to a health care provider. Oh bother, another complaining patient! Renaming that part of the record to “Chief Concern” seems just as accurate without judgmental negativity.

The term “med-wife” has been used derogatorily to describe a nurse-midwife who works in a hospital setting. It implies that access and use of medical intervention makes one less of a midwife; less committed to keeping birth “natural.” Certainly, hospital protocols can be challenging while trying to individualize labor and birth care. But midwifery can be practiced in every setting. In fact, it can be most effective in a medicalized environment. There is no such thing as “unnatural birth.”

Even the term “mid-wife” has its drawbacks. Decades ago, a colleague complained to me about feeling like the physicians she worked with (all male) treated her like a servant. “I think it’s the wife part, she sighed.” They take it too literally,” she concluded.

Several years ago, I attended the labor of a friend at her home. I was not primary midwife but consultant and support. The original plan was for a home birth. After a long slow labor, the exhausted mother decided to go to the hospital to complete her labor. Soon after she arrived, she had an uncomplicated delivery of a healthy baby, attended by her nurse-midwife. As the good news traveled through our midwife network, another colleague described the event as a “failed homebirth.” Ouch. I took exception to her language as there was nothing in this birth story that felt like failure. Mother and care providers worked together, adjusting the plan to produce a positive result that was completely successful.

Medicine is one profession rife with argot. Argot is an unofficial secret language of jargon used within a profession to hide meaning from outsiders, convey information quickly and create a bond. Some of this language is just for fun. Anesthetists are “gassers” and surgeons are “slashers.” Psychiatrists: the “Freud Squad.” Away from patient ears, it can provide comic relief in a demanding and stressful environment. But if that “slasher” gets on the elevator talking to his “gasser,” they need to be careful lest they start spewing the common derogatory slang within hearing of anxious patients and family. Referring to a comatose patient as a” deadhead” or a patient with dementia as a “walker” is disrespectful and cruel. 

Language can be playful, inspiring, or confusing, and hurtful. It is best when used mindfully.