Why do We Use Such Terrible Terminology?

So, I was reading one of the books on my list for Doula recertification and had quite a visceral reaction to one of the terms used in the section about Preterm Labor Treatments and that got me thinking that the terminology that we use everyday can cause us to develop fear, negativity and even lose confidence in ourselves.  This is not restricted to pregnancy and childbirth, but it seems to me that those circumstances call for even more care in the way that we phrase things.

I have had 2 children and have been a birth professional for several years.  Most of the terms used are very familiar to me, including the one that caused me to write this post.  What struck me is that although I knew the term and what it was, I’ve even known a handful of friends and acquaintances who have had the treatment; it never raised a red flag in my mind until now.  Chalk it up to a growing awareness of the power of words and my personal journey toward positive living.

By now you are probably wondering what it was that I read.  Okay, here it comes.  The Terrible Terminology: “Incompetent Cervix”  For those of you who are not familiar with the term, it refers to a cervix that shortens and begins to open prematurely and in the absence of preterm labor contractions.  This may occur in pregnant women who have experienced a weakening of the cervix due to conization (the removal of a cone-shaped wedge of cervical tissue during a cervical biopsy), surgery, or trauma.  If this is the case, the treatment is cervical cerclage (suturing the cervix closed until late pregnancy when the sutures are removed).   In these cases, most women can still labor normally and have safe vaginal births.

According to Mirriam-Webster, the term “incompetent”: means inadequate to or unsuitable for a particular purpose; or lacking the qualities needed for effective action, or unable to function properly.  Granted, when the cervix is unable to stay closed so that a pregnancy can continue to term, it does technically fit this definition.  However, this condition is usually caused by a previous event that has compromised its integrity and ability to stay long and closed until labor. 

I would prefer the term “weakened cervix” to be used when explaining to a woman that she needs to have the cervical cerclage.  Calling a woman’s cervix “incompetent” implies that her body is broken and perhaps inherently incapable of handling pregnancy and childbirth.  In my opinion, “Weakened” implies that her cervix started off strong and capable, but that strength has been reduced and so needs some extra support.  In my opinion, that gives a woman explanation of why the cerclage is necessary while not making her feel like part of her is broken.

This brings to mind another Terrible Terminology used all to often in childbirth: “Failure to Progress”.  This one seems pretty self-explanatory, but more often than not it is used to describe a labor that is just not moving quickly enough to fit into the doctor’s schedule or hospital protocol.  Usually women who are labeled this way end up with multiple interventions, possibly major abdominal surgery in the form of a cesarean section, and may describe their birth experiences in negative terms.  Most of us in the birthing community know that there are variations to labor and that as long as mom and baby seem to be coping well, a long labor is not a “failure” and eventually those babies are usually born just fine.

How many of us have not lived up to our potential, but would bristle at being called “incompetent” or a “failure”?  We’ve all heard about “the power of positive thinking” and most of us know that we feel better, even at the worst of times, if we can put a positive spin on our situation.  These are just a couple of examples of words that I feel have a negative impact and could be rephrased or not spoken at all.

So, I challenge you, just as I challenge myself, to think before speaking and consider the impact our words have on ourselves and others.