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The importance of the words we use
!DITORIAI
The importance of the words we
use
I recently attended a conference (the report of the conference will be in September issue) which has caused me some concern. My concern is to do with the words we use. The conference was the third annual congress of The Perinatal Society of Australia and New Zealand. Why, readers will think, am 1 concerned about that title'? It is the word 'perinatal" that concerns me. The term "perinatal' refers to the health of the baby during the latter third of pregnancy and the first week of life. This term has nothing to do with the health of the pregnant and postnatal woman, and yet it is creeping into the literature and everyday practice, in particular when referring to postnatal depression. This seems especially strange because, whilst we now recognise that this form of depression can exist in pregnancy, the definition of postnatal depression states that it rarely occurs immediately after the baby is born. I have similar concerns about terminology when I see units within maternity units referred to as 'fetal health/assessment units', or other such terms. This means that those staffing the units appear not to be concerned with the health of the woman, let alone her family. Unless we consider the health of the woman and her family we are never going to improve the outcome of pregnancy. My anxieties extend to the use of the term 'teenage pregnancy'. A teenage pregnancy is from the 13th to 19th week of gestation! The term people should be using is 'pregnant teenagers'. In using this term the teenager, the person, is not lost under the pregnancy. I have recently completed a study of bilingual support facilities for people from the ethnic minorities (Thomson et al. 1999) and have been amazed that in the literature the term 'ethnic minorities' is used repeatedly. By referring to these people in this way we forget the people, the individuals, in the groups and as such are in danger of forgetting that these groups are composed of
people. In the International News in this issue we have a report on the health of adolescents and the terminology used is correct. The definition of an adolescent goes as low as the age of 10 years and it is very worrying that children, for that is what they are at the lower end of this age scale, are
Midwifery (1999) 15, 65 © 1999 Harcourt Brace & Co. Ltd
being required to submit themselves to sexual experiences. Quite apart from the psychological problems this may cause, another report in the News reminds us of some of the physical dangers, e.g. cervical cancer, of early unprotected sexual intercourse. I have written before (Thomson 1986) about the correct use of words when I reported that childbearing women would not be referred to as "patients' in this journal unless it was obvious that they were sick. The use of the term 'patient" means that the person needs medical assistance to become well again, whereas most childbearing women are going through a phsysiological process and do not need medical assistance (Chalmers et al. 1989) (unless, of course, the maternity services have actually made the woman sick by the use of inappropriate technology and treatments). Use of inappropriate terminology allows us to forget the individual and treat them inappropriately. I ask that when referring to women in late pregnancy and the early postnatal period we do not use the term 'perinatal', but reserve that term for the health of the baby at that time. I ask that we refer to 'pregnant teenagers' not 'teenage pregnancies', unless we do mean between the 13th and 19th week of gestation. Use of the correct terminology may mean that we have to use more words, e.g. 'people from ethnic minority groups', but that is a small price to pay if it means that we consider the care of the individual, the person, the teenager, the woman, her family, instead of just the pregnancy and fetus/baby.
Ann Thomson
REFERENCES
Chalmers I, Enkin M, Keirse MJNC 1989 Effective care in pregnancy and childbirth. Oxford University Press, Oxford. Thomson A 1986 Patienthood and childbirth. Midwifery 2(4): 163. Thomson AM, Rogers A, Honey S e t al. 1999 'If the interpreter doesn't come there is no communication': a study of bilingual support services for people from ethnic minorities in the north-west of England. Report to the North West NHS Executive. School of Nursing, Midwifery & Health Visiting, University of Manchester.
The importance of the words we
use
I recently attended a conference (the report of the conference will be in September issue) which has caused me some concern. My concern is to do with the words we use. The conference was the third annual congress of The Perinatal Society of Australia and New Zealand. Why, readers will think, am 1 concerned about that title'? It is the word 'perinatal" that concerns me. The term "perinatal' refers to the health of the baby during the latter third of pregnancy and the first week of life. This term has nothing to do with the health of the pregnant and postnatal woman, and yet it is creeping into the literature and everyday practice, in particular when referring to postnatal depression. This seems especially strange because, whilst we now recognise that this form of depression can exist in pregnancy, the definition of postnatal depression states that it rarely occurs immediately after the baby is born. I have similar concerns about terminology when I see units within maternity units referred to as 'fetal health/assessment units', or other such terms. This means that those staffing the units appear not to be concerned with the health of the woman, let alone her family. Unless we consider the health of the woman and her family we are never going to improve the outcome of pregnancy. My anxieties extend to the use of the term 'teenage pregnancy'. A teenage pregnancy is from the 13th to 19th week of gestation! The term people should be using is 'pregnant teenagers'. In using this term the teenager, the person, is not lost under the pregnancy. I have recently completed a study of bilingual support facilities for people from the ethnic minorities (Thomson et al. 1999) and have been amazed that in the literature the term 'ethnic minorities' is used repeatedly. By referring to these people in this way we forget the people, the individuals, in the groups and as such are in danger of forgetting that these groups are composed of
people. In the International News in this issue we have a report on the health of adolescents and the terminology used is correct. The definition of an adolescent goes as low as the age of 10 years and it is very worrying that children, for that is what they are at the lower end of this age scale, are
Midwifery (1999) 15, 65 © 1999 Harcourt Brace & Co. Ltd
being required to submit themselves to sexual experiences. Quite apart from the psychological problems this may cause, another report in the News reminds us of some of the physical dangers, e.g. cervical cancer, of early unprotected sexual intercourse. I have written before (Thomson 1986) about the correct use of words when I reported that childbearing women would not be referred to as "patients' in this journal unless it was obvious that they were sick. The use of the term 'patient" means that the person needs medical assistance to become well again, whereas most childbearing women are going through a phsysiological process and do not need medical assistance (Chalmers et al. 1989) (unless, of course, the maternity services have actually made the woman sick by the use of inappropriate technology and treatments). Use of inappropriate terminology allows us to forget the individual and treat them inappropriately. I ask that when referring to women in late pregnancy and the early postnatal period we do not use the term 'perinatal', but reserve that term for the health of the baby at that time. I ask that we refer to 'pregnant teenagers' not 'teenage pregnancies', unless we do mean between the 13th and 19th week of gestation. Use of the correct terminology may mean that we have to use more words, e.g. 'people from ethnic minority groups', but that is a small price to pay if it means that we consider the care of the individual, the person, the teenager, the woman, her family, instead of just the pregnancy and fetus/baby.
Ann Thomson
REFERENCES
Chalmers I, Enkin M, Keirse MJNC 1989 Effective care in pregnancy and childbirth. Oxford University Press, Oxford. Thomson A 1986 Patienthood and childbirth. Midwifery 2(4): 163. Thomson AM, Rogers A, Honey S e t al. 1999 'If the interpreter doesn't come there is no communication': a study of bilingual support services for people from ethnic minorities in the north-west of England. Report to the North West NHS Executive. School of Nursing, Midwifery & Health Visiting, University of Manchester.