What’s in a word? Quite a lot as it turns out actually. Words have the power to empower and strengthen, or disempower and weaken. But why would anyone want to disempower a woman at the most vulnerable time of her life? It is quite simple really, disempowered people, will usually agree to anything. In short, they are manageable. In a hospital, where resources are stretched and time is of the essence, a manageable patient helps to keep the show on the road.
It all starts at the first antenatal appointment. From the very beginning the pregnant woman will be referred to by her first name, Susan or Jane, but the midwives will rarely introduce themselves at all. The consultant will be introduced as Dr. X or Y, never by his or her first name. This sets the tone for the rest of the pregnancy. From the get go everyone involved is in no doubt who is actually in charge and that is certainly not the pregnant woman. The woman is disempowered. She is returned to the classroom, where the teacher is referred to as Mr X or Miss Y and the students are all called by their first names. It is a power play from the start.
If you wanted to create a healthcare system which is centred around the patient, then your language reflects the importance of the patient. In this system everyone would be called by their first name, they would be no levels of importance or titles. The interactions would be about making the patient feel comfortable and in charge of their own health. It would not be focused on making the doctor and/or midwives and nurses feel important.
Those even vaguely familiar with the concept of good manners know you do not assume the right to use a person’s first name without first asking their permission. You most certainly would not refer to someone as Mum, unless they gave birth to you or brought you up.
From that very first appointment through to the labour ward we can see the lack of respect reflected in the language used. In the labour ward people come and go randomly. Often they fail to introduce themselves. They, fully clothed, rush around, failing to address the semi clothed woman lying prone on the bed, attached to machines. They pay attention to the output from the machines, whispering amongst themselves. But time and time again they fail to introduce themselves. When they do, they use her first name and their own title.
Often flippant remarks are addressed towards the woman about her labour, her birth plan or her pain relief options. Sometimes there are smirks and open laughter about her choices. Can any professional justify this? Can anyone think this helps a woman in labour? Will any of this help a woman feel strong or able to face one of the most important moments of her life with the confidence she needs. Medicine is well aware that our state of mind has a huge impact on our physical well-being. Then why would childbirth be any different.
After the birth, things don’t really get any better. Mothers on postnatal wards are referred to using the generic term “Mum”. Even their first name disappears at this stage. This language even continues into official documents and in the media. In a recent article in the Connaught Tribune¹, Tony Canavan, Chief Operating Officer of the Galway/Roscommon hospital group, which includes University Hospital Galway, where Savita Halappanaver tragically lost her life last October is quoted as saying “I would like to reassure the 3,500 “Mums” we see in the hospital every year that we have improved patient safety”. Had Savita Halappanaver been viewed as a woman and not a Mum, would she be alive today? We will never know.
It is indeed, ironic, that in a country where those working in maternity care are very conscious of their own titles e.g. Master, CEO, Midwife etc… that women are given the generic term “Mum”. Those even vaguely familiar with the concept of good manners know you do not assume the right to use a person’s first name without first asking their permission. You most certainly would not refer to someone as Mum, unless they gave birth to you or brought you up. Why then is this reality suspended in hospital? Doctors and midwives do deserve our respect. Those they treat are equally deserving of their respect.
In a 2009 paper² “Don’t call me Mom” by Amer A., et all, parents are asked how they want to be treated by their paediatrician. 88% of parents wanted to be addressed by their full name, however only 14% of residents and 24% of attending physicians actually did so.
I look forward to a day when referring to a woman as Mum (other than your own Mum) will be viewed with the same distain we now view the way black men were called “Boy” by white people in the southern states of the US many years ago.
Breda Shiels, AIMS Ireland
1. Connaught Tribune 31st May 2013
2. “Don’t call me Mom – How parent’s want to be greeted by their paediatrician” by Amer A et al Dept of Paediatrics Wayne State University – School of Medicine 2009