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Unit 3: Considering language

Unit 3: Considering language

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Learning outcomes

After completing this unit you will:

  • Recognise how important it is to use language appropriate to the individual woman
  • Know how to reflect the woman’s preferred language
  • Know the non-medical language to use with the woman

The importance of language

The language and terminology you use with women is very important. It is useful to give some thought to the language that you use with women experiencing a miscarriage so that you can support them as effectively as possible.

  • When it comes to pregnancy loss, women are often acutely sensitive to the words you use. They may not understand some medical terms so the language you use should be clear, sensitive and understandable to the average lay person.
  • Don’t use complicated medical language if a simpler explanation will do.
  • If you have to use medical terminology, be ready to explain it in lay language.
  • Some women will need interpreters, signers or helpers. The Miscarriage Association has leaflets in several languages and for women who may have reading difficulties, a learning disability or other communication problems.
  • Most women (though not all) will want you to refer to the pregnancy as a baby and to the miscarriage as the loss of their baby. Be sensitive to the words the woman uses (baby, pregnancy, fetus etc.), and then use the same language. If you’re not sure what language to use, ask her what she would prefer.
  • Do not use the term ‘abortion’, or threatened, missed or incomplete abortion, to describe miscarriage as this is inappropriate.
  • Women often say they find terms like ‘products of conception’, ‘blighted ovum’, ‘scrape’ and ‘vacuumed out’ hurtful and upsetting.
  • Try not to minimise the loss. Referring to it as ‘just a heavy period’, ‘bad luck’, or saying ‘you’re young, you can try again’ can actually increase distress.

It may have been ‘products of conception’ to them, but to me it was my baby.

This isn’t just a pregnancy I’ve lost, it’s a potential child that would have changed my life.

Practise your language

We suggest that you practise using ‘plain English’ versions of the terms health professionals use, especially those most difficult to explain, such as ‘anembryonic pregnancy’ or ‘molar pregnancy’. Try explaining them to a non-medical friend or family member.

Click on the medical terms below to reveal the lay term.

  • Non-viable

    Non-viable

    A pregnancy that will not continue to develop and grow but hasn’t yet miscarried.

  • Surgical management of miscarriage

    Surgical management of miscarriage

    Surgery to empty the womb.

  • Evacuation of retained products of conception (or of retained tissue)

    Evacuation of retained products of conception (or of retained tissue)

    Surgery to empty the womb (‘pregnancy tissue’ is a confusing term).

  • Haematoma

    Haematoma

    An area of bleeding in or near the pregnancy sac.

  • Blighted ovum or anembryonic pregnancy

    Blighted ovum or anembryonic pregnancy

    The pregnancy sac is empty. The embryo has not developed and may have been reabsorbed.

  • Incompetent cervix

    Incompetent cervix

    The cervix that opens (dilates) long before it should.

  • Fetal pole

    Fetal pole

    The first sign on scan of a developing baby.

  • Ectopic pregnancy

    Ectopic pregnancy

    A pregnancy that is developing in the wrong place, usually in one of the fallopian tubes rather than in the uterus (womb).

  • Molar pregnancy

    Molar pregnancy

    An abnormal fertilised egg implants in the uterus (womb). The cells that should become the placenta grow far too quickly and take over the space where the embryo would normally develop.

Exercise

Use this exercise to see which words you’d use with a woman experiencing a miscarriage. Read the medical terms and think about how you could explain them in lay language.

Finding the right words

Health professionals often find it difficult to find the right words, particularly if they do not have much experience of caring for women experiencing a miscarriage.

Women may ask you about what they are experiencing, whether the pain is normal or if their baby is going to be alright. If you cannot give clear answers to these questions, you could think about who might be able to, in the hospital or elsewhere.

In this clip, two ambulance crew members express their uncertainly about what to say to a woman who appears to be suffering a miscarriage.

Ambulance crew video

Click to watch the video above

Not being able to answer their questions is very difficult and makes me feel like I’m inadequate in my job, when in fact I’ve just not had adequate training.

Reflection

Think about how you would have responded to the woman if you were in this situation.

Listening and understanding

Women’s previous experiences can influence the way they present and how they react to news, whether it is good or bad.

This short film explores an exchange between Natalie and her general practitioner.

General practice guide video

Click to watch the video above

My GP couldn’t do anything to change what had happened but she listened.

Reflection

As you watch the film, reflect on how the GP could have used language to make the consultation more positive for Natalie.

Show understanding and empathy

You might not be able to meet all the woman’s expectations when she is distressed but understanding, kindness and acknowledging her feelings can help.

  • Acknowledge her emotional response, whatever it is
  • Say you are sorry for her loss, if appropriate
  • Don’t assume that the shorter the gestation, the less the sense of loss
  • Give time for the news to sink in and for her to ask any questions she has
  • Explain what will happen next
Doctor listening to patient

Reflection: Showing compassion and understanding

You may have thought of the following:

  • It would have been thoughtful to ask what information Natalie wanted and be guided by her responses
  • You should take note of how she looks and speaks: Natalie looks unhappy and rather tense
  • You could consider asking Natalie how she’s feeling or be more direct and say ‘you’re looking worried…’
  • If Natalie has questions or requests and you can’t give clear answers, explain why not and refer her to other services or specialists who would be able to help
  • Providing or referring to written information would also help Natalie