Medical terminology can have an adverse impact on women especially their grieving process after a miscarriage or pregnancy termination.
I’m clutching my partner’s hand. A plastic bag, which holds my clothes, sits limply on my lap. I’m wearing an open-backed hospital gown and staring down at a form I’ve been asked to sign.
I hereby agree to the excavation of contents (space for my signature)
Although it sounds rather like a building site, this is actually a clinical term for a curette or D&C; the scraping away of the womb lining after an incomplete miscarriage. To have one done, you need to sign the form agreeing to have your ‘contents excavated’.
It’s D-Day. My partner and I have been waiting for our ‘excavation’ for eight hours. The form has been signed, approving my surgery. That was at seven in the morning. I’ve known about my dead baby for a week. I’ve carried it around, talked to it, grieved, and then ordered it to leave me. But it won’t let go. It’s 3:59pm. The second hand clicks its last second journey towards the hour and I’m starving, having not been permitted food or water since last night.
4:00pm: The porter clatters in with his trolley bed and another woman hoists herself on. Her partner trots next to her as they lead her away, a rushed kiss planted before she disappears through the double doors.
4:45pm: The waiting room is empty. Everyone’s been seen but me. My partner has stepped out for air. I lift myself from the chair, my skin sticking to the not-so-leather seams. I wander to the desk again. “Excuse me. Do you know if it will be soon? I’ve noticed the other women have come and gone and…”
“I know you’ve been here since first shift this morning”, says the nurse.
She’s starting to swim before my eyes. I’m hungry and so thirsty and my body still thinks it’s pregnant. Pregnant women need to eat all the time.
“I am really sorry. There have been a lot of unscheduled caesareans. I know you don’t want to hear this, but your situation isn’t considered life-threatening.” She’s apologetic.
5:50pm: Suddenly I feel the rush. Cramps, coming fast and furious and a gush of hot blood. Bloody hell. My body has started to do what I’ve been waiting over a week for it to do. It is excavating my contents, and it’s beyond anything I’ve ever felt. I groan and double over as my partner walks back in to find me wound like a wire around the large day surgery chair, whipping and writhing in agony. “Is she okay? What is going on?” His voice has this panic to it, which makes me turn from my curled position and grab his hand. “It’ll be okay”, I mutter.
The nurse clocks the scene, and swivels in her chair, phone in hand. In quiet tones she says, “Yes, yes. She’s been here since 7am”. There is silence in the empty waiting room as she listens into the phone. I moan and writhe. I can hear her frustrated exhale. “Yes but she needs attending to.” Then conspiratorially with the theatre nurse, “I know. You guys must be under the hammer. This place. Honestly.” She hangs up and signals that it won’t be long. We are then left alone. I’ve now bled through the gown, over the chair and I’m braying like a beast.
Medical jargon: the lead character
During my research on this subject (it has now turned into a book) I recently composed a quick callout on social media, mainly within Australia. I wanted to know if any women recalled a medical term that stuck out for them while they were enduring a medical situation related to pre-pregnancy, pregnancy, or birth and if so, how did it make them feel? Within 30 minutes I had 67 responses. After 24 hours there were hundreds. The tone of the responses went from smarting, to sarcastic, to downright enraged. Some of these women referred to their experience years (and in two cases, decades) earlier. Some of the following phrases are colloquial, some clinically used, some no longer used. Every woman claims a medical practitioner of some sort used one the terms for her. Here are some of them:
- Unviable or non-viable pregnancy: when there is no foetal heartbeat
- Geriatric mother: a pregnant woman over 35 years of age (otherwise known as ‘advanced maternal age’)
- Incompetent cervix: if a pregnant woman’s cervix begins to dilate and thin before she has reached full term
- Operation kangaroo: a slang term to remove the joey from the pouch. In other words implement a dilation and curettage
- Boggy uterus: a uterus than is more flaccid than it should be
- Blighted ovum: when a fertilised egg attaches itself to the uterine wall, but the embryo does not develop despite pregnancy symptoms
- Incompatible with life: a term given when a baby’s condition means it is unlikely to survive after birth
- Poor maternal effort: a term used when a woman needs assistance during labour
- A lazy uterus: a uterus that isn’t contracting ‘correctly’ during birth
- Hostile womb or uterus: when the cervical mucus has incorrect PH for conception
- Naughty breathing: a colloquial term for a new-born baby who is having trouble breathing unassisted
- An uncoordinated uterus or uterine inertia: when a birth process is prolonged or contractions double peak
- Non-milker: term given for women who have trouble breastfeeding (and yes this was put on one woman’s bedhead after a long and arduous labour which left mum and baby exhausted)
I’m struck by how these kinds of phrases come up, not as a part of a client’s story, but often as a lead character, because there is no doubt that hearing such jarring language has an undeniable effect for many women.
The impact of hearing labels such as these can feel nothing short of brutal. Of course these clinical terms are shortcuts and serve a purpose for time-poor medical teams. But surely it is not too much to ask a clinician to exercise compassion and be mindful about when and how they use such terminology. At the end of the day, there is an intelligent, feeling, and often hurting or vulnerable person at the receiving end – and that person shouldn’t have to walk away from her experience more scarred than necessary.
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