Affirming language in birth work

You may have noticed that All Bodies Birth chooses to use gender-neutral and affirming language on all original materials and in all dealings with individuals and families that I support. This is both a personal and political choice that manifests my desire to challenge gendered and heteropatriarchal structures surrounding birth and to provide the best care possible to all people. But it might also be confusing to some, so I’m writing this to help you understand how I use language and why it's so important to me.

Since there are several angles to cover, and plenty of nuances where gender, sexuality, and language are concerned, I'll cover just the basics here. You can find suggested reading at the end of this post, and I really hope you'll follow up to learn more.

What do I mean by affirming language?

Affirming language is, quite simply, language that affirms and validates all people and their bodies, genders, and sexualities. Some of the terms used here may be unfamiliar, so before you dive in, take a look at this helpful graphic or read TSER's terminology page.

Let's start with affirming language around gender

I want you to really hear this point and sit with it for a moment if necessary: not every person who gives birth is a woman. Biologically, gestating a child requires that a person have a uterus, but it doesn't require that person to be a woman, and it doesn't require that person to enact a feminine gender expression. While many people with uteruses are assigned female at the time of their own birth, pregnant people can be women, men, agender, nonbinary, trans, genderqueer, or lots of other identifiers! And birthing people who do identify as women can have complex feelings towards their womanhood — they can represent it in unexpected ways, they can challenge or play with it, or they can hold ambivalence towards it, for instance.

So, don't assume that every pregnant person is a woman — in fact, don't assume anything about any pregnant person! Just ask some polite questions and lead by example ("Hi, I'm Sierra! I'm a doula and I use she/her pronouns."). Once you know how a person identifies, use language that mirrors theirs. Many birthing people do identify as women, and that should be celebrated! But so should all genders of birthing people. There are many, many beautiful ways to have a birthing body!

Photo by  Janko Ferlič  on  Unsplash

Sometimes when people notice my gender-neutral and affirming language, they say things like: 

  • "The vast majority of people who give birth are women so I should use that language"

  • "That isn't my target demographic"

While these are important points to consider, they miss the mark a bit, and my response to both of them is virtually the same. Think of it this way: if even one person is hurt, excluded, offended, or invalidated by something we've said, then it's a good idea to reflect on language, right? Because all birthing people deserve respectful, validating care that is attentive to their gender. And practicing affirming language is really simple on our part as birth workers but makes a huge impact on the communities we serve — we have the potential to help pregnant people and their families feel seen, heard, understood, and truly cared for. 

Next up: sexuality and sexual expression

All too often in the world of birth I witness assumptions of heterosexuality. This usually looks like "mom and dad" language, where someone (usually unintentionally) assumes that a family is made up of a mom, dad, and child(ren). Here are some obvious examples:

Screen Shot 2018-06-28 at 10.49.21 AM.png

These headlines all do the same thing: they convey one very specific image of "family" and leave out all the rest! When you think about it, bringing a breast/chestfeeding person a big cup of cold water is something any partner can likely do — so why are things like that labeled tasks for dads? Why aren't we focused on preparing partners and support people of all genders for pregnancy, birth, and early parenthood?

The reality is that "family" takes many, many shapes and forms. In particular, an estimated 3 million LGBTQ+ individuals in the United States have had a child — that's a lot of people who are left out when we say "mom and dad" instead of "parents"! And this exclusion takes a toll on LGBTQ+ people, who are already marginalized and struggling for rights and acceptance. 

So, why does language matter?

Photo courtesy of Broadly’s  Gender Spectrum Collection .

Photo courtesy of Broadly’s Gender Spectrum Collection.

It matters because it structures our world! It creates the possibilities that are available and sets the expectations for any given experience. It's a seemingly simple tool that can either be used to broaden our vision of "family" and affirm the lives and relationships of all people, or it can be used to set up boundaries and (whether we mean to or not) keep people out. 

Language doesn't just matter for queer, trans, and nonbinary people, although I would greatly appreciate not having to correct forms that read "husband" on the daily. It matters for everyone because language enforces ideas about what is "good" and "bad." It matters because it creates an overall image of pregnancy and birth that is frilly, pink, and floral, which is wonderful for some but really limiting for most! It matters because all people deserve care that is attentive to their gender expressions and sexual identities.

Moving up, out, and onward

Now that you hopefully have a broader perspective on language and birth, what comes next? Birth workers, I encourage you to take a look at your practice, revise your materials, and build an inclusive space where birthing people of all gender identities, sexualities, and family structures feel welcome and see themselves represented. Here are some ways that you can do so:

  • Ask for pronouns on intake forms and identify your own pronouns on your materials. Use neutral pronouns like "they/them" until you know which pronouns a person uses. (Similarly, ask for parent names on intake forms and use neutral names like “parent” until people have told you their parent names.)

  • Use whatever name a person asks you to, whether it is their name given at birth or not, and be aware that differences between current name and birth name might not be understood or well received by medical staff.

  • Replace "husband" with "partner(s)" on intake forms and on your materials.

  • Refer to birthing people by their first name to avoid anonymizing them or reducing them to a potential parenthood identity.

  • Check on the materials of people you refer to, like lactation consultants and yoga instructors, and encourage them to update their materials if necessary.

I also suggest investing in a deeper education on the needs of LGBTQ+ couples and families using some of the resources below.

Gender-Neutral Birth Terms and How to Use Them (Tynan Rhea)

Gender Inclusive Terms for Sexual Health, Pregnancy, and Birth (Manhattan Alternative)

Gender and Birth Resource List (Birth for Every Body)

Caring for LGBTQ Families Course for Birth Professionals (MAIA Midwifery and Fertility Services)

LGBTQIA Inclusive Pregnancy And Birth Care (BirthRoot Midwifery)

Providing Inclusive Services and Care for LGBT People (Fenway Institute)

I hope this introduction to affirming language gets you thinking about how you represent not only your business but also birth and family life through words. Remember that all work is work in progress, and our work of creating safe and affirming birth spaces is never done!