EXCLUSIVEHow dare you say woman! New woke bible for midwives urges using terms like 'gestational parent'

A new guide for doctors is recommending they use terms such as 'chestfeeding' and 'pregnant person' to be more accommodating.

Midwives and gynecologists should swap out 'breastfeeding' and 'mom' and use terms like 'gestational parent' or 'pregnant person,' according to the guidelines, revealed in a new report.

Additionally, 'father' should instead be 'a member of your support team.' 

And instead of breast milk, the group recommends 'human milk' or 'milk from the feeding parent.' 

That is according to a progressive group of midwives and academics from the US, UK, and Australia, who claim that dozens of terms related to parenting and childbirth should be substituted for more 'inclusive' words. 

A new guide suggests swapping breastfeeding for 'chestfeeding' to be more inclusive

A new guide suggests swapping breastfeeding for 'chestfeeding' to be more inclusive 

The guide, released in May and published in the journal Birth: Issues in Perinatal Care, is not a legally binding set of rules, but a recommendation for health care providers.   

The group wrote: 'We highlight that midwifery instead has an opportunity to be effective in its advocacy of human and reproductive rights for all by embracing inclusive language to reflect its intersectional commitment to reproductive justice.

'Ultimately, midwifery has an ethical duty and opportunity to lead in gender decolonization and reproductive justice through the use of inclusive language.' 

Midwives and gynecologists are both prenatal care experts, however, midwives are not medical doctors, and the scope of their duties varies by state. 

This guide is far from the only one that has proposed gender-neutral changes like these. Others published in the last several years have recommended terms like 'chesticles' for breasts and 'd*cklets' for clitoris. 

However, medical experts have argued that language like this could do more harm than good, 'dehumanizing' mothers and creating unrealistic expectations for trans parents. 

How do trans women lactate? 

Trans women can make themselves lactate by taking a combination of medicines called the Newman-Goldfarb protocol. It tricks the body into making milk. It was originally developed for biological women who adopted or had a child via surrogacy and wanted to breastfeed.

The method involves taking hormone boosting medications, including the pill. Other drugs that are used include anti-sickness medicine metoclopramide, heart medication digitalis and anti-psychotic chlorpromazine and sedative medications which are known to increase prolactin, the hormone responsible for milk production.

Domperidone, an anti-nausea drug, is the preferred option for the protocol as it has fewer potentially dangerous side effects. 

The drug regime is used in conjunction with a breast pump to mimic the changes a women's body undergoes during the late stages of pregnancy and shortly after the birth of a child.

Experts have urged caution about transwomen using the Newman-Goldfarb protocol to lactate. They have warned that long term health implications from using the treatment, for both adult and baby, are unknown. 

There have been separate rare cases of biological men undergoing lactation in the past without deliberately setting out to do so. These are usually the result of a rare medication side effect influencing hormone production, or from a hormone-disorder.

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To make their case for the more 'inclusive' language, the group cited a case study of a patient named Sam, a trans man with abdominal pain who tested positive on a home pregnancy test. 

Sam told hospital staff he was a trans man, but providers did not recognize that he had gone into early labor 'because of systems, biases, and stereotypes related to his gender presentation and identity,' such as assuming he was not pregnant or could not carry a pregnancy. 

Sam's baby died of a prolapsed umbilical cord, which happens when the umbilical cord falls out of the uterus before the fetus, cutting off blood flow to the fetus. 

The researchers argued that if Sam's care had focused on the fact that he still had female sex organs and was capable of sustaining a pregnancy, doctors may have found the prolapsed cord in time to prevent the fetus' death. 

However, assuming that only 'women' could carry a pregnancy caused harm to Sam and his fetus.  

The authors concluded in institutions where traditional gender roles are reinforced and no thought is given to alternative possibilities, health outcomes for patients are worse. 

Meanwhile, a 2022 study published in the journal Frontiers in Global Women's Health claimed 'sexed' language like 'mother' is crucial for avoiding confusion during situations like childbirth. 

The researchers wrote: 'Desexing the language of female reproduction has been done with a view to being sensitive to individual needs and as beneficial, kind, and inclusive.

'Yet, this kindness has delivered unintended consequences that have serious implications for women and children.

'Women have unique experiences, needs and rights in relation to pregnancy, birth, and breastfeeding that are not shared with others. It cannot be assumed that a woman’s interests will align with those of her husband or partner.'

The team opposing the new guide argued nearly 4million infants die every year worldwide - and the US has the highest maternal mortality rate in the developed world - therefore, 'the best interests of the child are paramount' and using clear language is essential for decreasing those deaths. 

The midwives, however, argued that as midwifery is a traditionally feminine profession, it is their duty to promote language as 'a manifestation of feminism in action.'  

To be more inclusive, one of their suggestions is replacing the term 'gynecologist' with 'reproductive health specialists,' as the former is derived from 'gyneco,' which means 'woman' in Greek. 

Last year trans woman Mika Minio-Paluello came under fire after she posted a picture appearing to show her breastfeeding her baby on a bus

Last year trans woman Mika Minio-Paluello came under fire after she posted a picture appearing to show her breastfeeding her baby on a bus

In 2018, the editors of the journal Advances in Neonatal Care proposed similar changes. Namely, they said they would no longer publish articles using the words 'breast milk.' 

Instead, the words 'human milk,' 'mother's own milk,' 'father's own milk' or 'donor human milk' are 'now preferred.'

And, the editors continued: 'The use of the word "lactation" over "breastfeeding" is also preferred whenever possible.'  

However, while the NIH's style guide says that 'chestfeeding' should be an option when discussing lactation, it adds that 'chestfeeding will not replace the word breastfeeding.' 

Critics have expressed that replacing 'breastfeeding' with 'chestfeeding' or 'breast milk' with 'human milk' could create unrealistic expectations for trans women who may not physically be able to breastfeed. 

In other proposals for more inclusive language, Dr Ilana Sherer, a pediatrician from California, proposed doctors call the vagina a 'front hole' and the penis an 'outie.' 

During a presentation at the American Academy of Pediatrics (AAP) National Conference and Exhibition in October, she proposed calling breasts 'chest' or 'chesticles.' For male anatomy, Dr Sherer recommended pediatricians call the penis 'outie,' 'junk,' 'strapless,' or 'bits.'

Her suggestions, given during a workshop entitled 'Discussing Gender and Sexuality in the Primary Care Office,' also included referring to the vagina as an 'innie,' 'front hole,' or 'T-penis' and the clitoris as 'd*ck' or 'd*cklet.' 

Despite a push, doctors have previously warned against politicizing medical language because it could confuse public health messaging, especially for people for whom English is not their first language.


lnclusive language guide 

EXCLUSIVE VERSUS INCLUSIVE LANGUAGE

INDIVIDUAL 

Assuming the gender of the individual receiving care and/or support person(s) --> Ask the individual their name, pronouns, and words they want to use for body parts and parenting roles (e.g., dad/mum/hijra). Use this terminology. Mirror the language they use. Ask for the name, pronouns, role, and relationship of any support person(s) present. Use this terminology. Mirror the language they use 

PEOPLE

Women/mothers/mums --> pregnant people, pregnant population, service users, expectant parents, gestational parents, anyone who is pregnant

Men/fathers/dads --> co-parents, non-gestational parents, a member of your support team

Maternal (adjective) --> parental [if another parent is not present], pregnant/birthing/postnatal, gestational parents'

Maternal consent --> Informed consent, [name's] consent, parental consent [if another parent is not present] 

Maternal notes --> Handheld notes/records, care record, antenatal/intrapartum/postnatal notes

Woman-centered --> person-centered, individualized

FEEDING 

Breastfeeding --> breast- and chestfeeding, breast/chestfeeding, body feeding, human milk feeding, human milk provision, lactation

Breastmilk --> breast- and chest milk, breast/chest milk, human milk, milk from the feeding parent/co-parent 

PLACES

Maternity --> perinatal services, perinatal care services, reproductive health services, gestational health services, pregnancy/birth/postnatal/infant feeding services

Women's center/hospital --> perinatal care services/center/hospital, reproductive health services/center/hospital, gestational health services/center/hospital

PROFESSIONAL ROLES AND TITLES

Matron, sister, midwife --> Executive Perinatal Lead, Senior Perinatal Lead, Lead perinatal practitioner

Gynecologist --> Reproductive Health Specialist

PARENTING GROUPS

Mom and baby classes --> antenatal/birth preparation/infant feeding classes, parenting groups, you and your baby class