Language in healthcare and why it matters

Language in healthcare and why it matters

The way we use language in healthcare can help people to understand or it can cause additional confusion. It can open discussions or it can create barriers.  In my work as a specialist midwife, every day I hear from people who say that they didn't understand what a health professional has tried to tell them, or I realise that there has been fundamental miscommunication due to the way things have been expressed. When you are faced with unexpected news about your baby during pregnancy, this can...

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Fetal abnormality and informed choice.

Fetal abnormality and informed choice.

If you are told during pregnancy that your baby has a life threatening, life changing or life limiting abnormality, you are faced with one of the most complex ethical debates of the 21st century. Much of my work involves walking with parents when a fetal abnormality has been identified, providing information, time and a safe place for them to process the news and to make an informed choice about what to do. In the UK we have the legal right to end a pregnancy (termination/ abortion), a choice...

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Is my baby ok? Antenatal scans and test result concerns

Is my baby ok? Antenatal scans and test result concerns

Every week, I talk to many people who are worried in pregnancy. Perhaps something has been said about an antenatal scan or examination or about an antenatal test result. There is clearly something "of interest" to the professionals, but is it something to worry about? I always feel sad that the communication with the professional wasn't clear enough. I worry that there are so many people in this sort of situation who will end up trying to make sense of things alone, or by asking friends (or...

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Edward’s syndrome (trisomy 18) or Patau’s syndrome (trisomy 13). What should we do?

Edward’s syndrome (trisomy 18) or Patau’s syndrome (trisomy 13). What should we do?

"There is a 1 in 100 chance that your baby is affected by Edward's syndrome or Patau's syndrome". That unexpected phone call from a stranger can change your life in a moment. Your brain scrambles to make sense of what you are hearing, to understand, to "un-hear" and deny that this news applies  to you. For many years I was the midwife who made those phone calls. Every time I received a "higher chance" result from the laboratory I would hold that result in my hands recognising the...

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Choices in maternity care

Choices in maternity care

Most of my long term work with families is when there are major issues of concern or a history of pregnancy difficulties, but I love working with families for whom things are going well. This is often short term, often a single consultation. My role with these clients is to provide information and discuss choices in maternity care. They often also appreciate me showing them how I work out their baby's position, listening to baby's heartbeat and explaining what antenatal screening tests and...

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Having a child with Down’s syndrome

Having a child with Down’s syndrome

In the UK, part of the routine antenatal care is the offer of a screening test for Down's syndrome. What would having a child with Down's syndrome mean? Why might you want to know? If the test is offered, does that mean that it is an awful thing for you baby to be affected by? Oh - did you say it is a choice whether to have the test? Questions and assumptions So many questions, and so many assumptions. In the many years I worked as a midwife in the NHS, I think it is fair to say that the...

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Pregnancy after loss (rainbow pregnancy)

Pregnancy after loss (rainbow pregnancy)

Pregnancy after the loss of a baby can be a very complicated emotional journey. Whether the loss was an early miscarriage, an unexplained stillbirth at term, a baby with very major health issues for whom you decided that the most loving decision was to end the pregnancy through termination, or whatever the reason, in another pregnancy you often experience a complicated mix of hope, excitement and fear. Pregnancy after loss is often referred to as a "rainbow pregnancy". The darkness and the...

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Worried about your baby and far from home

Worried about your baby and far from home

I have been working with a couple who live a very international lifestyle. Cross-cultural care, navigating two different healthcare systems adds to the challenges parents face when concerns arise. They were worried about their baby after screening tests, but far from home and trying to understand a new healthcare system. They came to me to try to make sense of confusing information.  https://yourmidwife.org.uk/services/decision-making-support-counselling/ They have given permission for me to...

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“Your baby cannot survive” – an abnormal pregnancy scan

“Your baby cannot survive” – an abnormal pregnancy scan

Going for an ultrasound scan in pregnancy is usually an exciting experience. When a major problem is seen, however, this excitement can change in moments. You can be faced with unexpected and devastating news. Being told "your baby cannot survive" makes it very difficult to hear any more. Abnormal pregnancy scan findings face you with complex decision making and choices that no parent wishes to face. Some abnormalities are so serious that it is certain that the baby will be unable to survive....

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We need to talk about baby loss

We need to talk about baby loss

In the 21st Century we seem to have accepted a myth that once you have a positive pregnancy test you can (and should) start to plan the life you will live with that child. A secondary myth is that every baby will be perfectly formed and perfectly healthy. Sadly, for a great many, those dreams are shattered. Part of my work is with families whose baby has died and so often I hear them say "I didn't know that babies could die". Babies are lost at all stages of pregnancy, at birth and afterwards....

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Angie Bowles, specialist midwife supporting choice. Reach out for help or advice today. Angie reads and replies to every one.