Euphemisms and birth: good, bad or ugly?

The topic of euphemisms and birth is a fascinating one. The English language is literally loaded with euphemisms relating to many different areas of life. Used as substitutes for words or expressions which are deemed by the speaker as being impolite, unpleasant or inappropriate, euphemes were originally words or phrases used to replace religious terms that were deemed unsuitable to be spoken. To draw upon a eupheme (‘good speech’) was considered good manners, as the alternative was to blaspheme (‘evil speech’).

What is considered polite or offensive is, of course, culturally relative. As evidenced by the fact that the appropriate way to ask for the toilet, bathroom, restroom or loo varies between different countries and social groups. And let me point out before we go any further that you’re reading an update of an article that was first published in 2008. Already, so much has changed, which further illustrates this point. But, as with many of my older articles, I have updated it where I can and left it here for interest. And as a source of discussion.

Euphemism use may reflect trends such as political correctness, and they range from the everyday to the obtuse. Would you know, for instance, where to find a composure bench, or what to do with one if you did? I learned this one only recently. It apparently describes furniture located immediately after airport security checkpoints, where you can attempt to put your shoes back on while holding your laptop under one arm and trying not to let any of your 100ml bottles fall out of the see-through plastic baggie that is precariously dangling between the only two fingers of the other hand that aren’t holding the wide variety of travel and identification documents that have to be shown to everyone from the traffic warden to the toilet cleaner. Or should that be the parking enforcement engineer and the restroom sanitation professional?

In such a complex world, how can we please everyone and still say what we mean?

Cleaning up the Lingo

When it comes to bodily-related taboos, though, people have long sought to avoid saying what they mean. It is surely no accident that euphemisms are especially widespread around the sacred topics of sex, birth and death. But while many of those in current use are still detectable by the listener, others may not be obvious. A herbalist once told me how the modern common name of the dandelion plant, which was traditionally used as a diuretic, came about. The original name of the plant – pissenlit – accurately reflected its properties but was deemed inappropriate for use in Victorian England.

Midwifery and medical practice is full of euphemisms that enable us to avoid being direct about body parts, fluids or processes. And we can often add an action in order to further indicate our meaning without having to use particular words. For instance, we can hand women little plastic pots and talk about getting samples in order to avoid having to choose which one of the many terms for urine we will use. Some midwives talk about checking the cervix (or simply checking you) instead of directly using the term vaginal examination, thereby neatly avoiding the word altogether. Euphemisms are also used in an attempt to not scare people. A common example of this is saying C.A. instead of cancer and, of course, the multitude of euphemisms – such as fatal injury and passed away – that people use to avoid saying the words die, dead, death or dying.

Softening the Jargon?

Sometimes, it’s hard to tell which (if any) of the modern alternatives was the original term. This is particularly the case in relation to words that describe aspects of sex and birth. There are literally hundreds of euphemisms that have come to be used to describe women’s genitalia. Many are considered to be offensive, which probably says more about our culture’s attitude towards women than anything. I love this depiction. Some of these words are arguably intended to feel friendlier and perhaps a bit softer than others. Curiously, however, some of the words that are currently considered the most offensive, and which are used as swear words by some, are among the oldest words. And they have, upon etymological inspection, relatively innocuous meanings.

Another key set of euphemisms in relation to women’s health are those which describe menstrual bleeding. It’s important to point out here that the phrase menstrual bleeding is itself only one possible description. Some people – for all sorts of reasons – prefer avoid using technical, medical descriptions. However, some of the more colloquial euphemisms such as the curse, being on the rag, or having a waterlogged pitch do not feel very empowering to some people. This may explain the increasing popularity of euphemisms which de-emphasise the idea of menstrual bleeding being negative, such as moon time.

Midwives and birth workers have to continually choose the language that we use with women, families and colleagues. And it seems to me that this is becoming an increasingly difficult task. Language is ever-evolving, and changes in it may reflect wider changes within cultures and in social and professional groups. I believe that the use of euphemisms in midwifery practice raises some interesting issues. One is: when we use euphemisms, what is it that we are trying to achieve? And what does our language hide or reveal, either intentionally or accidentally?

Is Softer Better?

As Nicky Leap (1992) pointed out in her seminal article on midwives’ language, health professionals have long tended to use words like hop and pop. Such terminology is arguably intended to soften the meanings of what someone is asking someone else to do. Or, perhaps more pertinently, what we are asking to do to them. The term ‘hop’ is often used, for example, to indicate that we want women to get onto beds or examination tables or into certain positions. And ‘pop’ is a slightly more wide ranging term, often preceded by the word ‘just’. It’s often used in an attempt to soften any number of clinical procedures which are routine but which individual women might not consent to if it was made explicitly clear that they had a choice. Just pop this thermometer in your mouth for me … I’m just going to pop the monitor on again for a bit … I’ll just pop my fingers inside to show you where to push (ouch, on so many levels, but it still happens…)

The use of euphemisms as a way of softening language might be considered somewhat less than ethically ideal. By which I might be implying that this is potentially disempowering or even wrong. But, hey, why be accurate when euphemisms enable us to apply a nice thick sugarcoat to whatever it is we want to say? Indeed, a trend towards linguistic spin and sugarcoating seems to have become a fact of life. Within the modern world, politician’s lies have become disinformation or categorical inaccuracies. Medical errors are therapeutic misadventures. Perhaps partly as a result of Western medicine having become so litigation-conscious, by which I perhaps really mean fear-based.

Words and Power

The use of this kind of softening language is not always intentional; we all pick up language from those around us, and it is easy to adopt terms and phrases unthinkingly and without having considered their meaning and implications. If we do take time to think about the words we use, one of the important questions for midwifery concerns the way in which language relates to power. From my own (personal and biased) perspective, I cringe when I hear caregivers using childish-sounding words such as ‘twinkie’ or ‘foo foo’ instead of vagina. Unless these are words chosen by the vagina’s owner, I am concerned that such terminology has the potential to infantalise. Not ideal at a time when we need to help them find their inner strength. Yet I am just as prone to softening medical or other language that I feel is potentially disempowering. I avoid using medical terms that I perceive as unnecessarily fear-filled (haemorrhage, risk factor). Instead, I choose words which I perceive to be less hormonally and emotionally upsetting (like bleeding and chance). I also quite like that some midwives call sanitary towels bunnies; which at least removes the connotation of dirtiness that the word ‘sanitary’ carries. All of these words in themselves, of course, are neutral; it is the meaning that we attach to them that is the issue.

One of the first modern texts to illustrate examples of intentional changes in midwives’ language was Spiritual Midwifery (Gaskin 2002), which tells how The Farm’s midwives rejected the word contraction and replaced it with rush. This was a deliberate attempt to remove a word which was felt to be unhelpful and introduce another word which conjured a different set of meanings and mental images and was thus more empowering. But not everyone felt comfortable using the word rush. And the search for a better alternative to the term contraction (sensation? surge?) wasn’t dissimilar to the debate around whether it is more appropriate to replace the word deliver with catch, receive or attend.

There exist differences in opinion even between those who have thought about their language; some people seek to find out what words women use themselves, and then follow suit. Others tend to stick to their own preferred terminology. Perhaps they feel that, if they are comfortable and unembarrassed with particular words, others will feel that way too. Even if they are not the words that they would use at home.

At the end of the day, there are no absolutes. Perhaps it is not the use of euphemisms per se that is the real issue, but the intention with which we use them.