#41 | How the Language We Use Impacts Our Birth: Interview with Sara Pixton of Birth Words

August 5, 2020

Have you ever wondered why we call it "labor" or say he or she "delivered" my baby? Maybe you felt defeated when your care provider diagnosed you with "failure to progress" or suggested you had an "incompetent cervix". The words we use matter a lot. Sara is a mother, educator, birth worker and founder of Birth Words. With a master's degree in linguistics, she was inspired to fuse her passion for words and birth into a revolutionary movement, bringing awareness to the words we use and reframing our language in a way that gives strength to the birthing woman. She joins us today to explain just how to do this.

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If you enjoyed this episode of the Down To Birth Show, please share with your pregnant and postpartum friends.

Between episodes, connect with us on Instagram @DownToBirthShow to see behind-the-scenes production clips and join the conversation by responding to our questions and polls related to pregnancy, childbirth and early motherhood. You can reach us at Contact@DownToBirthShow.com or call (802) 438-3696 (802-GET-DOWN). We are always happy to hear from our listeners and appreciate questions for our monthly Q&A episodes. To join our monthly newsletter, text "downtobirth" to 22828.

You can sign up for Cynthia's HypnoBirthing classes as well as online breastfeeding classes and weekly postpartum support groups run by Cynthia & Trisha at HypnoBirthing of Connecticut

Please remember we don’t provide medical advice, and to speak with your licensed medical provider related to all your healthcare matters. Thanks so much for joining in the conversation, and see you next week!

View Episode Transcript

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Have you ever wondered why we call it labor or say he or she delivered my baby? Maybe you felt defeated when your care provider diagnosed you with failure to progress suggested you had an incompetent cervix. The words we use matter a lot. Sarah is a mother educator, birth worker and founder of birth words. With a master's degree in linguistics. She was inspired to fuse her passion for words and for birth into a revolutionary movement, bringing awareness to the words we use and reframing our language in a way that gives strength to the birthing woman. She joins us today to explain just how to do this.

Hi, I am Sarah pixton. And I am here to talk about a little project I have called birth words, give you a little introduction into how I came into birth words. Because I think it gives some context to help you better understand what it is that I do with birth words. So after the birth of my son, which he's coming up on his fourth birthday, and in a couple of months, so almost four years ago, I felt the call to birthworks Bye I know many birth workers do just kind of grabbed me his birth was empowering, transformative and positive in all the right ways, especially in contrast to my first birth. And when I talked to friends about it, they were surprised to hear that I've had such a positive experience. And I knew that I wanted that to not be so rare. But birth should be a positive and empowering experience for many, many people. And so I became a birth doula. But around the same time, I was also starting a master's degree in applied linguistics, and I got into applied linguistics. With my background originally being in education, my bachelor's degree is in elementary education. And I've always felt that our words matter. So that's kind of what pulled me into linguistics to begin with. But as I continued to develop my birth, work, career, and kept working on my master's degree, I eventually realized that there was a really interesting overlap between those two fields similar to the way that I thought about the education experience. It's really important the way that we frame pregnancy, birth and the postpartum experience. I feel like there's a lot of power in the way that we allow ourselves to be influenced by words and the words that we mindfully and intentionally choose to prepare for and create our experience.

This is one of my own favorite topics as well. I love foreign language, and I love linguistics. And I remember learning something very interesting. At one point where Helen Keller when she was finally able to communicate, I remember how she was explaining that before she had language. She couldn't form thoughts. So when she was feeling an intense emotion, she didn't even have a name for it, whether she was frustrated, lonely, angry, sad, because there just wasn't a word to apply. to it, our words really shape our thoughts immensely. I remember having a friend who was a very successful business guy. And I remember he called me once after work and was chatting with me. And he said something like, well, we lost our biggest he was the CFO. And he was like, well, we lost our biggest client today. And the CEO resigned as a result. So he was Next up, and I will never forget his next words were. So this is going to be fun. And I thought, This is why he can handle a job like this, because he used the word fun. And then the same week, a friend asked me I was pregnant at the time. In the same week, a friend asked me what will I do if I hit traffic on the way to the birthing center? And they said, because that'll be a disaster. And I thought, holy cow, the way people use language, I mean, a disaster if I hit traffic, that was an intense word, and I had to work to get it out of my mind. Yeah, that's so interesting. It kind of explains why young children, especially like toddlers, before they have language, develop have such Fits of emotion and thats because they actually don't know how to put the words together to express it right. And then as we become adults, if we don't develop that emotional intelligence, and attach our emotions to words, we don't necessarily throw tantrums, like toddlers, but we can have just as much frustration and internal agitation because we don't know how to name what we're feeling.

I feel like language is a mediating tool. And I'm not coming up with that it's coming from Lev Vygotsky, who's a philosopher and education, that through language we mediate, right, it's this go between between our experiences and our internal life and helps to bridge that gap. And so it's really important that words and language that we choose to bridge that gap.

And this isn't this isn't something that most women think about when it comes to pregnancy, childbirth and postpartum. It's just Sort of like, the language that they see online or on social media or that their care provider uses is just what they accept and aren't consciously thinking about the impact that it has.

Exactly. If we take a step back and look at some of the language that we are not very mindful about that we just allowed to be part of the pregnancy and birth experience. So much of it is disempowering. So much of it puts authority in the hands of the care provider, like exclusively, right, we want, we have a care provider because we trust in their authority, but to give over just the authority of the process of giving birth, so much of the language just encourages that sort of attitude, and also speaks about labor and birth as if it's a machine that needs to be fixed or as if women are those giving birth are broken. So I really tried to just say, Wow, let's pause and be mindful about how we're describing this experience, as we're preparing for it. through pregnancy and as we're experiencing pregnancy, and then through the early parenting time as well.

We talk about this quite a lot. And maybe the most important one to start with is the fact that a doctor or midwife does not deliver your baby but you deliver your baby, no matter how you give birth, even if it's a surgical birth, you deliver your babies. And when I hear women speaking that way, like oh, well, that's the doctor who delivered me. It's like, don't do that from your mother. Your mother delivered you. We know that for a fact, no matter how you came into the world. I remember breastfeeding, woken up to this notion years ago when I was speaking to my mentor Nancy Wainer, friend and mentor. She's the midwife who coined the acronym VBAC, by the way. famous author, famous midwife, and I remember speaking with her years ago, and I said to her, how many babies have you delivered? And she said, Well, I've delivered three I've attended about 2800. Okay, I will not make that mistake again. So have you talked about that one in particular, have you think a lot of the reason we use that word comes from like our Judeo Christian roots? If you look at the Bible and the translation of like, the King James version, which was, oh, I don't remember all the dates off the top of my head, but centuries old, right? This language that then became a lot of the underpinnings of our culture, uses in that translation, the word deliver to mean like deliver from enemies and to talk about childbirth. But if you go back farther, and you look at the original language in the Hebrew of the Bible, there are actually two totally different terms used one that was relating to childbirth and one that was like delivering from enemies and delivering from sin and bondage, right. And at some point, they got conflated and then we got into to this place where somehow over hundreds of years, we started talking about our doctor's delivering us as if we were in some sort of bondage or being needing to be delivered from an enemy. When, wow, instead, really, there's this power and beauty in the birth giver, delivering the child into the world, right? Or some people, because of the history of the term deliver really don't even like to use it to say, some women are like, I just hate that that term has been used to talk about a doctor delivering me. So I'm just going to not use it at all and say I'm giving birth, and some women are like, you know what, I love that word. As long as I'm the one delivering my baby.

You can't go wrong with the word birth. The word really is the most fitting right Trisha? Don't you agree?

It's, it's what's happened. It's what's happening. I mean, the the history you just gave on the word deliver makes me sort of like cringe thinking about using it in birth, but then even if you take that whole history out of it you just think like the word deliver as we know it today is like about bringing a package to somebody like it's it's Amazon, it's pizza.It's not having a child come into your arms that is, you know, it's like, doesn't even make sense, right? doesn't even make sense. So yeah life. It's so engrained though me even as a midwife who has been conscious of not wanting to use that word for years, it's still slipped right for me. I still say it when I'm speaking in a certain way or to certain people, it's just like, it's, it's there. It takes a lot of effort to change these things. So that's number one, for sure. So let's talk about some of the others.

Yeah, I get asked a lot and in the work that I do to say like, okay, so give me a word list of words that I should use and words that I shouldn't use. And while I feel strongly about a few words and a few phrases that are commonly used, I also feel like it's important to just be Personally and individually reflective and intentional in your language, because so much about language is individual and it's unique to your lived experience. So I feel like I can't give a rundown of like, nobody should ever use these words and people should always use these words. And a good example of that is the word contraction versus like a surge or a wave. And I know, Cynthia, you are hypnobirth. instructor is that? Yes. So you're very familiar with all the other options, right, lots of other options and saying, Let's step away from these terms. And I've had discussions with a variety of people who have women who say, I really love the word contraction because I'm a dancer and I love that my muscles contract and I feel their strength. And so when I'm giving birth, I love to think about the contraction of my uterus. Now I know in HypnoBirthing, we talked about Well, that's not physiologically what you really want to be happening that tightening?

Well what I say to my clients is, the way the word will affect you is where your mind is when you use the term. So there is yes, there is a contraction happening in the upper uterine muscles. So I say if your mind is at the upper uterine muscles than the word contraction will work for you, if you're moving around the cervix, and the fashion of the service and your mind will not respond well to the word contraction. So it is personal, even in HypnoBirthing. But we present these other options and say, Are you aware of what you're visualizing when you're giving birth? If your mind is at the cervix, then maybe contraction isn't going to be the one that suits you best. We certainly don't want it to be contract that we default to search, right? We default to search under that assumption, but I always point out like, but think about where your mind is because there is indeed a contraction, but it's way higher up.

Yeah, I really like that. Because then like if that word gets you that feeling of like, Wow, what a powerful muscle I have that's contracting at the top, then great, but I like the word surge and wave for many brothers because they draw on more natural processes, right?

It's also a word that is bringing in power. It's like a wave and a surge is something that's building and gathering strength and gathering energy whereas contraction is clamping, tightening shutting down. Even though that is what you just said the physiologic process of what the muscle in the uterus is meant to do, not the cervix.

But it was not the whole body it's not just the cervix. Yeah, does exact is meant to do the exact opposite but but also your whole body needs to relax and and be filled with this energy and not be in a tight climbing. We don't want clamped, neck and mouth and you know, shoulders, we want all of that to be relaxed. The only part that Supposed to contract is precisely the muscles of the uterus that are doing the job during. that's a really good point. Yeah. And then the other thing about just like this underlying metaphors, right that we talked about, what is the body doing during labor and birth? What's the metaphor underlying it? And if we talk about a labor, stalling, those sorts of terms that make it sound like my labor is a machine that I climb into, and it's supposed to just chug along and do its work. And I'm kind of just writing but occasionally it stops and needs repair. And I'm not the repairman, right? Like it just shifts the power of who's experiencing this birth, and who's the one to, quote repair things when they go quote, wrong, right, rather than trusting in the physiological process, but it's more of a natural process that builds in ebbs and flows, right.

Yeah, and it's, it's like birth is its own unique effort. its own unique work, like labor encompasses all these different things in the world that we do. Like, the first thing that comes to my mind is like plowing a field. Like, you know, this is like the laboring work of hard, physical, exhausting work, but birth is not just that, yes, it's work and yes, it can be tiring. But it's also filled with this really positive energy of bringing forth life and it should just, you know, it feels to me like it should be separate from the generalization of labor and it's, it's really its own thing, its own being, which birth is really the best word to describe it. That's the only thing I can think of, to replace labor.

I like that because, like you say, we use use other words from other realms, and they come along with all sorts of other connotations and societal influences and assumptions and perspectives that can come along with the terminology if we're using words that are used in other areas.

And I can't think of any example of a care provider who says she didn't you know, my my patient has arrived and she's in birth. Do you, Cynthia, can you think of anyone who speaks? Well, no, but you just triggered something in my mind when you said patient because I'm a first patient for pregnant.

Oh, yes. Another one is another word. It's like so many, so many words to talk about. Yeah.

Yeah, it's nothing.

Yeah. So can we talk about patient for a minute?  I told a little bit of my personal story at the beginning, but this one's one that's pretty personally meaningful for me because before my first birth experience, which was a twin pregnancy and birth that ended in an emergency scenario, and I was on bed rest in the hospital. So I was a patient right like I was laying in bed, getting medication delivery. To me, like not allowed to get out of bed all of these things that were very, very patient like that was the identity that was mine. And then as I entered the birthing time, I think that it made a really big difference that that's how I've identified myself as a hospital patient in need of care. Right? Yeah, they're in need of care and, and a passive recipient of it, right. And so I think that when we use the word patient, again, it comes along with all of these ways of thinking about the person who is identified as a patient because typically a patient is one who is sick or injured, or in need of care, like you're saying, because there's something not going right. When we come to birth. We're like the epitome of life and health. Sometimes there are complications that need monitoring. But to use a term that implies so much of this passive perception of care when really The act of birthing is, like I said, the epitome of health and life as you bring forth New Life can be really problematic in how we prepare for an experience birth.

I can't imagine that birthing mothers were ever called patients before they entered the hospital. And then I believe when the baby is born in the hospital, the baby too is referred to as another new patient. This is definitely and then I think as the birth giver yourself, it's important to not think of yourself as a patient, right? And I think that that's another important aspect of this we keep talking about the individuality of the birth experience.

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let's talk about the word failure (FTP) number one reason for C section failure to progress can we right? Wow. Yep. What a terrible the tell somebody as they're they're beginning their journey of parenthood and to literally give you a label of failure like how Could we do anything more? Or say? Yes, at the beginning of their parenting journey, that is, oh, like that just rips my heart open. And it's so tricky, right? Because it's not as if doctors and midwives and those working in these clinical settings that use these terms are purposefully being malicious or purposefully, right? They're just they have a set of terminology that has its background in history, and is used in this situation. But I just think, Wow, let's pause and just think about some of these words that we use. So regularly, like you said, failure to progress. The most common reason that people end up with a C section. Wow. Ah, I hate it. It's a very strong word. It's a very strong word. I mean, it's not a failure anyway. I mean, it's that's what's so sad about it. It's not her failure anyway, failure to progress usually points Just a long, slow labor that our society has no interest in waiting for. Right? In the case of a woman who needs a C section or needs intervention, it's still not a failure. You know, the fact that no one is thinking about this or questioning this is what's so disappointing. The first time I heard that term, I had that thought right away, my son's birth story was published, and I talked about it in the birth story. I talked about that term and my emotional reaction to hearing what it meant, because my doctor said, after listing a dozen reasons why she quote, likes to give cenarion sections. She finished the list with failure to progress. And I said, What's that? And she said, I'm going to need to see you dilate a centimeter an hour. And I look back and think what right do you have to need anything of me? What language even to say, I'm going to need to see really, no doctor, I'm going to need you to support me and if I really need intervention, then I will need you to speak up and have a conversation with me that was so hard to listen to failure. And then you start having thoughts like I hope my body works. And then of course that can have a physiologic impact. Mm hmm. So we have to be so careful about how we speak to each other.

Yeah. Wow. powerful stuff, language. I mean, we have to become so much more aware of what kind of information we take in what we digest how we speak to ourselves, because our bodies are listening, always listening.

Yeah, so the, the guidelines that I use as part of my work, I have three key words that I talked about being with our language being reflective, being intentional, and being empowering. And I think each of those like they're not really a step through each of them. They overlap a lot. But as we're reflective, like we've been during this conversation, as we're saying, like, Wow, I've never thought about the implications of that word that so commonly used. I wonder how it's It affected my in other people's experiences, and is more intentional, sorry, intentional about choosing other words to create an experience, then it goes towards the third word and the empowering that I mentioned if saying, Let's use words to put power in the hands of the one giving birth. Like Cynthia was saying, I'm going to need to see this of you, right? Like as if that is the ultimate authority. Yeah, we've talked about a lot of big words like key key points like deliver and failure and labor. But then there's all these other very subtle words that are used in the in managing birth are incredibly disempowering. For example, when most of the time when a woman is checked in labor if she hasn't reached 10 centimeters, or a point where we feel very excited with languages, well, you're only four centimeters right or You're still stuck at five. That kind of language just isn't helpful. You remind me of another story that a doula shared with me in which a woman was laboring and I think she was in a semi reclining position, leaning back and her knees were bent and upward. And at one point, the provider, it was a female provider took her, took the woman by the knees and shook her knees, shook her legs and said, relax these legs. These legs are mine right now relax them. And I was just like, what? these legs are mine right now. These lights are never yours. This baby is never yours. This birth is never yours. Just get your ego out of this. Like what how even if it slipped out even when people apologize later and say I'm sorry I said such and such. It's very little consolation because words are a reflection of thoughts. So if someone slips and says something utterly inappropriate to like that, to me, like if that were to happen during a prenatal I would say that's a red flag because it doesn't matter that they can control consciously control the language they use going forward. They just slipped, they just let slip, how they think. It just slipped out of their mouth before they caught it. But that is a reflection of how they think like you can't get most providers to speak that way because their brain won't even go there. They couldn't be tired enough, they couldn't be drunk enough on enough glasses of wine to start talking that way because it just doesn't happen in their mind. use that kind of language. They don't think of their clients that way.

When we're talking to about cervical checks and the language about only this many centimeters are stuck at this many centimeters. I also think the introductory phrase to that is often I'm going to check you, right? That's a phrase that's often said, which, again, like, let's pause and be reflective about. I'm going to check you what kind of position does that Put the care provider in and the birth birthing woman, if she's being checked. It's like an exam, right? And we use that a cervical exam, we, and most people don't get empowered at the thought of being given an exam, right, especially when that they don't have a lot of power over the results of. And then again, it can plant those seeds of doubt, or mistrust of your body, like we talked about with the term failure. And when we were talking about that, and came back just a minute ago to failure to progress I also it also reminded me if then if you're one of those, given the label of failure to progress and had a C section, then if you have a subsequent birth and you're preparing for a VBAC, and if they were given this term of failure, and then now they're told they're trying For a vaginal birth, I mean trial of labor is this term that people use technically a first time giving birth is a trial of labor. Right? Which, oh, it's tricky, right? Because like, in some ways, I just want to tear that apart and be like, let's not use this word, let's not talk about it as if it's some kind of a clinical trial, or it just has that word try in it that again, can be kind of triggering to people who've been given a label of failure previously, and now they feel like they're only being given a chance to try. Absolutely, the subconscious doesn't respond well to the word. Try it. All. Right. So this is where we run into some really difficult things with this language and wanting to dismantle the whole system and rewrite the script, where different words would be used, but then at the same time, acknowledging, okay, if I am giving birth, and I'm preparing for this experience, I can't dismantle the whole system in my experience, like I can't say I'm not Giving birth. And so nobody's ever going to use the word trial. Nobody's ever going to use the term incompetent cervix, nobody's ever going to say that I'm stalling. Nobody's ever going to say that I'm stuck. Like we can reframe the words that we use in our mind. But we also, as we're reflective and intentional about the words that we're using need to determine strategies to respond when you do encounter those words that are, for instance, if you're preparing for a VBAC, and you're giving birth at a hospital, you are unlikely to be able to avoid the term trial of labor after suffering. And so you have to come up with some strategies to say when I encounter that term, how am I going to re identify it for myself? Because there might be a nurse or a care provider who says something in your birth that could be triggering, like these legs are mine right now. What are you going to do in that moment? When somebody says something like that, and I think a lot of it is lies, and just Your preparation, being mindful about using terms that put the power in your hands. And I don't know, what are your thoughts about that?

Well,I talk to clients about this because Tony Robbins is the first person who ever taught me about this in my life. So I tell them, Look, you can't control what other people are going to say. If you have a preference for the word surge over contraction or the word client over the word patient, we can't control and the big one and HypnoBirthing that I personally feel very strongly about is avoiding use of the word pain because I just might The only question I ever asked is, is this serving the birthing mother and if it is not, we don't use it. We don't say it. We don't do it. We don't show it. We just don't go there. Like how they haunt VBAC women with talk of uterine rupture all the time, but they never mentioned it to a first time mom when the risk is similar. We just we replace it. So I said we can't control that your provider might say that To your that your friends might, you can't go around to correcting everyone and asking them to use different language. Maybe you can with some people, but you replace it in your mind. So if they say, What are you feeling on the pain scale in your mind as you think about what they say say they're asking about my comfort level. If you hear them call you patient in your mind, just say, client.

Trisha, what were you gonna say? I was going way back to just something Sara said about a term that I wanted to make sure we address was the incompetent cervix.

Yes, and I hear just like that one to me is that's like right up there with the failure to progress always being like that to call somebody cervix and competent. I mean, I promise any woman after having been given that diagnosis supposed to go on in a future pregnancy and feel that her cervix is going to do its job.

Yeah, and I feel like it is representative of something that has With a lot of these terms that we've talked about many that we don't, haven't yet talked about, where the birthing woman's body is objectified, the process and experience of labor and birth are talked about as if they're happening outside of somebody's body. But we need to take a step back and say, hold on this cervix, which we've given this label of being competent to is a part of a whole person, a whole being with not just physical anatomy, but with emotions and experiences and future experiences. And so often, the commonly used terms treat the labor experience that way and that happens with cervical exams and just various points along the pregnancy at appointments with doctors. Sometimes we just talk about his experiences if it's separate from the whole person. That's among Basically almost any other experience, the Paramount of mind, body, spirit, emotion, mental, intellect, physical, all of these things happening at once. So to treat it separately with our language. I think it's just really, really tragic. And I think that with the sorts of language that changes that need to happen in birth, they're going to need to be that more intentional variety of language change, because just letting things happen over you seems like we just get this trickle down of these terms that are not helpful in the first space. Let's be mindful about the words and I call it sometimes the linguistic reformation. Let's pause and purposely make language change in this way that is more agentive and is purposeful and driven, Because it needs to happen.

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It's kind of like when someone has said to you in your life, don't worry and you think why would I worry? I wasn't worried at all. So he said until you said don't worry. These are all examples of how language impacts our experience.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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