Inclusive Language Saves Lives

by Ren Lorio-Dominguez Everyone deserves pregnancy care that includes them. Transgender and gender non-binary folks often struggle to see themselves represented in healthcare situations, or included in language surrounding birth. They frequently face barriers to care, face discrimination in care, or are unable to access care at all. A large 2015 survey found that a third of the transgender and non-binary respondents had negative experiences with health care workers in the previous year, including harassment, physical violence, or sexual assault. 8% had been outright refused healthcare in the previous 12 months. Those who also had disabilities or were people of color experienced these things at even higher rates. With these abuses happening so frequently, it should be no surprise that 23% reported they had not sought needed healthcare because of fear of mistreatment.1 Non-binary and transgender people need safe places to receive care. Healthcare professionals believing they are LGBTQIA+ friendly is not enough. Using inclusive language tells transgender and non-binary folks that you are aware they get pregnant, have babies, and lactate also. Language alone is also not enough, but it is a big piece of the larger picture. A study found that trans and non-binary people who had access to an inclusive care provider had significantly lower rates of depression and suicidal thoughts than those who did not; 38% when receiving inclusive care compared to 54% of those without.2 In a population that is nine times more likely to attempt suicide than the general population of the United States1, this is crucial. A good place to start in learning to use inclusive language is letting go of assumptions. Get comfortable asking people what their pronouns are, then use the ones they prefer. Start separating gender and anatomy in your mind. If the specifics of their anatomy are not relevant to the care you are providing, mind your own business. If they are relevant, which they often will be for birthworkers, avoid reflexively attaching gender to body parts. A pregnant person definitely has a uterus, but a woman may or may not, and a person with a uterus may or may not be a woman. Some anatomical terms have so much baggage with them that some transgender and non-binary folks may feel more comfortable using less loaded alternatives. If you’re unclear, ask what they prefer. One pregnant person may be completely comfortable discussing a baby passing through their “vagina”, while…

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Supporting The Client’s Wishes: An Adoption and a Tubal

by Anissa Sartini LM, CPM All names have been changed for privacy. I first heard about Steph through my insurance biller. I knew she was from another state and had attempted an herbal abortion. When that did not succeed, she decided to give the child to her brother and his husband, who had longed to begin the next stage of their family. She would be staying with them for her third trimester through postpartum recovery. I told my biller sure, pass my info along. I never did hear from them, so I didn’t give too much thought to it. But, months later, Steph called me. Soon after, we had our first prenatal visit scheduled at 29 weeks. When I first met Steph, she had just gotten back from her travels, preferring life on the road to a standard one-place residence. Steph was loud, beautiful, with short thick black hair and covered in tattoos. Her strong and assertive energy greeted me; we bonded quickly and easily. She shared that she had been consistently very stressed, emotional, but excited to meet me and start care. Her blood pressure measured a little high, but we agreed to try some remedies and watch it closely. When that proved insufficient, we tried medication, which held us over for a while. When my assistant and I greeted her at her 35 week visit, her swollen face, high blood pressure, +1 proteinuria, neurologic changes, and 26 pound weight gain hailed us with the very obvious information that her pregnancy had progressed to pre-eclampsia. We did a 24-hour urine test and referred her to a trusted OB. They confirmed what we knew and tried to keep her stable enough to birth at 38 weeks. However, at 37 weeks and 3 days, her symptoms let us know that baby needed to meet her new parents now.  I had met with Steph and kept in touch closely during this time. When the day of birth arrived, something told her she did not want to induce labor. Following her intuition and research, as surely as she knew she did not want this child for herself, she knew she did not want to subject herself or the baby to induction of labor. We discussed the risks and benefits of induction vs. cesarean. “It just seems wrong,” she maintained. “I’d rather have a cesarean. I just don’t feel right about an induction; I…

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A Letter From the Editor

Welcome to The Birth Mag! In the years since I first felt called to the birth community many changes have happened, while many other things have remained remarkably the same. The rise of social media has allowed for more voices to be heard, but many have continued to be heard almost exclusively by their own circles. The internet has increased our awareness of disparities in care, but too frequently the voices of those most negatively impacted by those disparities have been made unwelcome in the conversation. These things need to change, and it is my hope that The Birth Mag can function as a platform for both the joyful exchange of knowledge and the potentially uncomfortable hard conversations that need to be had for midwifery, and the rest of the birth community, to move forward towards a future that is inclusive, equitable, and sustainable. In the interest of moving forward, this magazine will include a quarterly print volume, but will have all articles available digitally as well. I am excited about the ability to bring you content that goes beyond what a traditional print magazine allows us to share. While I expect text and still images to make up the majority of what will be posted here, a digital medium means audio, video, and even interactive options are all available. This project has been a long time dream of mine, but it is absolutely not my baby alone. A huge thanks to the birth community members who have poured out their support for The Birth Mag before we ever got anything published. Every share, repost, and link is helping create a foundation that this magazine can be built on, and every single one is appreciated. Likewise, every contributor who took a chance and sent their writing to a brand new publication with no established track record is hugely appreciated. Thank you also to everyone on the collaboration team that has proofread articles, brainstormed ideas, helped find writers, or just generally provided the support and encouragement to get this started. This would not be happening without you. Together I believe we can do better. Jen Marlow LM, CPM (she/her/hers) Jen is a homebirth midwife in Fort Worth, TX, and the primary editor of The Birth Mag. When not catching babies, she loves to draw, garden, and cook.

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