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Madeline Bell is a mum to two young sons, Alex and Ted, and a champion for Make Birth Better (MBB), an organisation that supports families who are experiencing birth trauma and need support during early parenthood.

In this guest article, Madeline writes about the importance of communication for those who use health and care services. She also explains how language impacted her own birth experiences.

Guest article: "Language is crucial for empowering people who use health and care services"

You learn a lot about yourself when you have a baby. Before and during my pregnancy I felt successful and in control. But this changed after I gave birth to my son, Alex.

‘You’re only one centimetre dilated’

I felt positive when I arrived at the hospital. Everyone expected that I’d have a straightforward labour. But expectations didn’t match the reality. The midwife told me I was ‘only’ one centimetre dilated.

I felt crushed, like I wasn’t coping well enough and was wasting my midwife’s time. If my midwife had told me, ‘You’re one centimetre dilated, but you’re coping well with strong contractions’, I would have felt like I was doing a good job. Even removing the word ‘only’ would have made the situation feel very different.

‘We’re short-staffed’

I spent my first few hours of labour in a lot of pain. I was exhausted and had been waiting for two hours for an epidural. But my midwife kept disappearing for what felt like long periods of time and told me, ‘we’re short-staffed’.

This made me panic and lose my focus. If she’d told me that she just had to pop away, would be back soon and that I had nothing to worry about, that would have reassured me.

A few hours later, the surgeon examined me to see if I needed an emergency caesarean. I did. Without making eye contact, they stated, ‘You’re not progressing’. In my exhausted and emotional state, I felt judged.

For the first time since having Alex, I felt so proud

I felt cheated of the ‘normal’ birth experience and didn’t feel connected with Alex. But my community midwife was amazing. She knew I was unhappy with how my labour had gone and took the time to understand me.

Another midwife I spoke to was brilliant. She told me that no matter what, I couldn’t have given birth to Alex ‘naturally’. I’d coped with an extraordinary amount of pain, a long wait for pain relief, and had endured a caesarean on top of all that!

For the first time since having Alex, I felt so proud of myself.

Ted’s birth

Before my second son, Ted, arrived in January 2020, I reflected on the impact words had had on my previous birth experience.

To prepare, I practised positive thoughts and read a hypnobirthing book. Hypnobirthing looks at how we use phrases and language. I also planned coping mechanisms for my labour, like thinking of particular phrases to repeat in my head.

This birth experience was immediately different. My midwife told me I was ‘labouring three centimetres’. They explained that my contractions were significant enough for my health and care team to consider me as being in labour. I felt like I’d already achieved a lot. Everyone was smiling and relaxed on what was a quiet shift, which made me feel calm and content.

Elated and empowered

I didn’t need a caesarean this time. My midwife continually told me, ‘You’re doing so well’ and, ‘You’re coping really well’ during my labour. This made me feel so positive and helped me to stay in control. And at one point, my consultant commented, ‘That was a really good push’. This gave me an important sense of approval.

I felt immediately connected to Ted. And I’ve no doubt that this was partly related to the language and communication health and care professionals used during my labour.

Language is crucial

Health and care professionals have very busy jobs. They don’t always have the time to think about the language they use and how it affects people’s experiences.

Pregnancy, labour, and early parenthood can be vulnerable times for people and can trigger trauma. Language can influence people’s birth experiences, and can set the scene for early parenthood.

My midwives always strived to do their absolute best. Language isn’t perfect. There’s no ‘one size fits all’ approach. But health and care professionals can still try their best to get it right. Language is crucial for building trust and self-belief, and empowering people who use health and care services.

* This is an edited version of Madeline's blog published by Make Birth Better as part of their #everywordcounts campaign 2021.

What else can I expect when I read the public newsletter?

In our lead article, Luis Perpetuo from our Public Engagement team talks about how the people we serve are helping to shape our work. We recently hosted two online sessions. They’re the first of many steps we’re taking to involve the public in our work. Luis spoke to us about what happened at these events, our next steps, and why it’s important for us to involve the public in our work.

You’ll also find news about our latest annual report, the closure of our post-registration consultation and our new Council Chair, Sir David Warren.

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