Labia wards and birthing sheds- a patients perspective.

So there was a big kerfuffle on twitter about doctors using terms labia wards and birthing sheds and cabbage patch in such a public fora such as twitter.

I wanted to muse more about this here.  Although I did miss most of the spat on twitter I did see one “labia ward” tweet from a doc I follow and I did query the term as I did have a gut reaction to it. As usual no reply but you can’t reply to everyone so fairy nuff I suppose. (but no surprise he was one of docs also involved in this ranty post from me– although to be fair he used to be the one I had more respect for than the one I can’t stand. Should probably unfollow them both- doesn’t do my blood pressure any good!)

Now I am a teacher- I have a public persona and professional twitter account.  I am very careful what I write there. I also have a personal account which is often full of complete nonsense but I try not to let the two meet- I try not to discuss teaching stuff from my personal account for example.  That said I think all professions have a right to a private life and a space to vent- heck just reading TES forums sometimes may get eyebrows raised about the state of the education system in Britain!  But that’s the thing Twitter is such a public forum and anyone can follow anyone, so I do wonder if it is a suitable space for such comments to be made, as it is so public.  Vent away in the staffroom or even in medical forums online but the problem with twitter is anyone can follow anyone and your patients maybe following you (like my pupils may follow my pro account- eeep!).

I am a big fan of black humour as a coping mechanism as my blogpost on humour attests to, but I think you need to be incredibly careful when your black humour can upset such a huge number of people. Eg. in my case brain damage jokes about munchkin etc were only really going to upset me and close family and we were the ones dealing with the situation and it was a survival strategy for me. If a doctor had made any inappropriate brain damage jokes about munchkin then I would be furious if I was within earshot or found out- they wouldn’t have the right to do that because they don’t have that emotional investment in munchkin or could be feeling as traumatised by the situation as I was- so any black humour on their part would actually be cruel, insensitive and inappropriate.

In terms of my gut reaction to the term “labia ward” I was a little upset by it (more so by terms “cabbage patch” for ICU* and “birthing sheds” which I read about later) although for further reflection see **.  A large part of my PTSD from childbirth comes from being treated like a piece of meat on a slab, I was shown very little human kindness during the labour – no-body smiled at me, reassured me, told me I was doing well or it would be okay (apart from Midwife with a Halo who had to leave- as described in my birth story).  I had a meeting with the head of the delivery suite recently (which I shall blog about shortly) who was incredible, lovely and wonderful and said”what you need is for people to be kind to you this time”. And bingo- that’s it! Being looked after, being cared for- that’s exactly what I need (and what I am getting from my current hospital).  So reading medical professionals using such terms about their work did upset me.  I don’t want to know that medical professionals view their patients as labouring mooing farm animals, I want to know that medical professionals treat women in labour with kindness and respect for a very very painful scary time in their lives.  I appreciate (well I hope anyway) that the actual professional doctor patient interaction would never be so callous and that it was just doctors letting off steam, but the thing is a veil has been lifted.  I don’t want my doctor to “fake” caring I actually want him or her to care.  And I know that that is a lot to ask, and I know you have to “fake” it just like I have to pretend to actually like the complete little shit in my worst class of the week, in order to attempt to get him to work, but knowing that there are doctors who really do have such little regard for women by talking about them in such a way- well I just really really hope I don’t get one of you in my next labour, or if I do- I really hope you are a fucking good faker and make me feel safe and secure in your medical care before bitching online after your shift about how much I screamed . 😦

* P.S Musing some more on this- out of all the terms used I found “cabbage patch” to actually be the most offensive and upsetting of the whole debate (although to be totally fair see comments for where term originated).  Maybe it is because I am oversensitive to brain damage jokes due to Munchkins HIE (though she is fine now I am painfully aware of how badly brain damaged some babies can get during labour) but I don’t think it is that. I just think it is incredibly distasteful to joke about people who can’t respond or give as good as they get.  Yes the labour ward stuff was unfunny and made me not respect those doctors but at least I can rant about it on here and on twitter and let my feelings be heard about that, people on ICU can’t at that time.   The peculiar flipside of that is I would probably giggle a bit at the thought of a doctor stating a preference to work in ICU where it is nice and quiet rather than the rather noisy labour wards. I mean I’d prefer to listen to machines bleeping than women screaming their heads off any day. But I think the key is how that preference is stated, personally I wouldn’t be offended by tweeting something as I have just written it (although others maybe -so again it is a tricky one) but using terms such as birthing sheds (interpretation- women are cows), cabbage patch (interpretation dealing with vegetable patients) etc is just really horrible and is directly about the patient with a negative view on them rather than actually about a doctors preferred ward to work in- which he or she is entirely entitled too.

** On reflection of all of the terms I probably found Labia ward least offensive and in a different headspace/context most amusing – I love a punning linguist me. However interestingly I think I would have found the term “labia ward” used by a female doctor (who also has labia obviously!) to be much less offensive than when used by a male doctor who has previous form for slightly misogynistic attitudes towards birthing women (I worked this out from reading a comment on AMcunninghams blog from the female doc who claims to have coined the phrase) .  I can’t decide if this is very sexist or fairy nuff of me.  Ho hum.


About LadyCurd

Likes ladybirds & lemon curd. On reflection combining the two names was a mistake.
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11 Responses to Labia wards and birthing sheds- a patients perspective.

  1. So great to have your voice in this conversation about the way that health care practitioners discuss their work, especially in a public domain like twitter and other social media. I’m also glad the person in charge of the labour ward said those appropriate words to you – everyone needs kindness, but those who are in vulnerable situations need it most of all. I hope that attitude rubs off on the culture of the place. Admitting the wrong like that charge person did with you is very healing and augurs well for cultural change. One of the aspects of this discussion that is worrying, above and beyond the insensitive and inappropriate comments in the first place is the thread of name calling and disparagement in the ‘defenders’ of the right to be rude camp on facebook. Hopefully those folk will read comments like yours and think about their attitudes and the effect those attitudes and the words they spawn have on the people who need to trust us.

    • Thankyou so much for your comments. For the record- new hospital where they are being extra lovely to me is different to the one I gave birth in. Although the old hospital did respond to my 5 page complaint letter assuring they were putting things into place to minimise it happening again (and old hospital was deserving of a 4page praise letter especially for the community midwives and the NICU staff!). Head of delivery suite said her bottom line was “Kindness” and she didn’t wouldn’t let any unkind midwives on her delivery suite. She also gave me her mobile number to ring in labour so she can ensure whoever is on duty knows my case and looks after me properly this time! Medical professionals who go the extra mile like that are incredible and those are the ones who have incredibly lucky patients who are much less likely to get PTSD etc as an aftermath.

  2. A tweeter brought it to my attention that : Cabbage patch is a play on words- CABG=Coronary Artery Bypass Graft and refers to Cardiac ITU not ‘patients being cabbages ‘

    This does actually make it better- but us non medical mortals wouldn’t have known that- it’s one that should be kept in the profession. I know as teachers we have some fairly offensive wordplay acronyms that we really wouldn’t want parents, our bosses, pupils or the meeja finding out and using (so would be unwise to mention them here!) so it is unfortunate that this whole affair has become so public- as doctor to doctor I think some of the banter was ok. Just not one I particularly wanted to read about as a patient.

  3. Really good to hear your comments. I am a midwife and mother of daughter who will be having babies soon. You have articulated my fears…that comments made such as the ones in this argument..are a symptom of the dehumanized way that HPs thinks about patients.

    This has been a very interesting conversation and has certainly raised my awareness of how I talk about health care…whether it is in social media or in the tea room.

  4. Random passing doctor says:

    The problem is that sometimes you do need a way to distance yourself from disasters and tragedies at work. And language is the main one left to us. I hadn’t used to term Labia Ward (which, incidentally, was coined as a play on words by a rampant feminist who happens to be an anaesthetist: she felt that “Labour Ward” didn’t cover women who had pre-labour caesarean sections, or were being stabilised for their pre-ecclampsia, or in some units were attending for terminations, but labia was what they all had in common…including her) but I have used many others. This is not because I am uncaring. It is the opposite. But I have to be able to stop resuscitation on a baby who has suffered cot death, break the news to the family, try to comfort and explain things to them…and still be fit to turn round immediately afterwards to resuscitate a 24 week micropremmie. I’d love to be able to stop for a good cry in between. But I have to keep that for at home. When, believe me, I do. But I have to be able to not do that at work. This is for two reasons: the first is for my own survival, which you may not count as important, but as I say, the second is to be fit to look after the next sick kid. Or, for that matter, to stay calm when being shouted and sworn at by the irate parents of a really not sick at all kid, who had to wait because we’ve just spent an hour jumping up and down on the chest of a dead baby, stuffing them full of every drug we can think of. So….we will use what we can, to cope. And what helps, as you would find from talking to anyone who works in life and death situations (emergency services, armed forces, miners…) is camaraderie. And the shared language is one of the strongest tools for forging camaraderie. One could blame the tweeters for being daft enough to forget that they weren’t talking in public. But anyone blaming them for the actual language has quite clearly never been in their shoes.

    Oh, and my mother was a very dedicated teacher. So I know exactly how rude about parents and kids many of her colleagues were.

    • Thankyou for commenting. I do count “survival” as you put it of our incredibly hardworking doctors incredibly important and recognise the stresses and strains you are all under. I am also from a family mix of docs and teachers, so I have seen the stresses and camaraderie of both (although obviously teaching isn’t life or death-although kids and bunsen burners can get pretty close sometimes! ;)).

      The issue is the “actual language that forges this camaraderie” was overheard by the very people you wouldn’t want it to be overheard by. To be quite honest I really didn’t want to know about the terminology because as someone currently pregnant and suffering from PTSD from my last birth who can get triggered even going near a delivery suite (and I haven’t even tried to go into a delivery room yet), then I don’t want to know the spoof joke derogatory terms used to describe a place that fills me with such horror and upset anyway plus unfortunately I would not want to be treated by any doctor who did use such terminology as my interpretation would be (rightly or wrongly) that they did not respect me as a woman about to give birth.

      I thought my blogpost tried to get across I recognise the need for black humour but the audience needs to be those who can share the black humour and laugh with it. I recognise it is my issue on how I am responding to the words and choosing to interpret them, but surely you can see the effect some of those terms could have on people outside of the “team”, and unfortunately whilst team members may know you are a kind caring professional who doesn’t mean it in that way and its a tool for the much needed support network, Joe Public probably doesn’t and will make an inaccurate assumption about you based on using such terms just as certain people did about me who didn’t know me as well cracking jokes about my brain damaged baby.

      I think the unfortunate thing about the whole affair is that it got blown up so publicly- yes it is a storm in a twitter teacup but it has raised some incredibly interesting questions about public, private personas and languages professionals use (teachers, doctors etc) which is why I felt I had to respond with my perspective.

  5. Random passing doctor says:

    I’m afraid that would be your loss. The cold fish who don’t give a damn, or those who have largely escaped to the comfortable ivory towers of academia, don’t need to use these mechanisms. It’s the ones that care that do. Because if you don’t care it doesn’t get to you. But when it does, you need to find ways to survive it. There are only so many times you can hide crying in the linen cupboard before either quitting, finding a mechanism, or losing it. Not, of course, that I would advocate using terminology in front of patients, because of the misunderstandings that can arise…with people not knowing about CABGs, or attributing mysogeny to an increasingly female, and feminist, profession.

    And this is particularly sensitive at the moment. RIP the PICU consultant who let it get to them, and committed suicide this weekend. Apparently they were well known for being particularly caring.

  6. Jane says:

    “Coping” is just an excuse for bad behavior. There are many much more mature ways of coping with difficult conditions. Using derogatory language to dehumanize patients is juvenile, disrespectful and is a perfect display of how medicine has gone awry. Medical schools should not be accepting students who have such a juvenile way of coping with the world. Perhaps “emotional maturity” should be a criterion for acceptance. Actually, no “perhaps” about it…

  7. Jane says:

    “The claim that being a physician is so difficult that “anything goes” backstage misuses the concept of coping as cover for cruelty, or as an excuse for not addressing maladaptive responses to pain.”

  8. TackiestOnes says:

    Passing Doctor,
    Trying to make out that the original poster might be “rude” because your mother was rude and that this is equivalent to dehumanising patients was low.
    Saying that some jokes are not misogynist only because a woman came up with them, shows you do not understand (or choose not to notice), the sheer volume of woman hating from all genders.

    I think you’ll find that being cruel is not a “coping mechanism” but rather “being a dicksplash”.
    Yes, being a doctor is stressful however, it does allow your colleagues to act in any offensive and cruel way they see fit, in public.

    Find another coping mechanism.

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