You're a geriatric pregnancy. Stop age shaming women!
I must admit that I write this post with a little rage. I recently had two clients call me after their appointments with their doctors. The same story for both. ‘Zo, they are recommending induction because I am technically a geriatric pregnancy. I don’t really want to be induced but now I am not sure what to do’.
WTF? GERIATRIC! This is absurd. These women were 36 and 39 years old respectively. And guess what… they went on to have the most positive and empowering births!
When did it become okay to technically term a healthy, beautiful pregnant mother a ‘geriatric’ if she was over 35 years old? Google ‘geriatric’, this is what you get:
adjective
1. relating to old people, especially with regard to their healthcare.
“a geriatric hospital”
noun
1. an old person, especially one receiving special care.
“a rest home for geriatrics”
Do doctors realise that their choice of words is not only offensive but completely undermining their patient’s confidence? Was this their intention (to keep the power in their hands) or are they subconsciously doing it without realising??? I don’t know... it has me stumped.
Language is so powerful! As a Hypnobirthing Practitioner, I am very aware of this! The power of language and words is key component of what we teach. We can choose to use words that are empowering and validating, or we can revert to words that are shaming and demeaning.
To be labelled a geriatric pregnancy is in my view terrible! It is outdated and an offensive term that is still sometimes used to describe people giving birth at age 35 or older. Why can’t we just look at the woman’s health situation, the baby’s health etc. and manage our care accordingly?!? Mother centred care, that is individualised for her circumstances.
As Pip Wynn Owen states, a fellow Hypnobirthing Practitioner:
“When I dared to have my 4th baby at 38 years of age. I was presented with the risk factors which are mainly congenital abnormality, diabetes, and high blood pressure. When all of these were ruled out, no one mentioned my age again.
But now even if a woman over 35 gets to 38 weeks, has had 3 babies, doesn’t have diabetes, doesn’t have high blood pressure, and her baby is growing well she is still treated as high risk and constantly threatened with induction.”
I acknowledge that we have evidence that indicates that stillbirth risk increases with maternal age along with other risk factors, but it’s also important to understand, however, that age-related concerns rise gradually, not all at once at age 35 (Correa-de-Araujo & Yoon, 2021; Fretts, 2021). This article is a must read if you want to understand the risks of stillbirth in pregnant people over 35 years.
We also have evidence, thanks to the 35/39 trial that evaluates the effectiveness of early induction of labour at 39 weeks in older women – the findings show:
“There were no maternal or infant deaths and no significant between-group differences in the women’s experience of childbirth or in the frequency of adverse maternal or neonatal outcomes”. (Walker et al 2016: 813)
So, what we can gather from this is that while studies show that risks factors increase with maternal age, it doesn’t necessarily mean that early induction will improve outcomes. Read more about this trial here.
I’ll say it again, let’s look at the big picture here and understand if patients over 35 years have additional risk factors for stillbirth aside from age? If so, these factors present or not should guide decision making and empowering language must be used!
Mother and partner should be involved in this decision-making process and have a right to ask for evidence-based information to assist in making informed choices around their care. There are a lot of things to weigh up to determine what path is the right one and caregivers can proposed their recommendations, share their expertise/knowledge and ideally support their patients decisions wholeheartedly.
I have put some links for further reading on this topic. Go nuts.
Should every mother be induced at 39 weeks? The ARRIVE trial
Ten things I wish every woman knew about the induction of labour
The whole 9 months – what happens when babies are born before they are due?