JADE Student Edition 2019 JADE JSLUG 2019 | Page 55

use of medical terminology which aids understanding between health care professionals would not be an issue. Disadvantages Poor communication is seen as a major element of negative patient experiences and has led to women feeling less in control of their own birth experience (Vermeir et al., 2015; National Institute for Health and Care Excellence (NICE), 2017). Furthermore, it has been linked to inefficient professional worktime and can even lead to compromises in patient safety (Marsh, 2019). Research has shown that the use of language which the patient does not understand can lead to a more paternalistic method of care where the practitioner makes the decisions for the patient (Sartorius, 2015). Care is done to the patient rather than with the patient. All nurses and midwives must abide by the NMC Code which states that informed and shared decision making is best practice (NMC, 2015). The inappropriate use of medical terminology and acronyms adversely affects the patient experience, creating feelings of helplessness, mistrust and has a negative influence on empowerment and satisfaction (Roter et al., 2009; Hong et al, 2010; Dahm, 2012). Research has found that, in general, women have a lack of understanding of the procedures surrounding birth (De Benedictis et al., 2018). This lack of understanding leads to decisions often being made by the professionals without any consultation with the women, or a consultation which the women do not understand due to the professionals using medical jargon. This also demonstrates a lack of true informed consent. The NMC Code states that midwives and health professionals must gain informed consent before any procedure or investigation (NMC, 2018). A lack of informed consent means the procedure cannot be carried out. Informed consent has also been shown to decrease anxieties and increase patient satisfaction through greater knowledge around their own health and wellbeing (Goldberger et al., 2011). Medical jargon can also be linked to negative language, which when used has an adverse effect on women’s health and wellbeing. In midwifery, words such as ‘failed’, ‘contractions’ or ‘tear’ are commonplace, but these could have a detrimental effect on women’s mental health (Vranceanu et al., 2012). Hypnobirthing is becoming more popular with women nowadays, with the word ‘contractions’ being replaced with the word ‘surges’. These word changes are having a positive effect on women’s pain tolerance throughout the birth process (Graves, 2014). Hypnobirthing is linked to the self-affirmation theory, which supports the use of positive language to further affirm and empower the woman (Steele, 1988). Positive communication throughout pregnancy and birth is seen to lower caesarean section rates, operative vaginal births and the use of epidural anaesthesia (Harris and Ayers, 2012; Reed, Sharman and Inglis, 2017). This in turn creates, in women, more positive memories of the birth process. Although medical terminology can span language barriers, it can be extremely difficult for women and families who have English as a second language or are not fluent in English at all to understand what is being discussed (Binder et al., 2012). Approximately 40% of women from ethnic minorities who use maternity services have reported that the care they have received has been of poor quality, due to their lack of understanding, a reduction in informed consent and discrimination they face (Attanasio and Kozhimannil, 2015). The use of interpreters positively influences women’s care as the language spoken is known to the women. However, interpreters are not always present at every appointment, and can create issues when the practitioner cannot fully assess the woman’s understanding (Meddings and Haith-Cooper, 2008; Stapleton, Murphy and Kildea, 2013; Puthussery et al., 2010). Recommendations of communication Language promotes the positive relationship between patient and caregiver but, used ineffectively or without prior thought, can have adverse effects on the entire pregnancy and birth experience (Mobbs, Williams and Weeks, 2018). Communication can also Article #8 55