A friend of mine is 39 and expecting her third child. It was a planned pregnancy and she and her husband are overjoyed and crossing their fingers for a little boy to join their all-girl family.
But as she and I were texting the other day and I asked how her latest ob/gyn appointment went, she sent an eye-roll emoji and said she was humiliated and embarrassed when her doctor reminded her of some risks since she was considered a geriatric pregnancy.
A few years ago when I was pregnant with my second daughter, I remember being mortified when the nurse referred to me as a geriatric pregnancy. Mind you, I was 40 at the time so I was no spring chicken, but still. I knew full well that I was older than the average mom, but the last thing I needed or wanted to hear was that my pregnancy was labeled geriatric.
Clinical Words Are Graffiti – And They Can Really Pack a Punch
The word geriatric is a kind of “graffiti“, meaning it is something that either distracts or detracts from the ideal patient experience. It can be hard to recognize graffiti when it is part of your profession, which is why it’s so critical to always try to see things through the lens of the patient or the customer.
When care team members talk with and among one another, clinical terms make sense. This is their area of expertise. But some clinical terms and words can (unintentionally) pack a punch. In fact, to the average patient who probably has zero medical training, many terms can be confusing. Think of the elderly woman who is told she can “discharge” tomorrow. Or the teenager who is told he needs a CT scan. Or the pregnant 40-year old who came to your office to make sure her baby is healthy only to be told she was “old.”
My friend and I both know that we’re over 35. And we realize that ‘geriatric’ is the clinically accurate term to use when describing a pregnancy in women over the age of 35. But goodness, can’t they find a better term? Or better yet, is it possible to preface the term geriatric with a bit of an explanation. Something along the lines of: Your exam went well and everything looks good. As you know, there are risks with any pregnancy but particularly when the mother is over the age of 35. I’d like to discuss those risks with you now so together we can minimize them and help you have a safe and healthy pregnancy and delivery.” (Note: this technique is called Caring Out Loud® and it’s a tool that helps reduce anxiety by talking to patients in a language they understand.)
Perhaps no one has really thought about how the word might make a pregnant woman feel. In my case, I remember being nervous and unsure when my husband and I learned we were expecting our second child. I thought about the seven-year age gap between this new child and my older daughter. And I thought about how old I would be at her high school graduation. (Note: my friend thought these same things.) We both knew we were older moms. But the term geriatric made us feel old. As if we were anomalies in the ob/gyn offices sitting alongside the glowing 20-somethings who were cradling their growing bellies with youthful anticipation and joy.
Dear Medical Community: can we please come up with a name that doesn’t make us feel that we’re somehow inadequate or incapable of growing and giving birth to a child compared to our younger counterparts? Pretty please?