Positioning statements
Here are a few of our favorite policy or positioning statements affirming that inclusive communication is the steppingstone towards best practice. And that is our obligation to move beyond gendered language and our implicit bias to stop continuing to exert harm, creating and perpetuating inequities which cause rising rates of morbidity and mortality in all vulnerable populations. According to the American Medical Association, this is just meeting the standard of practice.
The American College of Obstetricians and Gynecologists (ACOG)
"Valuing, respecting, and affirming an individual’s identity
contribute to improved health outcomes, and the language used to communicate
with individuals about themselves and their communities plays a critical role
in affirming identity.
The American College of Obstetricians and Gynecologists opposes discrimination on the basis of gender identity, urges public and private health insurance plans to cover necessary services for individuals with gender dysphoria, and advocates for inclusive, thoughtful, and affirming care for transgender individuals.
As the leading medical organization dedicated to the health of all individuals in need of gynecologic and obstetric care, the American College of Obstetricians and Gynecologists (ACOG) acknowledges the effect language has on individuals and populations. To be inclusive of women and all patients in need of obstetric and gynecologic care, ACOG will move beyond the exclusive use of gendered language and definitions. This change includes integrating language that reflects the broad spectrum of gender identities into ACOG guidance, resources, and communications in order to improve the quality of care for all patients, including those who identify as women and those who do not."
The Academy of Breastfeeding Medicine (ABM) and WHO and UN
"Implicit biases affect the language we use, and thereby contribute to gender inequality and health inequities, which contribute, in turn, to rising morbidity and mortality of vulnerable populations.
The ABM is acting in accordance with the United Nations (UN) and World Health Organization (WHO) 2030 Sustainable Development Goals and the specific UN and WHO call for ‘‘ending violence and discrimination against lesbian, gay, bisexual, transgender, and intersex people,’’ and the ABM affirms ‘‘the highest attainable standard of health as a fundamental right of every human being’… The ABM Affirms That Language Should Be as Inclusive as Possible When Discussing Infant Feeding… ABM recognizes that not all people who give birth and lactate identify as female, and that some of these individuals identify as neither female nor male… With individual families, it is important to ask about and use the pronouns and words with which they identify."
The American Academy of Pediatrics (AAP)
"The American Academic
of Pediatrics urges pediatricians to maintain a welcoming, safe, and secure
environment for all patients, especially SGM (Sexual and Gender Minority)
patients,
which includes but is not limited to individuals who identify as lesbian, gay, bisexual, asexual, transgender, Two-Spirit, queer, and/or intersex.8 Documentation of SOGI information has been explicitly targeted as primary demographic information for EHRs within Meaningful Use Guidelines, encouraged by the Institute of Medicine, and added to the United States Core Data for Interoperability demographic recommendations. Major EHR vendors have solutions for SOGI data capture, yet the literature on pediatric practice implementation is lacking compared with adult provider counterparts…
Without comprehensive intentional changes, pediatric patient-provider relationships potentially extend a nonaffirming, noninclusive environment impacting patient wellbeing and interactions with health care professionals. SGM youth may slip through the system unrecognized, identifying them as an “invisible minority.” Safe, authentic expression of one’s gender identity has been theorized to contribute to maintaining a sense of true self. Not acknowledging minority status, however, exacerbates known health disparities faced by SGM patients, a concept identified as “corrosive disadvantage,” in which poor outcomes secondary to one identity are made worse because of a different minority identity. Failure to address SGM status in a patient with low socioeconomic status, for example, would exacerbate the known poorer health outcomes of patients with low socioeconomic status. Because intersectional identities form an individual’s lived experience of the world, one way to mitigate the minority stress of SGM patients is to openly address SOGI."
The Association of American Medical College and the American Medical Association
"Yet the evidence—the
science— shows that even despite great intentions, some decisions made at the
practice and institution level, and by individuals themselves, are not meeting
our intended desired impact to ensure the full potential for optimal health for
our patients. Most alarmingly, there are signs some of our systems continue to
exert harm, creating and perpetuating inequities.
By health inequities, we mean gaps that are “unjust, avoidable, unnecessary and unfair.” They are neither natural nor inevitable. Rather, they are produced and sustained by deeply entrenched social systems that intentionally and unintentionally prevent people from reaching their full potential. Inequities cannot be understood or adequately addressed if we focus only on individuals, their behavior or their biology. We have the opportunity— and the obligation—to do better, and to achieve more equitable outcomes. We believe that a critical component of that effort involves a deep analysis of the language, narrative and concepts that we use in our work. We share this document with humility. We recognize that language evolves, and we are mindful that context always matters. This guide is not and cannot be a check list of correct answers. Instead, we hope that this guide will stimulate critical thinking about language, narrative and concepts—helping readers to identify harmful phrasing in their own work and providing alternatives that move us toward racial justice and health equity."
National Insitute of Health (NIH) Style Guidelines
"Using more limited
and specific language is sometimes important. For instance, if discussing a
study that only involves pregnant cisgender women, gender-specific language
(pregnant women) would be most accurate to reference that study’s findings.
• Use all genders instead of both genders, opposite sex, or either sex. If referring only to sex, use female, male, or intersex.
• The term chestfeeding or bodyfeeding can be used alongside breastfeeding to be more inclusive. Nonbinary or trans people may not align with the term breastfeeding because of their gender or may have a dysphoric relationship to their anatomy.
• Avoid unnecessarily gendered language. There are ways to be gender-neutral and inclusive. You could use everyone or all instead of men and women and distinguished guests or folks instead of ladies and gentlemen.
• Avoid language that assumes the mother is the primary parent or caregiver. Use parenting instead of mothering unless referring specifically to a mother-child relationship. You can also use caregivers and caregiving to be inclusive of non-parents in caregiving roles.
• Many practices recommended in pregnancy to women/pregnant people can also be directed to fathers/non-pregnant partners. Too often, the burden of prenatal care and establishing healthy habits are directed only at the pregnant person, when a partner can also play an important role.
• Gender neutral terms like pregnant patients, pregnant people, birth parent, or other wording as applicable (e.g., pregnant teens), present an inclusive alternatives. Use judgement and context to determine whether to use pregnant women, pregnant people, pregnant patients, or other inclusive descriptors. Specific phrasing like people with uteruses can be helpful when writing NOFOs or advertising studies to ensure only eligible participants are enrolled for the specific research conducted.
• Using more limited and specific language is sometimes important. For instance, if discussing a study that only involves pregnant cisgender women, gender-specific language (pregnant women) would be most accurate to reference that study’s findings. If the word women is preferable, but transgender and nonbinary people are also referenced, phrasing like women and other pregnant patients can provide an inclusive alternative."
Links
Style Guidelines
Style Guidelines
The Centers for Disease Control and Prevention (CDC)
"CDC’s Health Equity Guiding Principles for Inclusive Communication are intended to help public health professionals ensure their communication work, including communication of public health science, meets the specific needs and priorities of the populations they serve and addresses all people inclusively, accurately, and respectfully.
These principles are designed to adapt and change as both language and cultural norms change.
Why do words matter for health equity?
Why do words matter for health equity?
Language in communication products should reflect and speak to the needs of people in the audience of focus, using non-stigmatizing language. This means:
• Using a health equity lens when framing information about health disparities
• Using person-first language and avoiding unintentional blaming
• Using terms for select population groups while recognizing that there isn’t always agreement on these terms
• Considering how communications are developed and looking for ways to develop more inclusive health
These are just a few examples—organizations like the AAFP, ACOP, AWHONN, NHMA, NMA, ROSE, and USBC, among others, all have their own valuable resources. We encourage you to review the policy and positioning statements from the organization that guides your practice for the most relevant and comprehensive insights.
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Inclusive Communication Surrounding Childbirth, Lactation, and Infant Feeding
The AAP, much like Evergreen Perinatal Education, recognizes that these concepts may be new to many of you. Even recent graduates may not have received adequate classroom education on these topics, despite strong support from best practices and policies. To bridge this gap, the AAP has collaborated with numerous partners to create this PowerPoint presentation, designed to initiate internal discussions about the inherent "woman-ness" of perinatal health and its potential negative impact on our patients.
We want to emphasize that this guide is just the starting point for an important conversation. It is not, and cannot be, a checklist of correct answers. Instead, we aim to stimulate critical thinking about language, narratives, and concepts—helping healthcare providers recognize harmful phrasing in their own work and offering alternatives that move us closer to health equity.
The Project Advisory Committee, which developed this PowerPoint, adheres to organizational policies that demand a more comprehensive approach to using degendered language, implementing inclusive hospital practices, and establishing more equitable standards of patient care. This guide is designed to inspire thoughtful reflection and action toward these goals.
EPE's DEI Resources
Here at Evergreen Perinatal Education, we pride ourselves on research. We then use that research to inform all our practices and documents. After many open dialogues with our national and international partners, clients and reading over course surveys, it became apparent that there is not a place where people can confidently receive the education they feel like they need on health equity.
To help you familiarize yourself with new terminology and concepts, we’ve created this glossary and terminology update chart. The chart lists outdated language alongside the updated, more accurate terms you should use. We will continue to revise this list as we gain new insights and receive feedback from users.
GLOSSARY
TERMINOLOGY UPDATES
PRONOUN GUIDE
To support your learning of these new terms, we’ve also provided free digital flashcards. These resources are designed to make the transition to inclusive language smoother and more effective.
Inclusive Practice in Perinatal Care Support
Finally, explore our guide to learn how to use inclusive language and design intake forms that respect diverse identities. Language shapes interactions, and this guide offers practical tips to ensure your perinatal care practices are welcoming and respectful.
Co-lactating Parent Feeding Plan
Prenatal Risk Assessment List
LATCH Score
Support Group Databases
We are creating a list of lactation support groups specifically for families of color. These groups play a crucial role in providing culturally sensitive support, fostering community connections, and addressing the unique challenges faced by different queer folx in their lactation journeys.
By highlighting these valuable resources, we aim to empower families and improve overall health outcomes. We invite you to submit information about any lactation support groups that focus on serving families of color, so we can ensure they are included in this important resource.
Any group’s information that is submitted to us will not be shared until we have received permission from their contact information provided.
Transform Your Hospital’s Policies with Inclusive Practices
We can help elevate your hospital's care by incorporating inclusive practices into your policies and daily operations. Our consulting services specialize in helping healthcare institutions create welcoming environments for all patients. We offer tailored solutions to integrate inclusive language, address diverse needs, and enhance patient experiences. Partner with us to ensure your hospital provides compassionate, respectful care that honors every individual’s identity. Contact us today to get started!
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Education Initiatives
All Evergreen Perinatal Education LLC courses follow the IBCLC Detailed Content Outline. And Evergreen Perinatal Education has been accepted by International Board of Lactation Consultant Examiners® (IBLCE®) as a CERP provider for the listed Continuing Education Recognition Points (CERPs) programme. Determination of CERPs eligibility or CERPs Provider status does not imply IBLCE®’s endorsement or assessment of education quality.
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