Birth Preferences in English | Maternity Conversation

0:00 A patient hands you her birth clan. You can't promise any of it. What do you say? By the end of this episode, you'll have the language for pain relief and skin to skin, and for reopening the plan if the day changes, without promising what you can't.

0:15 Listen to Midwife Santos with a worried first-time mum.

0:19 I've written it all down, but what if none of it goes the way I want?

0:24 That's exactly why we go through it now, so you know what your options are, whatever happens on the day.

0:30 That what if moment is exactly what we're working on today. I'm Nadia.

0:35 And I'm Tom. This is Medical Voices, the language of medicine, not medical advice.

0:41 We'll start with the vocabulary, then listen to the full conversation.

0:46 Before we step into the session, let's get the words in place. Ten terms, each with an example you can borrow. Term 1. Labor. The process of giving birth from the start of regular contractions until the baby is delivered. American English spells it without the U, but it sounds the same. Example, call the maternity unit if you think you're in labor.

1:16 Term 2. Pain relief and analgesia. Both mean ways of reducing pain, but pain relief is what you say to the patient, and analgesia is what you'll usually see written in the notes. Example. Have you thought about what pain relief you might like?

1:35 Term 3. Epidural. A type of regional anesthetic given in the lower back that numbs pain below the waist during labor. In a birth plan conversation, the midwife names it and leaves the details to the anaesthetist. Example. If you'd like an epidural, the anaesthetist will talk you through it.

1:59 Term 4. Gas and air and entinox. A mix of nitrous oxide and oxygen that you breathe in through a mouthpiece during contractions. British patients say gas and air, and entinox is the name you'll see on the equipment and in the notes. Example. Gas and air is there whenever you want it.

2:22 Term 5. Water birth. Labouring and sometimes giving birth in a pool of warm water. It's something a maternity unit can offer, not something a midwife prescribes. Example.

2:43 Term 6. Contractions. The regular tightening and relaxing of the womb that moves labor forward. Listen for the collocations. Regular contractions. Strong contractions. Contractions every few minutes. Example. Are your contractions coming regularly yet?

3:06 Term seven. Cervical dilatation. How far the cervix, the neck of the womb, has opened during labour, measured in centimeters. British clinicians usually say dilatation with the extra syllable, while American clinicians say dilation. Example. We'll check your cervical dilatation to see how far along things are.

3:33 Term 8. Skin to skin. Placing the newborn directly on the mother's bare chest straight after the birth. Patients and clinicians use the same phrase, and it's asked about as a preference, never assumed. Example. Would you like skin to skin as soon as the baby's born?

3:56 Term 9. Breastfeeding intention. What a patient plans to do about feeding once the baby arrives. The word intention rather than decision deliberately leaves room for a change of mind. Example. Can I note down your breastfeeding intention for now?

4:19 Term 10. Postnatal ward. The hospital ward where mother and baby stay after the birth to be checked and supported. You learned antenatal back in episode 16, and postnatal is the other half of that pair. In the US, you'll usually hear postpartum. Example. After the birth, you'll go up to the postnatal ward.

4:47 10 words ready to use. Let's hear them in a real conversation.

4:52 If OET speaking is on your horizon, listen for how often the midwife offers rather than tells. We're in the antenatal room of a hospital maternity unit. I'll be Midwife Santos, who some of you met in episode 16, and Nadia is Mrs. Harris, 34 weeks pregnant with her first baby. Mrs. Harris, come on in.

5:16 Lovely to see you again.

5:19 You too! I didn't expect to see you here. I thought you only worked at the community clinic.

5:25 I split my week between the clinic and the unit, so you're stuck with me. How have you been?

5:31 Honestly, pretty good. Everything's been straightforward. The scans have all been fine, and the baby's kicking all the time, especially at night.

5:40 Good. Plenty of movement is exactly what we like. And I see you've brought some notes for your birth plan.

5:48 I have. Two pages, actually. I may have got a bit carried away.

5:53 Not at all. May I? This is really thorough. Before we go through it, can I say one thing about what a birth plan is and what it isn't? Go on. A birth plan is a starting point, not a contract. I can't promise everything will go exactly the way it's written because birth doesn't always cooperate. But I can promise we'll talk to you first if anything needs to change.

6:24 That's fair. I just want to know I'll be asked, not just told afterwards.

6:29 You will be. If we need to change this on the day, we talk first.

6:35 Okay, that actually makes me feel better already.

6:39 So, pain relief. Would you like me to go through the options, or have you already thought this through?

6:45 I've read the leaflets. What I'd really like is to try the pool. My sister had a water berth, and she loved it.

6:52 That's your preference, and we'll do everything we can to support it. Some women find the warm water really helps with the contractions. I can't promise the pool will be free when you're in labour because it depends who else needs it that day. But it's absolutely a preference, and we'll note it.

7:11 And if it isn't free?

7:13 Then we'd adapt as we go. Gas and air is there whenever you ask for it. On your notes, it'll say entinox, but it's the same thing. And if you decide you'd like an epidural, a specialist anethetist would come and talk you through it on the day.

7:30 Do I have to decide about the epidural now?

7:34 No. You might find you don't want it at all, or you might ask for it. Both are completely fine. So, under analgesia, which is just our notes word for pain relief, I'm writing pool if available, gas and air, epidural kept as an option.

7:53 Can I ask something a bit silly? How will I know it's the real thing? Everyone says you'll just know, which isn't very helpful.

8:02 It's not silly at all. Labour usually starts with contractions that become regular, stronger, and closer together, and they don't ease off when you rest or change position. Call us when they're coming regularly, if your waters break, or if you're simply not sure.

8:19 And when I get here?

8:22 A midwife will check you and the baby and see how far along things are, your cervical dilatation. Then we'll keep you in the loop at every step. Can we talk about the first few minutes after the birth? Would you like the baby placed straight on your chest, skin to skin?

8:42 Yes, definitely. That's one thing I'm sure about.

8:46 Lovely, I'll write that down. And have you thought about how you'd like to feed?

8:51 I'd like to try breastfeeding, but honestly, I don't know if I'll manage, and I'm a bit scared of feeling like I've failed.

8:58 Then I'll put breastfeeding intention. Would like to try. It says intention, not decision, for a reason. Whatever you decide now, you can change your mind once the baby's here, and you'll have support whichever way you go. Med nomads. A question for the midwives and nurses watching. How do you ask about feeding plans without sounding as if you've already decided for the patient?

9:27 It's a tricky register in any language. Share your go-to phrasing in the comments.

9:34 Can I be honest? I've written it all down, but what if none of it goes the way I want?

9:39 That's exactly why we go through it now, so you know what your options are, whatever happens on the day.

9:46 I know, but I keep picturing something going wrong, everyone rushing around, and me lying there with no idea what's happening.

9:53 Then let me say it again, because it matters. I can't promise everything will go exactly the way it's written, because birth doesn't always cooperate. But I can promise this. If we need to change this on the day, we talk first. You're not told afterwards what happened, you're part of the decision, even when it has to happen quickly.

10:18 And if there isn't time to talk?

10:20 Then I'll tell you what I'm doing and why as I'm doing it. But that's rare, and it's not the plan. What kind of changes do you actually mean though? It could be something small, like asking you to get out of the pool so we can listen to the baby more closely. Sometimes labor needs a bit of help to get going, or to keep going.

10:43 And occasionally, the safest way to deliver the baby turns out to be a cesarean. Whatever comes up, you'll hear why, you'll hear what the choices are, and you'll have a say.

10:56 So if things change, the plan's just wasted.

11:00 Not at all. If things change, the plan tells whoever's looking after you what matters most to you. Even in theatre, if you and the baby are both well, skin to skin can often still happen. The plan bends, it doesn't disappear.

11:16 The plan bends, it doesn't disappear. I like that. I might write it at the top.

11:22 Please do.

11:24 And afterwards? Where do we go?

11:26 After the birth, you and the baby move to the postnatal ward. How long you stay depends on how the birth goes. Anything from several hours to a few days. Midwives will check on you both and help with feeding.

11:42 Will my partner be allowed to stay?

11:45 Here, one birth partner can usually stay with you, and other visitors come during set hours. Policies do change though, so it's worth double checking nearer the time. Right, I'll add all of this to your notes. Bring your plan and your maternity notes with you when you come in, and whoever's with you on the day will have read it.

12:09 And in the meantime, if the baby's moving less than usual, if you have any bleeding, or if your waters break, don't wait for your next appointment. Call the Maternity Triage Line straight away.

12:24 I will. Thank you. I feel much better about it now.

12:28 Good. Then I'll see you again at 36 weeks.

12:33 Now let's take three key exchanges again, a little more slowly this time.

12:39 A birth plan is a starting point, not a contract. I can't promise everything will go exactly the way it's written, because birth doesn't always cooperate. But I can promise we'll talk to you first if anything needs to change.

12:57 That's fair. I just want to know I'll be asked, not just told afterwards.

13:04 You will be. If we need to change this on the day, we talk first. Then let me say it again, because it matters. I can't promise everything will go exactly the way it's written, because birth doesn't always cooperate. But I can promise this. If we need to change this on the day, we talk first. You're not told afterwards what happened.

13:34 You're part of the decision, even when it has to happen quickly.

13:38 And if there isn't time to talk?

13:41 Then I'll tell you what I'm doing and why as I'm doing it. But that's rare, and it's not the plan. Can we talk about the first few minutes after the birth? Would you like the baby placed straight on your chest, skin to skin?

14:00 Yes, definitely. That's one thing I'm sure about.

14:04 Lovely, I'll write that down. And have you thought about how you'd like to feed?

14:10 I'd like to try breastfeeding, but honestly, I don't know if I'll manage, and I'm a bit scared of feeling like I've failed.

14:18 Then I'll put breastfeeding intention. Would like to try. It says intention, not decision, for a reason. Whatever you decide now, you can change your mind once the baby's here, and you'll have support whichever way you go. So what made that conversation work? Five moves, starting with the one we promised you.

15:35 Point one, holding a preference without turning it into a guarantee. When Mrs. Harris said she'd like the pool, the midwife didn't say fine, and he didn't say, we'll see. He said, That's your preference, and we'll do everything we can to support it. He commits to effort, not to an outcome. Around it, listen to the sofness.

16:00 Some women find, you might find, we'd adapt as we go. They describe a possibility without promising it. In OET speaking, this is part of what assessors listen for under information giving.

16:17 Point 2. Offering options, not a recommendation. Look at how the midwife opened the topic. Would you like me to go through the options, or have you already thought this through? The patient decides how much explanation she needs, and since she'd read the leaflets, he didn't repeat them. Then each option got neutral language.

16:36 Gas and air is there whenever you ask for it, and an anaesthetist would come and talk you through the epidural. No ranking, no warnings. And when she asked about deciding now, both answers got equal weight. Both are completely fine.

16:54 Point 3. Asking, then accepting the answer. The midwife didn't announce, we'll put the baby on your chest. He asked, would you like the baby placed straight on your chest? Not every patient wants that, for personal or cultural reasons. The feeding question was even more open. Have you thought about how you'd like to feed?

17:19 No hint of a right answer. And when Mrs. Harris sounded unsure, he didn't persuade. He wrote down her own words, would like to try, and reminded her she could change her mind. Ask, accept, record, and only then move on.

17:41 Reopening the plan. Twice the midwife used the same three-part pattern. I can't promise something because of a real reason, but I can promise something else. I can't promise everything will go exactly the way it's written. Because birth doesn't always cooperate. But I can promise this. If we need to change this on the day, we talk first.

18:05 It's honest about the limit and still gives the patient something solid to hold. Notice on the day, too. In British English, it means on the actual day of the event, here, the birth, not one day in the future. And you met antenatal in episode 16. Today you heard its partner, postnatal.

18:30 Point 5. A quick look across the English-speaking world. Gas and air is standard in the UK, Australia, and New Zealand, but much less common in the United States, where you'd usually hear it called nitrous oxide. In the UK, many women can choose a hospital, a birth centre, or a home birth. In the US, options often depend on insurance.

18:58 And two small ones. A British patient says, My waters have broken. An American says, My water broke. And the British theatre, as in operating theatre, is the OR in North America.

19:16 Let's see what's stuck. Three questions, and try to answer out loud before Tum does. Question one. A midwife says, we can offer you gas and air. What is gas and air? And what's its clinical name?

19:36 It's a mix of nitrous oxide and oxygen that you breathe through a mouthpiece during contractions. On the equipment and in the notes, it's called entinox.

19:47 Question two. What's the difference between pain relief and analgesia?

19:57 In meaning, nothing at all. Pain relief is what you say to the patient, and analgesia is what goes in the notes.

20:07 Question three. You learned antenatal in episode 16. What's the matching word for the time after the birth?

20:20 Postnatal, as in the postnatal ward, where mother and baby stay after delivery. In the US, you'll more often hear postpartum.

20:31 How did you do? All ten terms and the whole conversation are in the free PDF transcript linked in the description.

20:40 And that's episode 24. Mrs. Harris leaves with a plan that can bend without breaking. Next week, something completely different a practice nurse, a patient who smokes, and a short, focused conversation built around the five A's. See you then, Med Nomads. See you next week.