How should we address pregnant patients in clinical practice?
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| Názov: | How should we address pregnant patients in clinical practice? |
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| Autori: | Chervenak FA; Northwell Health, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY; Division of Medical Ethics, Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY., Mcleod-Sordjan R; Division of Medical Ethics, Department of Medicine, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY., Pollet SL; Northwell Health, New Hyde Park, NY., Bachmann G; Department of Obstetrics, Gynecology, and Reproductive Sciences, Robert Wood Johnson Medical School, New Brunswick, NJ., Oyelese Y; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA., Al-Kouatly HB; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA., Warman A; Division of Medical Ethics, Department of Medicine, Lenox Hill Hospital, New York, NY., Sparber LS; Division of Medical Ethics, Department of Medicine, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY., Grünebaum A; Northwell Health, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY; Division of Medical Ethics, Department of Obstetrics and Gynecology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY. Electronic address: AGrunebaum@Northwell.edu. |
| Zdroj: | American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2025 Dec; Vol. 233 (6), pp. 607-614. Date of Electronic Publication: 2025 Aug 05. |
| Spôsob vydávania: | Journal Article; Review |
| Jazyk: | English |
| Informácie o časopise: | Publisher: Elsevier Country of Publication: United States NLM ID: 0370476 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6868 (Electronic) Linking ISSN: 00029378 NLM ISO Abbreviation: Am J Obstet Gynecol Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2005->: New York : Elsevier Original Publication: St. Louis. |
| Výrazy zo slovníka MeSH: | Obstetrics*/ethics , Obstetrics*/legislation & jurisprudence , Terminology as Topic*, Humans ; Female ; Pregnancy ; Physician-Patient Relations |
| Abstrakt: | Language, both spoken and written, plays a critical role in shaping clinical communication, documentation, research integrity, and patient trust. In obstetric care, terminology must align with biological reality, uphold clinical accuracy, respect patient identity, and increasingly, comply with federal policy. As of January 2025, Executive Order 14,168 reframes gender-inclusive language as a threat to women's dignity, safety, and well-being, asserting that "efforts to eradicate the biological reality of sex fundamentally attack women" and it mandates sex-based language, reversing prior encouragement of gender-inclusive terminology. This shift has created ethical, operational, and legal tensions for clinicians, who must reconcile conflicting expectations from federal mandates, professional guidelines, and patient needs. Several institutions have already experienced funding losses due to noncompliance with evolving mandates, underscoring the stakes of aligning clinical language with policy. This manuscript examines the impact of these developments on obstetric language, drawing on legal frameworks, ethical principles, and professional standards. A PubMed analysis through 2024 reveals the continued predominance of "pregnant woman" (60%), increasing use of "pregnant patient" (20%), and a growing presence of inclusive terms (20%). While sex-based terminology facilitates regulatory compliance and clinical clarity, inclusive language may improve trust among gender-diverse populations. We propose a balanced context-sensitive framework, called Balanced Pregnancy Language, which aligns documentation and billing with federally mandated sex-based terms while allowing patient-preferred, inclusive language in clinical interactions and nonstructured documentation. The Balanced Pregnancy Language model preserves scientific clarity, ensures compliance, and supports ethical commitments to respect patient autonomy. Given recent federal shifts affecting documentation standards and data collection practices, the Balanced Pregnancy Language model offers a balanced and ethically grounded solution. It enables clinicians to meet sex-specific regulatory requirements while respectfully affirming patient identity, thereby preserving both institutional integrity and the ethical delivery of care. (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: SAGER guidelines; balanced pregnancy language; clinical communication; federal mandates; gender identity; inclusive language; medical ethics; obstetric terminology; pregnant patient; pregnant woman; sex-based documentation |
| Entry Date(s): | Date Created: 20250804 Date Completed: 20251121 Latest Revision: 20251124 |
| Update Code: | 20251124 |
| DOI: | 10.1016/j.ajog.2025.07.049 |
| PMID: | 40759385 |
| Databáza: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Language, both spoken and written, plays a critical role in shaping clinical communication, documentation, research integrity, and patient trust. In obstetric care, terminology must align with biological reality, uphold clinical accuracy, respect patient identity, and increasingly, comply with federal policy. As of January 2025, Executive Order 14,168 reframes gender-inclusive language as a threat to women's dignity, safety, and well-being, asserting that "efforts to eradicate the biological reality of sex fundamentally attack women" and it mandates sex-based language, reversing prior encouragement of gender-inclusive terminology. This shift has created ethical, operational, and legal tensions for clinicians, who must reconcile conflicting expectations from federal mandates, professional guidelines, and patient needs. Several institutions have already experienced funding losses due to noncompliance with evolving mandates, underscoring the stakes of aligning clinical language with policy. This manuscript examines the impact of these developments on obstetric language, drawing on legal frameworks, ethical principles, and professional standards. A PubMed analysis through 2024 reveals the continued predominance of "pregnant woman" (60%), increasing use of "pregnant patient" (20%), and a growing presence of inclusive terms (20%). While sex-based terminology facilitates regulatory compliance and clinical clarity, inclusive language may improve trust among gender-diverse populations. We propose a balanced context-sensitive framework, called Balanced Pregnancy Language, which aligns documentation and billing with federally mandated sex-based terms while allowing patient-preferred, inclusive language in clinical interactions and nonstructured documentation. The Balanced Pregnancy Language model preserves scientific clarity, ensures compliance, and supports ethical commitments to respect patient autonomy. Given recent federal shifts affecting documentation standards and data collection practices, the Balanced Pregnancy Language model offers a balanced and ethically grounded solution. It enables clinicians to meet sex-specific regulatory requirements while respectfully affirming patient identity, thereby preserving both institutional integrity and the ethical delivery of care.<br /> (Copyright © 2025 Elsevier Inc. All rights reserved.) |
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| ISSN: | 1097-6868 |
| DOI: | 10.1016/j.ajog.2025.07.049 |