Belinda Alievska warns of the unintended consequences of changing pregnancy loss terminology, highlighting the potential for such shifts to influence reproductive justice debates and intensify emotional burdens.

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In a climate where courts, like in the case of LePage v. Center for Reproductive Medicine, are ruling on whether the term “child” includes frozen embryos and fetuses – both inside and outside the uterus – the importance of language in reproductive discourse becomes apparent. This legal backdrop mirrors recent discussions surrounding the terminology of describing pregnancy loss, demonstrating that the language surrounding female reproduction is not just a matter of semantics; it is deeply intertwined with societal attitudes toward pregnancy, the rights of women, and the discourse on abortion. Jessalyn Bohn’s seminal 2023 article, “When Words Fail: ‘Miscarriage,’ Referential Ambiguity, and Psychological Harm,” makes a compelling case for rethinking the language surrounding miscarriage. Bohn advocates for replacing the term “miscarriage” with the terms “intrauterine death” and “preterm delivery”. These alternatives, she argues, more accurately describe the two distinct events that occur during a miscarriage – the death of the fetus and its early delivery – and avoid placing undue blame on the mother for the unviability and subsequent loss of the pregnancy.

Bohn additionally argues that adopting these terms to discuss the experience of miscarriage acknowledges the significant impact on all parents involved, offering them more precise language to express their grief and experiences. However, while Bohn’s proposal aims to bring both clarity and sensitivity to an often-painful subject, it’s necessary to consider the broader implications of such linguistic changes. Specifically, the term “intrauterine death” demands careful consideration for its potential to influence debates surrounding pregnancy amidst a highly charged political atmosphere.

Photo Credit: goodfon.com. Image Description: A photo of the fertilization process with an egg and sperm.

Language shapes our understanding of the world. The terms used to describe miscarriage and pregnancy loss often carry not only medical implications but also social, emotional, and psychological connotations. For example, the etymological definition of the term “miscarriage” implies a “mistake” or an “error”.  Bohn highlights how this term and other terms that are currently used in its place – such as spontaneous abortion – can inadvertently assign blame or imply guilt on the part of gestating parents.

In suggesting the use of “intrauterine death” and “preterm delivery” in place of terms like miscarriage and spontaneous abortion, Bohn has two goals: first, she is attempting to describe the medical event of miscarriage more accurately. Second, she is attempting to remove referential ambiguity to eradicate the misplaced guilt and disenfranchised grief created by the current language of pregnancy loss.

However, Bohn’s proposed change in terminology has implications beyond the realm of individual grief; it can fundamentally alter the public and political discourse surrounding abortion.

Current clinical practice avoids using terms of personhood and instead directly addresses the pregnancy itself, using phrases like “termination of pregnancy” or “pregnancy loss”. This approach in medical language aims to maintain neutrality by focusing on the medical aspects of pregnancy, avoiding the morally and emotionally charged territories of “life” and “death”. Adopting terminology that emphasizes the loss of life, such as “intrauterine death,” could shift the perception of abortion from a medical procedure to an act with more profound moral and emotional weight.

The term “death” is often reserved for the loss of life. We use the term death to speak of humans, pets and other animals, and other living entities (such as plants). Outside of these categories, the term death is not frequently used – and if it is, it does not carry the same emotional weight as when it is used to describe the loss of life (e.g. speaking about the “death” of a star in outer space).

When the term “death” is used in the context of pregnancy and pregnancy loss, there exists the risk of this shift in language potentially being used to strengthen the arguments of those who oppose abortion, providing them with the linguistic tools that frame the debate in terms of life and death from the earliest stages of pregnancy.

Bohn’s work on the ambiguity of miscarriage has already been endorsed by pro-life groups who have taken to social media platforms to share passages from her work to support their pro-life discourse.

Despite Bohn’s explicit effort to shift guilt and blame away from mothers through endorsing a revised linguistic framework, her work is being recognized by groups that openly proclaim “you don’t have to be religious to have a problem with killing humans” on the front page of their websites.

Attempting to mitigate the guilt and blame of gestating parents through revised terminology, can in this case, contribute to new forms of blame and lead to increased stigmatization of abortion, making it more difficult for individuals to seek reproductive care and services or discuss their experiences openly due to the heightened emotional and moral scrutiny. It is therefore crucial to be mindful of the implications of linguistic change, as they might have dire consequences for an already fraught issue, necessitating a careful and considered approach to language changes in the context of reproductive health.

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Belinda Alievska is a PhD Student and Research Assistant at the University of Waterloo, Department of Philosophy.