Don't exclude mothers from maternity care

It was something of a shock last month to read that the General Medical Council, or GMC – a statutory body – had removed all mention of 'mothers' from a maternity document for its staff, whilst its internal menopausal policy had similarly been stripped of references to women.

I don’t know whether the Council Members of the GMC – the body tasked with regulating doctors and improving medical education and practice – had missed their biology lessons, when they would have learnt that men produce sperm, women produce eggs which, fertilised, grow in their wombs and are then given birth: by women, their mothers. And when child bearing days are over, women go through the menopause.

It is bad enough that women employed by the GMC are being written out of relevant policies, but the implications for medicine and the training and oversight of doctors is far more serious.

Given the GMC’s statutory purpose to protect and promote the health of the public, this should apply to ALL patients, especially women, who give birth and who should not be dismissed in language or respect.

Another GMC duty is to maintain public confidence in the medical profession, but one has to ask how women could trust a doctor who thinks men can get pregnant. Indeed, the idea that men get pregnant, or go through the menopause, is the sort of thing you might expect from a students’ union, not from respected medical professionals.

Given widespread concern about these GMC antics, I submitted various written questions to the Department of Health, which led the Lords Minister, Lord Markham, to respond, rather worryingly, that this guidance was only for GMC employees and not doctors, implying it somehow wasn’t the government’s bailiwick, despite being the employer of the vast majority of doctors registered with the GMC.

Despite that, he did emphasise that the Government was clear that biological sex matters and it was important to use appropriate language that recognises the separate health and biological needs of men and women, and that removing language around biological sex and women had the potential for adverse health consequences. As he wrote “Language used in healthcare settings … should use clear terms that everyone can understand and … we continue to work with NHS bodies to ensure that women are properly represented in communications and guidance”. 

Quite so, but it is hard to correlate this apparent concern with an apparent calm acceptance that the GMC (whose role is set out in the 1983 Medical Act and which is responsible for the standards of doctors practicing in the NHS) can promote a thinking which reduces motherhood to 'people who have babies' and the menopause to 'people with an average age of 51'. If this is the language used in workshops, documents – possibly even interviews or exams, including for overseas doctors – the NHS should surely be asking some serious questions.

We will do so in the Lords. Tomorrow, I will be asking what discussion the government has had with the GMC on its removal of the words “mother” and “women” from its policy for pregnant or menopausal staff, and whether this reflects GMC advice to doctors as to how to treat and describe patients.

As one GMC employee said: “It’s not appropriate for a medical organisation to ignore biology”. However, staff are too scared to call this out. We know enough about whistle blowers being ignored. Now we see a climate of fear within major national bodies such as this.

There is growing evidence that sex-based language is crucial in maternity healthcare, especially for women with English as a second language. 1,400 clinicians wrote to the NHS demanding that the word 'mother' be reinstated in women’s health advice – unbelievable that such a letter was needed. In trying to make a maternity policy gender neutral, the GMC risks sending a hostile even insulting message to women in medicine and, crucially, to their patients for whom the identity of “mother” is often very important.

We will see on Tuesday whether the government is sufficiently concerned about the treatment of mothers in the NHS to have some robust discussions with the doctors’ regulator.