Pregnant Women or Pregnant Patients, Not Pregnant People: Why Words Matter in Medicine
When language gets political, patient care suffers
Language in medicine is never neutral. The words we choose shape not only how we communicate with patients but also how we record data, conduct research, and advocate for public health. In obstetrics, terminology around pregnancy has become increasingly contested. Should we say “pregnant women,” “pregnant patients,” or “pregnant people”?
As an obstetrician, I argue that words matter deeply. Accuracy, ethics, and respect are all at stake. While inclusivity is a legitimate value, replacing biologically and clinically precise terminology with vague or ideologically driven alternatives risks undermining patient care, professional responsibility, and scientific clarity.
Why This Debate Has Emerged
For centuries, the medical literature has used the term “pregnant woman”—from Hippocrates through to modern public health frameworks. The phrase connects pregnancy to female biological sex, ensuring clarity in communication about anatomy, physiology, and risk.
Later, the term “pregnant patient” emerged in the mid-20th century. It reframed pregnancy within the physician-patient relationship, emphasizing duty of care and professional responsibility. Today, “pregnant patient” appears widely in leading journals and in guidelines, and its usage has steadily increased.
More recently, some organizations began advocating for terms like “pregnant person” or “birthing individual.” These emerged partly to acknowledge the very small percentage of pregnancies (about 0.07% in one U.S. cohort study) that occur in transgender men and nonbinary individuals. For advocates, such terminology signals inclusivity and recognition of gender diversity.
But medicine must not only be inclusive. It must also be precise, evidence-based, and ethically responsible.
What’s at Stake: More Than Semantics
The choice of terms has real-world consequences.
Clinical clarity. Pregnancy is a sex-specific biological state. Using “pregnant woman” maintains a direct link between biology and care. If clinical documentation eliminates sex-based distinctions, clinicians may miss sex-specific diagnoses (e.g., ectopic pregnancy in a transgender man documented only as “person with abdominal pain”).
Research integrity. Medical research depends on precise terminology. Using generic terms like “pregnant person” in scientific publications risks obscuring sex-based data, undermining study validity and reproducibility.
Patient trust and dignity. Many patients strongly identify with being called “pregnant women” or “pregnant mothers.” Exclusively gender-neutral language risks alienating the majority while aiming to include a small minority. Surveys and international practice show that culturally embedded sex-based terms remain dominant across languages and health systems.
Policy and funding. As of 2025, U.S. federal policy has shifted. Executive Order 14168 mandates sex-based terminology in federally funded documentation and research, reversing prior federal encouragement of gender-inclusive language. Institutions that fail to comply risk losing Medicare, Medicaid, and NIH funding.
Yet Executive Order 14168, while framed as a defense of women’s dignity, is also problematic. By rigidly mandating sex-based terminology, it removes physician judgment, patient preference, and clinical nuance from the conversation. Medicine should resist both extremes: the exclusive use of generic terms like “pregnant people,” which obscures biological reality, and the legally enforced use of “pregnant woman,” which disregards the identities of some patients and risks eroding trust. Ethical communication in obstetrics requires balance—precision in science and documentation, but flexibility and respect in human interaction. Mandating language by political decree undermines professional integrity and risks politicizing clinical care even further.
A Balanced Approach: The “Pregnant Woman” and “Pregnant Patient”
The most responsible approach is to use “pregnant woman” and “pregnant patient” as primary terms. Each serves a complementary purpose:
“Pregnant woman” grounds care in biological sex, essential for accurate diagnosis, research, and advocacy in maternal health.
“Pregnant patient” emphasizes the physician’s professional obligation, framing the pregnant individual within the therapeutic relationship.
Both terms respect the biological reality of pregnancy while upholding professionalism. Together, they offer a framework that is medically accurate, ethically grounded, and socially respectful.
Respecting Identity Without Sacrificing Science
What about the small group of transgender men or nonbinary individuals who become pregnant? Here, physicians must practice cultural humility—listening carefully, asking how patients wish to be addressed in conversation, and accommodating respectful preferences in clinical interactions.
But in documentation, research, and policy, sex-specific terms must remain. A practical solution is the Balanced Pregnancy Language framework recently described by Chervenak, McLeod-Sordjan, Pollet, Bachman, Oyelese, Al-Kouatly, Warman, Sparber, and Grunebaum. It proposes:
Use of sex-based terminology (“pregnant woman” / “pregnant patient”) in structured documentation and research.
Patient-preferred terminology in direct clinical interactions and narrative notes.
This dual approach ensures compliance, scientific clarity, and patient dignity.
Ethical Dimensions
Obstetric ethics has long emphasized professional responsibility. Frank Chervenak, Lawrence McCullough, and Amos Grunebaum have argued that physicians have both beneficence-based obligations to the fetus and autonomy-respecting obligations to the pregnant woman. That framework requires language that preserves clarity about who is being cared for, and what responsibilities the physician holds.
Ethically, conflating sex and gender by using only generic terms like “pregnant person” introduces confusion and risks harm. By contrast, using biologically accurate terms while also acknowledging patient identity during interactions respects both truth-telling and autonomy.
Why Words Matter for Advocacy
The term “pregnant woman” has also been historically essential for women’s rights advocacy. Diluting that terminology risks weakening public health messaging and feminist advocacy for maternal rights. Global campaigns on maternal mortality, maternal nutrition, and violence against women rely on woman-specific language. Removing it may inadvertently obscure the sex-based inequalities women continue to face in reproductive health.
At the same time, “pregnant patient” serves advocacy by emphasizing that pregnancy is not only a private experience but also a state of health requiring professional responsibility, standards, and systemic support.
The Bottom Line
Medicine must walk a careful line between inclusivity and precision.
Pregnant women: a term essential for biological accuracy, maternal advocacy, and clear communication.
Pregnant patients: a term emphasizing professionalism, responsibility, and patient-centered care.
Pregnant people: a vague alternative that risks confusion, undermines research, and alienates many patients while serving very few.
As an ObGyn professor, I believe we must resist pressure to abandon biologically and clinically grounded language. Our ethical and professional duty is to provide care that is scientifically rigorous, respectful of patient identity, and aligned with the realities of pregnancy.
Words matter. And in obstetrics, the right words protect not only clarity and integrity but also the women and patients whose lives depend on us.
#ObGynEthics ; #PregnancyCare ; #InformedConsent ; #MaternalAutonomy ; #PregnantWomen ; #MedicalLanguage ; #HealthcareEthics ; #CulturalHumility ; #USHealthcare ; #Obstetrics