Reimagining Postpartum Care: A Call for Greater Inclusivity

Laer Streeter, MD, MPH (they/them), Boston Medical Center

Most—if not all—obstetrician–gynecologists understand how powerful language is when describing the work we do. With our field becoming so political, the way in which words are chosen can make great strides or lead to great setbacks. Even good intentions may lead to exclusion of different groups. During the month of Pride, now more than ever, we must strive for inclusivity.

One of the easiest ways to create a more affirming space for LGBTQIA+ patients and health care professionals is to use more inclusive language. After all, the field of obstetrics and gynecology is not the same as the field of women’s health—and yet many of the conversations about reproductive justice often focus on cisgender, straight women, leaving out other marginalized populations that deserve comprehensive obstetric and gynecologic care. 

At Boston Medical Center, I saw how the power of words changed the physical landscape, and with it a culture shift, to empower the patients we serve. When I started my intern year, I noticed a discrepancy between the titles of the various obstetrical units. Our sick pregnant patients were seen in the triage unit and hospitalized in the antepartum unit when indicated, and our laboring patients were admitted to the labor and delivery unit. However, after delivery, our patients were then transferred to the mother–baby unit. The title was born out of a desire to emphasize the nurturing mother–baby dyad and was created with good intention, but it left out some of our patients. It would behoove me to highlight the exclusionary nature of a unit title that included “mother” when a birthing parent who identifies as transgender may not identify with motherhood. But beyond the transgender community, it excluded other patients as well: the grieving birthing parent who experienced a fetal or neonatal demise, a birthing parent who had been separated from their premature newborn now admitted into the neonatal intensive care unit, or a birthing parent whose newborn had been taken into protective custody by the state. These were patients I saw daily in the mother–baby unit, and yet their experiences did not align with messaging of the ward they were recovering in; in fact, the name of the ward may have been traumatic for some. 

When my and other colleagues’ concerns were brought up to department leadership, a decision was made to change the physical space yet again for the better, for improved inclusivity. Many titles were discussed in the brainstorming process, but at the end of the day, the decision was made to change the name of the unit to one that would suit its purpose: Postpartum. That title allowed for all stakeholders to accept without excluding any one patient population.

It may not seem like a huge change, but sometimes the most subtle actions are the most meaningful. I know if I were to walk through the doors not as a health care professional but instead as a patient, I would be proud to be transferred from the labor and delivery unit to the postpartum unit for my care after birth. 

I encourage people to think about the ways in which they can change the physical space around them to be more inclusive, whether that be the name of a clinic, ward, or even bathrooms. Words have power and being intentional about using more gender-inclusive language can make huge strides for the LGBTQIA+ community and beyond. 

This Pride Month, ACOG wants to hear from members about what the NYC Pride’s theme of Reflect. Empower. Unite. means to them in 2024. Please send your submission and a headshot to [email protected].