Researchers integrated information from 45 protein, metabolite, and immune data points to identify a window two to four weeks before a pregnant person will go into labor. — Abby Olena, “Blood Biomarkers Predict the Onset of Labor: Study” The Scientist, May 8

Words matter, especially when they are used as labels to describe, characterise or classify a group of people. A change in the words used for these purposes merits asking what caused that change, who advocated for it, and why was it made.

We are currently seeing a change from speaking of “pregnant women” to speaking of “pregnant persons”. What might this change signify? Is there any problem with speaking of “pregnant persons“, rather than “pregnant women” or should we welcome this development?

Who or what is a person matters because personhood carries rights and protections. Therefore, might the change be intended to benefit pregnant women? On the other hand, might it be contemplating unprecedented possibilities opened up by new reproductive technologies and affirming, or perhaps even promoting, what the American law professor John Robertson called the individual person’s “absolute right to reproductive freedom”?  

Male pregnancies?

For example, is the word “person” meant to accommodate the possibility of biological men having babies? Women who have received uterine transplants have recently successfully gestated and given birth to a baby. There is already talk of providing men with such transplants — making it possible for them, too, to gestate and give birth to a baby, presumably by Caesarean section, even though “male pregnancy” could pose quite serious risks for the child.

The advocacy of replacing the term “breastfeeding” by “chestfeeding” is consistent with this possibility and shows yet again that a change in wording is not just a change of description, but of substance. “Chestfeeding” refers to biological men who take female hormones in order to trigger lactation to enable them to “chestfeed” their baby. Some heterosexual or homosexual biological males want to do this and male to female transsexuals are another group with that desire. Midwives in England have been told by the National Health Service (NHS) to use the term “chestfeeding” not “breastfeeding” or “breast milk” in order to respect transsexual females.

Pregnant transmen?

Consistent with “chest feeding” being intended to include male to female transsexuals, could the words “pregnant persons” be intended to accommodate biological women who identify as male gender – female to male transsexuals — who have a baby? Are they the mother or father of the child or just a “pregnant person” who gives birth to a child? A United Kingdom court has refused the request of a female to male transsexual person, Freddy McConnell, to be identified as the father on the birth certificate. It stated that the person who gave birth to a child is the child’s mother, not the child’s father.

“Pregnancies” in artificial wombs?

Or, might it be meant to cover ectogenesis – gestation in an artificial uterus, which scientists have now achieved with lambs? Are both the sperm donor and ovum donor of the foetus in the artificial uterus “pregnant persons”?  

It would be a mistake to assume ectogenesis will never happen with human children. The renowned reproductive technology research veterinarian, Professor Alan Trounson, one of the pioneers of IVF, once told me, “If you want to know where science is headed look at what it’s making possible in animals in the present and that will be what we can do in humans in seven years.”

That prophecy has proven to be largely true with regard to reproductive technologies.

Inclusive language

Might the term “pregnant persons” be inclusive language, an expansive concept of pregnancy, meant to recognise that the child in utero, at least the naturally conceived one, has two parents both of whom are expectant parents and are, in that sense, “pregnant persons”? If this were the intent, would it mean that the father of the unborn child would need to consent to a woman’s decision to have an early elective Caesarean section, a trend that is of serious concern to doctors?

It is not uncommon to speak of a pregnant woman as “expecting” or being an “expectant mother”.

In fact, she is already a mother and what she expects is the birth of the baby. Likewise, the father is also expecting that event. Interpreting the word “pregnant” as indicating an important expectation resonates with the wider second interpretation of the word “pregnant” in the Oxford English Dictionary: “Full of meaning; significant or suggestive: ‘a pregnant pause’”.

Pregnant persons and new reproductive technologies

What would accepting the approach just suggested mean in relation to sperm and ova donation or surrogate motherhood? Would the gamete donors be “pregnant persons” when an embryo was conceived using their gametes? Is a person or are persons “commissioning” a surrogate mother “pregnant persons”? Does it make a difference in that regard, whether or not they or the surrogate mother are biologically related to the foetus?

These questions call to mind an old cartoon which appeared in The New Yorker when reproductive technologies were newly on the scene. It shows a nurse holding the hand of a little boy, both with their backs to the viewer. Facing them and the viewer are several iconic pear-shaped adults at a cocktail party, each holding a martini. The nurse introduces the line of adults to the little boy one by one: “This is your commissioning daddy, your commissioning mummy, your sperm donor, your ovum donor, your gestational mummy, your lawyer to draft all the necessary legal agreements, and your psychiatrist to sort you out.”

Are the first five adults all “pregnant persons”?

Some feminists object to reproductive technologies on the grounds that they are disempowering of women and disrespectful of their natural role in reproduction. Is the change to the language of “pregnant persons” a further instance of this phenomenon?

A different angle on the problem

Or, from another different perspective, might the word person in the term “pregnant persons” be intended to reinforce respect for women by reinforcing their recognition as persons with the same human and civil rights as men. It is easy to overlook how, until relatively recently, women were not recognised as either persons or having rights, let alone equal rights with men. For Instance, even in Canada, it was only with “The Persons Case” in 1929 (Edwards v. Canada AG A.C. 124, 1929 UKPC 86) that such recognition occurred and, appallingly, it is still absent in some countries.

In this regard, it bears keeping in mind that we usually only omit the word “person” when we speak of someone in a negative way. For example, the connotations of juvenile delinquents, criminals, the disabled, the old, or mental incompetents are negative. We do not speak of “mental competents”, but rather mentally competent persons.

Moreover, dropping the word “person” depersonalizes people and allows us to dis-identify from them in order to reassure ourselves that we are not like them and never will be and therefore that we will never be treated in the way in which we are treating them. Omission of the word “person” in such circumstances often precedes and leads to discrimination, stigmatization and even scapegoating.

Could that indicate that the language of “pregnant persons” is preferable to that of “pregnant women”?

Margaret Somerville AM, DSG, FRSC, FRSN, DCL is Professor of Bioethics at the University of Notre Dame Australia School of Medicine (Sydney campus). She is also Samuel Gale Professor of Law Emerita, Professor...