Source: Photo by Omurden Cengiz on Unsplash
Throughout your perinatal journey from early pregnancy to the day you give birth, you will encounter many decisions you need to make. Self-advocacy during this process is imperative as you communicate your needs and preferences regarding everything from where you would like to deliver your baby to medical interventions that might be recommended by a healthcare provider. It is your right to be informed, and it is your right to say yes or no when it comes to decisions related to your healthcare and birthing experience.
B-R-A-I-N* is an acronym for a 5-step decision-making tool that can help empower you to speak up, ask questions, communicate your needs, and come to a decision.
Benefits: How is this beneficial to you, your baby, and your family as a whole?
Risks: What are the risks or consequences associated with this decision? What additional decisions might follow?
Alternatives: Are there any alternatives? Apply BRAIN to other options.
Intuition: Do you have a strong gut feeling or intuition? How do you feel?
Nothing (or Not Now): What if you do nothing? What if you delay making a decision? Ask for time to decide.
For example, your doctor might suggest using a medication like pitocin to induce labor. You might feel rushed to say yes, but actually have questions and feel overwhelmed with where to start. Using this tool, you can stop and slow things down long enough to make an informed decision. B-R-A-I-N reminds you to ask your doctor about the benefits, risks, and alternatives to inducing labor and to using pitocin. You might learn that inducing labor was recommended for a reason related to your baby’s health or you might learn that inducing labor was recommended because you have been at the hospital for a long time. You might also learn that while there are important health reasons to induce labor, there is an alternative to using pitocin that you were not previously aware of. The tool then reminds you to take a moment to check in with how you are feeling and see whether you have any gut reactions or intuition regarding the decision. B-R-A-I-N makes room to consider multiple important things: your values, the facts, and your feelings. Lastly, you would ask what would happen if you decide to do nothing or delay making a decision for some time.
While you may end up saying yes to the doctor’s suggestion, going through the 5 steps means you are making an informed decision. The steps allow time for you to gather information, clear up any confusion, and make the decision that is best for you after taking time to consider the various factors. Because it can be challenging to advocate for yourself in times of stress and during heightened physical and emotional states, you can share the B-R-A-I-N tool with the people on your team. Consider asking your partner, friends, family members, or doula to use the tool on your behalf. Remember that being an active participant in your healthcare is not pushy or dismissive of your doctor’s expertise; you have the right to make informed decisions.
*Childbirth and Postpartum Professional Association. (2019). Labor Doula Manual. CAPPA.
