Making Informed decisions in birth

THE acronym for birth that EVERYONE SHOULD KNOW:

B. R. A. I. N. S.

Every great teacher knows the power of acronyms. In birth, they are no less powerful! Making decisions in life can be tough, options are bountiful and knowing where to start can be tough. Using acronyms during labor is a great way to gather information quickly and efficiently. Your support team such as your partner or friend can support you by memorizing these as well.

B.R.A.I.N.S will help you to communicate with your providers, get you all the answers to questions regarding interventions, and assure you in your journey through labor. It doesn’t mean that making decisions in the throws of contractions won’t be tough. Utilizing B.R.A.I.N.S. as a tool will get you the information needed to make those responsible and well-informed choices.

WHAT IS B.R.A.I.N.S. AND HOW DOES IT RELATE TO BIRTHING?

We need to have brains in order to make decisions and that is just what this acronym is all about. B.R.A.I.N.S. stands for Benefits, Risks, Alternatives, Intuition, No/Nothing, and Strengths/ Safety/ Satisfaction. I will go through each step in specific, but I want you to remember that this acronym is helpful throughout life and not just in labor. There are pros and cons to every decision you make, whether it is big like choosing where to give birth, or small, like picking your outfit in the morning. The BRAINS acronym will help you make informed decisions that are right for you through every moment in life.

As you become a parent, there are millions of decisions to make: parenting styles, sleep training, breastfeeding vs. formula. BRAINS is a great source of knowledge and can empower you to make decisions that feel right for you! Throughout pregnancy you are loaded with opinions from where to give birth, how to move throughout labor, whether to have an epidural, and so much more. BRAINS helps to weed out opinion from fact, get you the data that is relevant to you, and turn inwards to decide what options are right for you.

Breakdown of B.R.A.I.N.S.

BENEFITS

Just like a pros and cons list is going to look different for everyone, benefits from a decision may be different for you. Think about more than just the statistics! Numbers are great and necessary information, but true benefits come from the outcomes that relate to you. What are the benefits? How does this benefit relate to you? Are there more physical, emotional, or informational benefits?

RISKS

Similar to benefits, getting the research and data on risks is more than just the numbers. Find out what are the risks for your options. I recommend ranking the risks based on what seems most dangerous or threatening. What are the risks? What is the likelihood of the risk occurring? Are there ways to avoid these risks? Could this choice lead to further risks down the road?

ALTERNATIVES

For almost everything in life, there are alternatives to consider. Now, each alternative might have its own benefits and risks to consider, but having options in my mind is better than not having them. Think about your preferences, if the risks are outweighing the benefits, seek out and hear your alternatives, but if the initial option is speaking to you, set aside the alternatives and continue with the remainder of BRAINS. What are my alternatives?

INTUITION

As they say, listen to your gut. As human beings, we tend to have an initial reaction. Often times, this initial reaction is the best option, but it’s important to keep an open-mind. What is your intuition tell you? Do you feel hesitation? Lean into that hesitation and ask yourself where does it come from?

NO, AND NOTHING

Saying no can be powerful and you have every right to it. Depending on the severity of the situation, doing nothing can be a great option. You heard the benefits and risks for your option, now what happens if you do nothing? This a great question to ask because if there is no immediate need for an answer, doing nothing for awhile can help you figure out your decision. What if I say no? Do I need to make a decision right now, or can I do nothing and wait?

STRENGTHS, SAFETY, AND SATISFACTION

When I initially learned the BRAINS method, the S were not included. I had only BRAIN, but with the inclusion of the three s’s BRAIN gets enhanced in a way that I believe speaks volumes. When debating any decision, think about your strengths. How well are you equipped to handle either decision you make? Your feelings of safety change from day to day, check in with yourself and ask, what is going to make me feel the safest? And with the final S of satisfaction, remember that some decisions will feel right because of who you are and what you have experienced. Keep in mind what will bring you satisfaction. Will you feel satisfied with one option over the other? Sometimes, neither will bring you satisfaction and that can impact your decision too.

HOW TO USE BRAINS AS A DECISION MAKING TOOL IN LABOR AND BIRTH?

Now that we know the steps in decision making, let’s practice with an example how it can be used during labor and birth!

Picture this: you have been laboring beautifully and have been dilated to 7cm for nearly 3 hours. Your provider comes in and suggests utilizing Pitocin (a synthetic version of oxytocin that is used to induce or augment labor) to keep your cervix dilating and move you along to birth. You are open to discussing the intervention and now have the great BRAINS acronym as a tool to help you reach your decision.

You begin by asking what are the benefits of using Pitocin. It can help your cervix continue to dilate and enact stronger contractions to do so. Now, you ask what the risks are. Potential risks include a lower heart rate that could decrease oxygen flow and potential extra bleeding after birth. Your provider gives you the direct statistics for both benefits and risks. Now, your partner chimes in and asks, “What are the alternatives?”. Your provider tells you that you can try moving in different positions to change continue dilating your cervix, start at a low dose of Pitocin and see how that feels, or wait another hour and see what happens. During this conversation you have been feeling that tug in your gut, intuition is here! You consider your initial reactions and tune into what your body is telling you. Your provider already brought up how doing nothing could play out. You consider that as an option as you think about your safety, satisfaction, and strengths. Do you feel safe using Pitocin? You have done an incredible job so far, what strengths can you lean on in making this decision? And how satisfied will you be with your birth experience if you use Pitocin?

Only you can decide what feels right during this time! On this day you may choose to say yes, whereas, if you labored on a different day you may have chosen to wait it out. Know that every decision you make throughout your labor is right for you. BRAINS helped you make this decision and no one else can make that for you.

INFORMED DECISION MAKING IN BIRTH

The BRAINS acronym is such an important tool to have throughout labor and birth, but remember it is a great resource to have beyond birth. BRAINS can help you make decisions throughout pregnancy and everyday life decisions. Having all the information you need to make decisions is so crucial in feeling empowered, knowledgeable, and confident. It may happen that BRAINS does not get you all the information you feel like you need. In that case, remember that providers, nurses, doctors, midwives, and doulas are all serving you! Ask more questions, consult family members, and take the time that you need.

Keep BRAINS written down in a journal or on your birth plan as a reminder. Practice makes perfect, try to use it ahead of birth and find your rhythm and confidence in decisions you make.

As mentioned earlier, no matter what decision you make, trust yourself that it is the right one for you in this moment! Your support team should not be making decisions for you, but can help bring to light different perspectives and avenues you did not think of. Lean on them when needed and trust your inner strengths, they have gotten you to this moment.