When I teach about birth one thing I often say is that the person in labour really needs to be able to shut off the thinking part of their brain and relax into it. It has been said that you need to fall into labour just as you would fall asleep. You can’t make it happen, you need to switch off and let your body do it.
The thinking in labour usually needs to come from your birth partner, your advocate and voice. They need to keep their brain switched on and be ready to support, encourage and speak up when you need it.
But that is all for another day. This is a different BRAIN.
As you progress through your pregnancy to birth the chances are that something will come up that you need to make a decision about. You might even sail through pregnancy but come up against something unexpected in labour. It is pretty unusual to get the whole way through the journey without a curveball somewhere along the way!
So what happens? Your midwife or doctor is suggesting a course of action that you hadn’t considered or, maybe, have never heard of before. They are looking at you expectantly for an answer. The expected answer will more than likely be a yes to what was offered.
What do you do?
A smile and agree
B force a smile, panic and run away
C say you need to think it over and leave
D use your BRAIN and ask for more information
For lots of people this situation is a hard one. You might have just been given results or news that is worrying, or that is changing the course of your care. You might only be days or weeks from your due date or you might be in labour already. Your baby is the most precious thing in the world and you want to protect them and keep them safe so it is really easy to panic and say yes without really knowing what you are saying yes to.
But of course it isn’t that simple. Interventions come with their own risks. The right choice for one person might not be for the next. We are all individuals with different physical and emotional states which will affect our choices. Your care should be personalised to YOU. Just because you have high blood pressure or diabetes or are a certain age doesn’t mean you need a one size fits all approach.
The BRAIN acronym is really helpful in making decisions, whether you are on the spot in a labour room, sitting in an antenatal appointment or are at home doing your own research. It is really important than any decisions you make are informed choices that you are happy with. It doesn’t really matter if your health care professionals are happy with your decision, as long as you are happy you are making a choice with full awareness of your options and risks.
BENEFITS
What are the benefits of what is being offered? It sounds obvious but you need to understand why this is being offered to you. Acceptable answers do not include ‘putting your baby at risk’, you need to know the specifics.
RISKS
What are the risks associated with what is being offered? Unhelpfully there will be risks for saying yes or no. To make an informed choice you need to know BOTH of these. Please don’t just accept hearing the risks of saying no. You need to fully understand what you are saying yes to as well. When we consider risk (or chance, which is a much gentler way of hearing it) it is most helpful to hear the absolute numbers. A percentage or a 1 in X. It isn’t very helpful to hear ‘your risk is double’. That sounds scary straight away because there is no context. Hearing your risk is 0.6% compared to someone else at 0.3% is also doubled, but you might be ok with a 0.6% chance of something happening. Or to view it more positively, a 99.4% chance of it not happening.
ALTERNATIVES
What are the options for you? Find out about alternatives that you might consider first or instead of the proposed option. You might need to dig a bit or do some research of your own but it is worth seeing what else you could consider.
INSTINCT OR INTUITION
How are you feeling about this? Your intuition is usually pretty good and is a perfectly valid thing to consider. Do you feel there is a need to do something or do you feel all is well and you are happy saying no at this time?
NOTHING
Also a very valid question to ask. What happens if we do nothing? As with risks, you are looking for helpful answers not scaremongering ones. Your choice to do nothing might be for an hour or two if you are in labour, or it might be for a week or two if this is towards the end of your pregnancy. Either way doing nothing might be the right option for you.
TIME
It doesn’t fit the acronym, but worth asking how long you have to make this decision. Do you need to decide this minute, in this appointment, today, before your next appointment? And not for the convenience of anyone else, but because action needs to be taken.
I appreciate this can be a tricky topic because we want to trust the people caring for us and we don’t want to take any risks when it comes to our precious baby, but the people caring for you are not you. They don’t have your feelings, your experiences and your preferences. They are coming at this from a different angle altogether, bringing their own experiences and feelings.
This is why it is so important you are able to ask be confident to ask questions and make sure you have the information you need to make a decision you are comfortable with. That is how we achieve positive, confident and empowered birth – coming from a place of control and knowledge.
Antenatal classes can really help with your understanding around birth and the sorts of things that might be offered so that you can be prepared rather than find yourselves put in the spot. Learning alongside your birth partner means that they have all that information too and can speak up and advocate for you if the need arises.
You can find details of my antenatal classes here