Empowering Choices: Using the B-R-A-I-N Method for Informed Decision-Making Throughout Pregnancy, Birth, and Beyond
I am going to share with you a very simple, free, and highly applicable tool that you can use to help you make confident, informed, and shared decisions throughout the course of your pregnancy, birth, and beyond.
This one simple tool can make the biggest difference in the care you receive as you prepare to bring your baby into this world.
You may feel overwhelmed by the amount of information available on the web or coming from your friends, family, and care provider. You may not know where to begin. And that is completely normal!
If you are reading this, you are one step closer to having the birth you desire and deserve. If you are reading this, kudos to you for taking steps toward a healthier, safer, and happier birth! Gaining knowledge throughout your pregnancy to prepare for your birth and the postpartum is super important, but applying the knowledge you gain is where the true power exists.
As birth doulas and perinatal educators, we talk a lot about communication with your care provider. It is very important to ask questions of your provider early and often. By asking questions early and often, you have a better chance of identifying red flags and either working openly with your care provider to get on the same page or possibly even switching to a more supportive provider. Either way, having frequent, open, and honest conversations will help you feel more prepared and confident in the care you are receiving during your pregnancy and birth.
Also important is to align with a birth support team who will support you, respect you, listen to your needs and wants, and provide you with evidence based care.
Now you may be wondering, where do I begin? How do I ask questions of my provider? How do I know the right decision to make? When do I ask questions and what do I do with the information given to me?
The simple answer is to use your B-R-A-I-N!
This method is the most important tool in your metaphorical tool bag! And you can use it starting right now! B-R-A-I-N stands for Benefits, Risks, Alternatives, Intuition, and Now.
To understand this tool and why it is important, we need to first talk about shared decision making.
Shared decision-making:
Is a collaborative process that acknowledges patients' authority in their health care decisions.
Offers the opportunity for you to receive complete and accurate information, to clarify values, and to receive decisional support.
Helps you to gather evidence based information through the course of your care.
Engages you in an exploration of your respective values, knowledge, and previous experiences.
Helps you make a decision based on the results of your exploration.
Maternity care in the United States is becoming increasingly complex and procedure-intensive, and patients often have inadequate knowledge to make informed decisions. Advantages for using a shared decision-making process include higher maternal satisfaction, more positive relations among the care team, and higher levels of trust.
B-R-A-I-N is an acronym that should be used when you are faced with a recommendation from your care provider OR when you come to a decision point during pregnancy, labor, birth, and beyond.
Benefits - Risks - Alternatives - Intuition - Now
Really this tool can be applied for ANY care you receive including the healthcare of yourself or your child in the future.
How it works:
B-R-A-I-N walks you through each component of a truly informed decision and then allows you to check-in with yourself before making your final decision. It shifts the power from the provider to you. You become the active participant you need to be to advocate for yourself and your baby. And doing this will help you to have a safer, healthier, happier birthing experience.
You may feel nervous asking questions of your provider as they are the Doctor and they are perceived to know all the things and to know what is best for you. Doctors and Midwives have a wealth of knowledge and their professional experience and expertise is valuable and serves an important role in the birth of your child. However, what they have to offer is just one piece of a very large and complex puzzle. They do not know your individual experiences, knowledge, and values that all have an impact on your experience and care.
When you combine your doctor’s expertise with your informed intuition you have a better chance of having a safer and happier birth.
Let’s get into breaking down the B-R-A-I-N decision making tool. B-R-A-I-N stands for benefits, risks, alternatives, intuition, now.
You will ask:
What are the Benefits of this test, procedure, or whatever the item is? What are the benefits to NOT doing it?
What are the Risks associated with doing or not doing it?
What are the Alternative options available to you?
Then you check in with your Intuition. What does your gut tell you?
And then
Do we need to do anything Now? Or what if we do Nothing? What if we wait an hour or two or a day or two?
This is 100% your right! This is your baby, your body, and your birth and you have every right to know about all the things happening to you and your baby!
You may feel like you can’t or shouldn’t ask questions of your provider because maybe you worry about upsetting your provider or making them think you don’t trust them. This isn’t about not trusting them. This IS about informing yourself about ALL of your options, taking all things into consideration and THEN making the decision you feel best suits you and your situation.
I think the key to this is to understand that you “don’t know what you don’t know”. So you may not even be aware that you should be asking questions…you may assume what is happening is “normal procedure” so why ask any questions. You want to use this decision making tool ANY TIME there is something being done to you or your baby.
The more often you do it, the easier it becomes!
The best time to talk to your provider is BEFORE the birth. Ask questions early in your care and often! Don’t wait until you are in labor to have a conversation with your provider about their practices. You want to have this type of conversation throughout your pregnancy so that when you get to the birth, everyone is in sync and your expectations are in line.
Ideally your provider will welcome these questions and conversations openly and transparently. If they do not, try to talk further with them and work toward getting to the same page. If you continue to see “red flags”, it may be time to switch to a more supportive provider. If this is not an option for you, then you will want to continue to be your own best advocate. Ask questions, ask for time to make a decision, ask for them to explain it to you more if you don’t understand, ask a trusted source likea doula or childbirth educator. Weigh out the information and make the best decision available to you.
Per Childbirth Connection, the purpose of informed consent and decision making is: to respect your right to self-determination. Your rights to autonomy, to the best available information and to protect your children and yourself from harm are very basic human rights.
When should you use this tool? Any time there is something being done to you or your baby and you need more information before making a decision.
During prenatal visits, your Dr. or midwife may spend ample time with you BUT for many, they do not, and they may even appear to be rushed. Schedule a separate office visit or set-up a phone call with them outside of your regular prenatal visits to have a more in-depth conversation about your pregnancy, birth and your preferences for both.
Write the B-R-A-I-N acronym down and keep it with you so you can reference it when you are in a situation and need to ensure you are making an informed and shared decision.
Better yet, use the FREE printable that includes multiple copies of the acronym for you to print, cut out, and put in all the places you may need it (wallet, car, kitchen, bedside table, partner’s wallet, etc.)
We hope you find this helpful! You can start using this simple and free tool NOW. You are fully capable, strong, and smart to apply this to every aspect of your life. Doing this one simple thing will make a huge difference in your life.