Making difficult decisions

risks informed consent brain mnemonic
 

During pregnancy and birth, many women are required to make decisions or agree/decline care plans offered by their doctor or midwife. 

In other areas of health, we might have the opportunity or feel secure in asking for second opinions, researching other options or just saying no.

When we are having a baby however, quite often our default position is to give our decision making and reasoning over to the "experts". After all we don't want to make the wrong choice... and what do we know?

Unfortunately, not all decisions are so black and white, not all opinions of all midwives, doctors, birth centres and hospitals are the same, and not all policies and standard protocols are made for you, with your unique circumstance, opinions and beliefs.

Some people caring for you and yours have a very narrow focus of what "safety" is. Does safety in birth simply mean that you and your baby survive the experience without obvious disability or morbidity? Or does safety in birth mean that at the culmination a strong and vibrant woman is physically, emotionally, spiritually and mentally prepared for the work of mothering? With a baby that is switched on and primed with the instincts and reflexes to thrive?

Does safety in birth simply mean that you and your baby survive the experience without obvious disability or morbidity?

Or does safety in birth mean that at the culmination a strong and vibrant woman is physically, emotionally, spiritually and mentally prepared for the work of mothering? 


Asking questions doesn't make you a disagreeable patient. It makes you a woman prepared for the responsibility of motherhood. 

If you have time (in pregnancy for example) working on a birth plan can be a helpful tool to guide your decision making, or at least give you some idea of good questions to ask.

If childbirth is throwing you a curve ball and you need to make decisions on the fly, the BRAIN mnemonic is pretty helpful to give you some questions to ask, and help you tease apart your feelings and options when making decisions.

Asking the person caring for you "is this necessary?" just doesn't cut it. Generally speaking the person caring for you doesn't get into the business of babies because they are uncaring, so if they are offering you an intervention/ solution/ plan of care if it usually because they think it is necessary.

Using the BRAIN mnemonic you will have an opportunity to weigh up your thoughts about the offered plan. its pretty simple and you can save it and keep it with your hand held notes.

 Women centred care. It means that although you might employ people around you to care for your baby and you medically, ultimately you are the one who

Benefits: What are the pros to this plan? (usually pretty easy to answer)

R

Risks: What can go wrong with this plan? ("risk" is a funny word to use, but the truth is nothing in life is without risk, so whatever you choose will not be completely risk free. Walking down the street is risky, driving a car is risky, and i have heard it said that "birth is as safe as life gets". Word of warning: If someone says there is NO RISK to an intervention they are offering i'd advise digging a little deeper)

A

Alternatives: What are the other options? Are there second opinions? What do other doctors/midwives/hospitals/policies do? Tell me all the options and scenarios.

I

Intuition: What does your intuition tell you? Is this decision feeling right? We may have fear, and this still might be necessary. I'm not saying everything that is offered is going to feel great, but try and listen to your inner-self when you decide if this feels correct.

N

Nothing. What about if we wait? Don't do anything? Go home? Come back? Come back later? Change our mind? Get off the train? (you get the point). Sometimes we are not at a point of no return, even if it feels like it. Is it just a scheduling issue, or is there an actual concern with your/your baby's health?


 

The great thing about using your brain is it is not about "pushing an agenda" or any kind of birth philosophy.

It is all about giving you a voice, and helping you be in the centre of decision making.

Where you belong.

 

Jennifer Hazi is a mother, midwife, childbirth educator and doula educator in Sydney, Australia.

She is really passionate about women having voices and choices in maternity care and absolutely loves working alongside women and their loved ones during this time. 

She teaches childbirth and parenting education online and in person, works clinically as a midwife and provides physical and educational support to families with new babies up to 3 months old.

Jen also speaks and writes regularly about childbearing, motherhood and transitioning to parenthood.