I was speaking with another expectant father this morning, and our conversation turned to decision-making during childbirth and the almost inevitable need to tell some health-care professional to stick it in their ear.
It’s always hard to tell a trained expert to shut up, slow down, and explain it again. Just think about when your mechanic tells you your car’s problem (and asks “do you want me to fix it?”) or the sewer guy says he’ll really need to dig up your front lawn to do it right. But amid the chaos of childbirth, it’s even harder.
p{color:gray}. Photo: Not really related to this post. Just a cute picture of The Lu.
That’s why we really latched onto an easy mnemonic for decision-making, based on the acronym BRAIN(Benefits, Risks, Alternatives, Intuition, Nothing). Our childbirth-class instructor, Allison, passed along this scheme that’s useful whenever a doctor or nurse proposes an intervention of some sort that requires a decision. All you have to do is ask yourself — and better yet, ask out loud:
* B: What are the *benefits* of following this proposal?
* R: What are the *risks* of this proposal?
* A: What are the *alternatives* to the proposed intervention?
* I: What does my *intuition* (or instinct) say about it?
* N: What would happen if we do *nothing* right now?
One of the strengths of this rubric is that it exposes the alternatives, and there almost always are some! Slowing down enough to think through five questions at least makes it less likely that you’ll make a snap judgment, be cowed by the sheer insistence of a third party, or simply abdicate responsibility to the expert — and less likely that you’ll regret it later.
A year ago, Ann posted about this in discussion with her BabyFit friends, and made the wisecrack that she “was teasing [me] the other day about using it when deciding to changes lanes while driving.” But seriously, it does seem like a useful tool for making all kinds of decisions, not just in the maternity ward.
By the way, Allison, are you still out there? :)
Before Eli’s birth, I spoke to a doula on the phone and she gave me the B.R.A.I.N. advice as well. I do think it was one of the few more helpful pieces of knowledge that Nathan and I learned our whole 9 mos. of educating ourselves. Because we were giving birth in a hospital we needed to have a decision making tool. Unfortunately, I can’t remember if we used it when finally deciding to go on Pitocin. After those initial 36 hours of labor, we just wanted “it” out. (Unfortunately, I’m not really convinced that the Pitocin helped in that process b/c it was another 15+ hours after that and 5 hrs. of pushing and forceps before Eli was finally born. Though, I’m sure that if we had decided against the Pitocin, I would still be wondering today if I should have taken it – possibly the labor would have been shorter and easier?) And, after all is said and done, I don’t know what decisions we could have made to make that a better experience. I appreciate that even though Eli’s birth was a long and bumpy road, I can look back at the whole process and at least say, “I don’t regret the decisions we made”. If nothing else comes of it, at least B.R.A.I.N. can help give that peace of mind in the end. (Sorry, I sorta rattled on a bit).
Btw, we are so excited for you three! And, I appreciate your posts so much. It gives me hope that I too could have another child someday and manage to keep a little bit of my sanity. :)
that’s such great advice, even for one who is (as far as I know) done having babies! I always feel cowed by doctors and nurses and unable to think under pressure in front of people – that’s a great way to prompt some coherent thought.
Thanks for sharing this. It really does seem wise advice for all types of decisions.
I am slowly beginning the process of being certified as a birth and post pardum doula, so I am going to tuck this away, hopefully I will be able to use BRAIN in a year or so with a laboring mom.
Nicole if you need some of the books, let me know. I have 3 of the CAPPA required reading. After realizing that I”m years away from becoming a doula if at all, I would like to get them off my book shelf. My email is on my blog, or Ann has it.
I wish we’d had this when I was having Kaia. Thanks for sharing, Jon!
Hey! This is a great tip. I bet I’ll think of this often when making decisions about Ramona. In fact, I think this is already what we kind of do anyway, but I’d never thought of it in such an organized way. Thanks guys :)
We used our Brain by having a Doula to do it for us!! I have read that B.R.A.I.N somewhere before, but when it came time to actually birth Lydia, I needed someone else to help us with it all and that was what she did. Even the week before she came when we were given the option to induce, she walked me through all of that and we decided that it wasn’t what we wanted. Thank Goodness because we had the perfect birth with the perfect outcome and there is nothing more we could want and that is fantastic as it probably was/is the last one (although my crazy hormons say, just one more!).