B.R.A.I.N. stands for:
As you know, acronyms are a good way to help us remember and quickly retrieve a sequence of points or steps when we need them the most. In this case, the acronym B.R.A.I.N. can come in handy during labour and birth.
You may be offered interventions
Unless you are having an unassisted birth, chances are that when you or your partner are in labour and about to give birth, you will have one or more health professionals with you. And this is true whether you’re giving birth at home, in a midwife-led unit, or on the delivery ward at the hospital.
During labour, you or your partner may be offered pain relief, for example, which is a form of ‘intervention’. Other procedures may be recommended for you at a particular time, and it’s always worth remembering that regardless of what is being offered or (even strongly) recommended by health professionals, the ultimate decision as to whether to accept an intervention or procedure is down to you and your partner – you have to give consent before anything can happen to you, your partner or your baby.
During labour and birth, however, you or your partner may find yourselves feeling very vulnerable – it’s hard to evaluate options objectively and make informed decisions in these situations. And this is exactly why using the B.R.A.I.N. acronym can remind you of a set of questions to make a better, more informed choice. It really can make all the difference in the way you handle what could be a very ‘emotionally-charged’ situation. Asking the right questions (and getting the answers to those questions) will give you the confidence that you are making the right choice for you and your family at that point in time, given your specific circumstances.
What are the benefits of the intervention or procedure that’s being offered to you? How can making this choice benefit the mum or the baby? What will it do for you and your family? Why is this particular thing being suggested or recommended to you or your partner at this moment in time? Unless this has already been outlined and satisfactorily explained to you, remember to ask. You can’t make an informed decision if you’re accepting something without knowing why you are doing it.
What are the risks of this action or procedure? What may or may not happen if I make this choice? How could this negatively impact you, your partner, or your baby? Once again, remember that you are not making an informed choice if you don’t know what risks you are facing. A risk isn’t something that will most definitely happen. But it is something that might happen as a result or side-effect of the intervention that’s being offered to you. Risks can be accepted and mitigated, but you may not know how unless you ask. And it’s important that you are comfortable with the benefits and risks of the choice(s) that you are being asked to make.
Now you know the benefits and risks of option A – great! Is there an option B (and C and D etc.?) If you don’t choose this particular intervention right now, is there anything else that could be done as an alternative? Could option A still be an option later on? And if you do have alternative choices available to you, don’t forget to start the B.R.A.I.N. sequence again – you definitely want to know about the benefits and risks of all your options!
What is your intuition telling you? What does your gut say? Does this feel like the right thing to do at this moment in time? Whilst in labour, a woman may feel emotional and vulnerable, so it’s important that she has someone with her who can ‘advocate’ for her. If you are a birth partner for someone, you may not know all the answers, but an important part of your role is to ensure that Mum’s opinions and choices are voiced. So help her create the time and space to access her intuitions, without pressure, so she can either express and communicate her views directly or through you, her birth partner.
And finally, what happens if you do nothing? What happens if you don’t have this intervention or procedure now? Today or ever? What happens if you don’t have a sweep today? Or an induction next week? What happens if you refuse to have a vaginal examination to check for dilation? Only you can evaluate the answer, but it’s important that you know the facts. You may decide that what happens if you do nothing is a perfectly acceptable outcome for you and your family in your circumstances. Or perhaps that opens the door for alternatives that otherwise wouldn’t have been offered for you. And as you continue this dialogue, you can be sure you are making the best decisions you can.
Have you ever used the B.R.A.I.N. acronym before? Do you think it would be a useful tool for your next labour and birth?