Using the BRAIN tool to make informed decisions.

BRAIN Acronym for Supporting Physiological Birth and Informed Choices

B - Benefits

What are the benefits of this intervention or decision?

This step involves understanding the positive outcomes that may result from accepting a particular intervention or action. It’s important to ask:

How could this intervention help me or my baby?

Will it make labour easier, faster, or more comfortable?

Does it support a safe and healthy birth?

Example:

If considering an epidural, benefits might include pain relief, allowing rest, or enabling the birth partner to be more involved.

R - Risks

What are the potential risks or negative consequences associated with this intervention?

Knowing the risks helps weigh the possible downsides to making an informed choice.

Could this intervention lead to complications?

Are there side effects for me or the baby?

Might it affect the progress of labour or increase the likelihood of further interventions?

Example:

Risks of an epidural could include a drop in blood pressure, longer labour, or increased likelihood of instrumental delivery.

A - Alternatives

What are the other options available?

Exploring alternatives ensures that the decision isn't limited to just acceptance or rejection of an intervention.

Are there natural or less invasive options?

Can I try different positions, relaxation, or movement?

Is waiting or monitoring a viable option?

Example:

Instead of immediate augmentation with Oxytocin, you might choose to wait and see if labour progresses naturally, or try massage, water immersion, or breathing techniques for pain relief.

I - Intuition

What does my body, mind, and feelings tell me?

Trusting your intuition and bodily sensations is crucial.

Do I feel comfortable with proceeding or declining?

Am I feeling pressured or confident in my decision?

Does my gut instinct align with what I’ve learned?

Example:

You might feel strongly that you want to avoid certain interventions unless absolutely necessary, or that you’re open to natural methods.

N - Nothing (or "Next")

What happens if I choose to do nothing or wait?

Sometimes, the best choice is to allow the natural process to continue without interference.

Is there a reason to wait and see if labour progresses?

What are the potential outcomes of doing nothing?

Can I be confident that my body knows what it’s doing?

Example:

Choosing to wait for labour to progress naturally without augmentation, trusting that your body and baby are working together.

Summary & Usage:

The BRAIN framework is a powerful tool for pregnant women and birth supporters to facilitate informed, conscious choices during labour and birth. It encourages women to actively participate in decision-making, understand all aspects of interventions, and respect the natural process whenever possible.

Practical Application Example:

Imagine a woman in labour begins to feel fatigued and considers an epidural. Using BRAIN, she might ask herself:

Benefits: Would pain relief help me rest and regain strength?

Risks: Could it prolong labour or increase intervention risk?

Alternatives: Are there other pain management options I can try first?

Intuition: Do I feel ready to accept or decline the epidural?

Nothing: What if I wait and see if I can manage the pain naturally a bit longer?

This process helps her make a decision aligned with her values, body, and circumstances.

Hiring an independent midwife or a doula can help you make an informed decision. They will advocate for you and ensure you have enough information to make decisions. They will be aware of your wishes and will be known and trusted by you and your partner.

Remember you have the right to say no this is your body, your birth, your baby.