You’ve got some choices to make.
There are some choices you may know you have responsibility for when it comes to birth. Like where will you give birth and who will be your birth partner and what will you choose to help you manage the sensations of labour. But if the number of times we hear birth stories that begin with ‘I had to’ or ‘They wouldn’t let me’ are anything to go by then you may have more choices than you realise. If you would like some ideas on these types of choices check out our blog about birth plans. Read on here to learn more about how BRAIN for birth choices can help you make decisions.
You Have Human Rights in Pregnancy and Birth.
Knowing your rights and how to make decisions is an important factor in planning for your birth and when interventions or changes to your plan A are suggested during the process of labour and birth. If you want to know more about your rights check out the Birthrights Website
First things first you ARE allowed.
You are allowed a homebirth, you are allowed to choose a c-section if you need one for mental health reasons just as much as if you are offered one for medical reasons, you are allowed a vbac. You are allowed to say no. You are allowed to say no. You don’t have to have an induction, you don’t have to have an internal exam, you don’t have to lie down on a bed.
The right to informed consent.
Your medical care givers have a legal responsibility to make sure you make an informed decision about all of the interventions they are offering you. Sometimes they do a good job of making it clear that the decision is yours, sometimes they can assume that everyone will do whatever the policy says. But as a unique individual you have every right to say thank you for the information and advice but I’m going to choose to do things differently.
You are the expert in you.
This can sometimes seem like a daunting level of responsibility to take on especially in a society where we’ve come up with ‘doctor knows best’ as a saying. Now doctors do know lots of things, they are very well trained for caring for you in emergency situations should they arise. But they work in a system that’s set up with lots of policies and they don’t know you as well as you know you.
So how can you know which piece of advice or intervention you are offered is the right one for you to take up.
BRAIN is a useful acronym for making choices in pregnancy, labour and birth.
BRAIN: Benefits. Risks. Alternatives. Intuition. Nothing.
When faced with a decision or given advice the benefits of the recommended course of action are a good starting point. Benefits can be subjective so it’s important to evaluate the benefits listed by someone else as to whether that feels important to you or not. Benefits may be to your physical health, your baby’s health or to your mental health. They may be a benefit that’s very likely to happen or they may be only a possible benefit.
If someone is trying to persuade you to do something, they may be tempted to miss out the risks or understate them. Asking specifically for the risks of the recommended course of action will give you the opportunity to evaluate for yourself how much of a risk that feels for you. You may want to ask for the absolute risk rather than or as well as the relative risk to help you understand fully. If a risk doubles that may sound like it must be very risky but if the risk doubles from 1% to 2% risk that’s a very different situation than if it doubles from 20% risk to 40% risk for example.
There’s rarely one option in any situation. Asking what the options are will help you to know which most appeals to you. You may need to go back to the benefits and risks questions about each of the alternatives also.
Intuition or instincts reminds you of a question you need to ask yourself. What feels right to you? Sometimes we can feel a bit out of touch with our instincts but if you have a really strong feeling that one alternative is not right for you or that another is then it’s a really good sign it’s the right decision for you. If you don’t have a strong feeling don’t panic. ‘Head’ decisions, those made by weighing up the alternatives and the risks and benefits are good decisions too. Remember there’s no such thing as the wrong decision you will always make the right decision for you in the moment with the information you have. Things make change in time and you may change your decisions as events unfold but that’s also fine. You have the right to change your mind.
What happens if we do nothing? What if we let things be? If we keep going with what we have been doing and wait and see? If we re-evaluate the situation in a hour or two and see if anything has changed? There are situations which are urgent but there are many more situations which are not urgent where some time to think is the best decision for now. In an hour you might feel differently about the possible interventions or you might have already had your baby. If no one is in any danger you can always wait and see if that feels like the right decision to you.