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Friday, June 24, 2011

Use your BRAIN for informed decision making

"YOU HAVE A RIGHT TO CONSENT TO AND REFUSE ANYTHING 
THAT INTERFERES WITH YOUR BODY OR THE BODY OF YOUR CHILD."
-Emily from Doula Ambitions blog

I first came across the BRAIN acronym for informed decision making while studying the ICEA website. There is an Informed Consent Discussion Sheet on the website that I like to share with clients. I have decided to follow Emily's lead (quoted above) and share the BRAIN acronym on this site. 

As a doula (in training), I feel it is part of my job to help clients feel empowered with the decisions they make during pregnancy and birth. Many women are in a vulnerable position and simply follow doctors' orders without question since, after all, "Doctor knows best." Yes, doctors and midwives are very knowledgeable and are trained to help you throughout pregnancy and birth. However, they are not perfect. You are the expert on YOUR body. I have heard moms say many times, "I just KNEW {fill in the blank} was happening, but the doctor wouldn't listen. It turned out I was right. I wish s/he would have listened." Remember, no one can do anything without your consent. If you do not SPEAK UP, then unfortunately, that is consent enough. 

Many women are worried about being perceived as contrary and confrontational. No one wants to be considered a "bad patient," right? However, it is up to you to make sure that you are receiving the care that you want and need. It is up to you to make sure you are fully informed of your choices. And how can you be fully informed? Do your research and ask questions! Asking questions is a great test as well. If your care provider seems like s/he does not like the fact that you are asking questions, that is a red flag! There are plenty of providers that welcome questions from their patients. Find them. 

Using your B-R-A-I-N:

Benefits:

How will this help my labor?
How will this help my baby?
How will this help me?

Risks:

How will this affect my labor?
How will this affect my baby?
How will this affect me?

Alternatives:

What are my other options?

Intuition:

What does my gut say?

Need Time:

I need time to think this decision through.
I need a private moment to talk with my family.
I would like to wait for now.

I recently had the opportunity to practice this activity with a client who was being faced with induction. She expressed the concern to me that she wanted to go into labor on her own. It turns out that she had not had the opportunity to speak face to face with her doctor and was receiving all information through a source that was not her primary care provider. By calling and asking questions, she no longer has a looming induction and will have the opportunity to talk to her doctor face to face about her options. (Provided that baby does not decide to make an appearance before then.) 

Please know that just because someone is suggesting a procedure, it does not mean you must do it! Go through the questions, consider all advice given, consider alternatives, listen to your intuition and make the most informed decision that you can. If you are informed, you can go into any decision with the confidence and knowledge that you are doing the absolute best thing for your baby and for yourself. 


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