In labor, use BRAIN

This handy concept offers a great reference for moms as they weigh the risks and rewards of labor choices.
If you remember any one thing about labor choices, remember this: They are your choices, and yours alone. (For Spectrum Health Beat)

In the childbirth classes I teach, I like to pose a question to the coaches: “Do you think you can do anything that changes mom’s labor?”

Then I pose a question to the moms: “Do you have any control over labor, or does it just happen?”

Most of the time, the coaches don’t think they have much influence over labor and delivery. I’m finding that the moms, however, are increasingly aware of the fact they have a great deal of control over their birth plan and delivery.

In labor and in birth, moms have more choices now than they did just 10 years ago.

At Spectrum Health Gerber Memorial, for instance, this includes choices about the birth plan, including the use of birth balls, peanut balls and the TENS unit. It also includes a choice about using nitrous oxide, for example, added as an option a little over a year ago.

With so many choices, how do moms decide? What should influence their decisions? Is it just about the mom, or are there other aspects to consider?

This is where we turn to BRAIN, a concept found in the educational materials for our childbirth classes.

The acronym—Benefits, Risks, Alternatives, Intuition and Nothing—provides a good reference for moms as they analyze all the particulars of a given choice relating to labor and delivery.

Let’s take a look:

  • Benefits: How would mom and baby benefit from this choice? If it’s a medication such as an epidural, for example, what would you gain from it? If it’s a test, such as second trimester testing, what would you learn from it?
  • Risks: Are there any risks to baby or to mom? How serious are these risks? Are they short-term or long-term risks?
  • Alternatives: Are there other options? What are they? What risks do these options present? These are necessary questions to ensure you’re making the most informed decision about your plan.
  • Intuition: What does your gut say? When you listen to the pros and cons, how do you feel and what do you think about it all?
  • Nothing: Always remember you have choices and you are in the driver’s seat. Maybe it’s best to do nothing for now. Later, you can change your mind. But the bottom line is, it’s your choice.

I like this Marisa Cohen quote I found: “Our childbirth choices are largely unconscious, dictated by our history with doctors and pain, our trust or skepticism of science and technology, the influence of others, our need to control versus our ability to let go, and much more. As all these factors come together, we choose our place on what I call the Childbirth Choices Continuum. The options in the middle are the most mainstream, acceptable choices in America today. Those out on the far ends are the most harshly criticized—by experts, by the press and, mostly, by other women. They’re also the least understood, largely because women are afraid to talk about them.”

I think this is very true.

I’ve talked with women who plan to go without an epidural, and one of them shared how her best friend told her she was stupid for making this choice.

The fact is, it’s the mom’s choice—not the friend’s. It is always the mom’s choice.

It’s not what your friend or even your partner thinks. It’s about what you think.

As you explore your options and set out to make your decisions, remember to let your BRAIN work for you.

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