Using your B.R.A.I.N to make Informed decisions during pregnancy.

Decision making in pregnancy is a big deal! Suddenly, you’re faced with making all kinds of important decisions for yourself and on behalf of your baby. The information you hear from your care provider, your friends and family, the books you read, and the media can be contradictory at times, which can make decision making hard.  

B.R.A.I.N is an acronym that stands for Benefits, Risks, Alternatives, Instinct, Nothing.

Whatever choices you are faced with, the B.R.A.I.N decision making tool can help you to make decisions based on your own beliefs and values, feelings, and personal circumstances.  This decision-making tool can help you to gather the information you need so that you can make informed choices about your pregnancy, birth, and parenting journey. 

To make a truly informed decision, you need to use your B.R.A.I.N.

B = Benefits

• What are the benefits of this procedure, for me, my baby, or the progress of my labour?
• How will this be a good thing for us?
• Why is this option being suggested?
• What is the problem, and how will this procedure help?

R = Risks

• What are the risks of this procedure, to me, and to my baby, or the progress of my labour?
• Are there any risks to potential future pregnancies?
• What are the potential negative side effects of this procedure?

A = Alternatives

• What are the alternatives to this procedure?
• Is there a different way we could achieve a similar result?
• Is there a less invasive option to this procedure?
• Where can I find more information about this procedure and it’s alternatives?
• Are there any natural therapies that I can try before we try this procedure?
• Who can I talk to to get a second opinion before I make my decision?
• Do we have time to discuss alternatives or is this an emergency? 

I = Intuition

• What does my intuition / instinct tell me?
• How do I feel about this procedure?
• What does the little voice in the back of my head say?
• ‘I’ can also stand for Information.  What are the details of this procedure? How is it performed? Will I be in hospital or at home? Which medications / interventions are used?  When you get the result from this procedure / test how will you use it, and how will this change the course of action from here on? 

N = Nothing

• What happens if we do ‘nothing’ i.e. If I choose to decline this procedure? 
• What are the benefits / risks of declining this procedure?
• Can we decline treatment for now, and re-assess later or after we have discussed this further?
• ‘N’ can also stand for Next.  What is the next step if I choose to consent?  What is the next step if I choose to decline?  If I consent and this procedure doesn’t work, what is the next step?

You can put the BRAIN decision making tool into practice by thinking about the following decision-making points that may arise during your labour and birth, and weigh up the benefits, risks, alternatives etc. of each one.  Keep in mind that your decisions will change based on the information you have at the time, and some of this information will only be available when you are in the moment. 

• Ultrasound scans
• Home birth 
• Epidural
• Hospital birth
• Vaginal examination
• Induction

You can also use the B.R.A.I.N decision making tool for decisions after your baby is born, to help you make decisions around health and medical procedures, sleep spaces, car seats, childcare, and parenting choices.

Remember, informed decision making is not about the course of action you choose, it is how you get to your decision that counts!

You may also like to have a look at this summary (adapted from “The Code of Health and Disability Services Consumers' Rights”), to learn about your rights to informed decision making.

Informed decision making and your rights under the law.

• Right 5

Every consumer has the right to effective communication in a form, language, and manner that enables the consumer to understand the information provided. Where necessary and reasonably practicable, this includes the right to a competent interpreter.  Every consumer has the right to an environment that enables both consumer and provider to communicate openly, honestly, and effectively.

• Right 6

Every consumer has the right to be fully informed of their circumstances, including explanations of his or her condition, the options available, an assessment of the expected risks, side effects, benefits, costs of each option, and the estimated time within which the services will be provided, and the results of these tests and procedures.  Before making a choice or giving consent, every consumer has the right to the information they need to make an informed choice or give informed consent.  Every consumer has the right to honest and accurate answers to questions relating to services, including questions about the identity and qualifications of the provider, the recommendations they have, and how to obtain an opinion from another provider.  Every consumer has the right to receive, on request, a written summary of information provided.

• Right 7

Every consumer has the Right to make an informed choice and give informed consent.  Services may be provided to a consumer only if that consumer makes an informed choice and gives informed consent.  Every consumer must be presumed competent to make an informed choice and give informed consent, unless there are reasonable grounds for believing that the consumer is not competent. 

For a full list of your rights please see: The Code of Health and Disability Services Consumer's Rights.