Informed Consent: Use Your B.R.A.I.N

Over the course of your perinatal journey you’re going to have to make some important decisions. Maybe you don’t want to be induced but your doctor discovers you have gestational diabetes and suggests an induction. Or perhaps your labor has been going for 30 hours, you are exhausted and your midwife wants to discuss an epidural that wasn’t part of your birth plan. Time for informed consent.

The B.R.A.I.N acronym is a great tool that allows you to consider and understand all of your options before making these decisions. It can help make otherwise overwhelming situations easier to navigate.

You, as well as your partner or support person, can use this to help ensure that you understand your options and make an informed decision. Part of my role as a Birth Doula is to make sure informed consent is being practiced, so in those tough moments where your provider may be asking you to consider an intervention that you’re unsure of, I’ll be there to gently remind you to use your B.R.A.I.N.

What Even Is Informed Consent?

You want to make the best decisions and you want to be informed about all of your options. This is what informed consent & decision-making is all about. Your provider must give you all of the benefits and risks of whichever option you are presented with so you can choose whether to accept the option or not. But what does this look like in real life?

Using Your B.R.A.I.N

I walk all of my clients through the acronym, B.R.A.I.N as part of the informed consent process. This method helps ensure you have all the information you need through discussion with your care team to make the best decisions.

B.R.A.I.N. stands for:

Benefits

Risks

Alternatives

Intuition

Nothing/Next

Let’s Break it Down

Benefits:

This is an easy one because usually when an option is being offered to you, it's because there are benefits in mind that are believed to help remedy whichever concern is being addressed. So ask, what are all the benefits here?

Risks:

Next, ask about all the risks that come along with the option on the table. Ask about immediate, short-term and long-term risks as well as the likelihood of those risks happening. You can ask your provider for handouts and more information for you to review if you’d like.

Alternatives:

Are there any alternative options to remedy this concern? Sometimes providers present one option because it is the option they believe to yield the most benefits for you and your baby. So ask about the alternatives so you know what all your choices may be.

Once you have all the alternatives, go through the risks and benefits of each, so you can weigh them next to each other. In most cases, you may find your provider’s original suggestion is the best and go with it. But you don’t want to look back and realize there were options you didn’t explore.

Intuition:

What does your intuition say? Sometimes we hear something that makes sense and sounds great in our heads, but our gut is saying no. Just like we may be presented with an option we don’t want and our head is saying no, while our intuition knows it’s the best decision. So listen to your intuition.

Nothing:

Ask your provider, “What happens if we do nothing?” Sometimes time is what you need. Whether it's time to let things run their course or even time alone to think about all this information, talk about it with your partner and come to a decision. Most decisions during pregnancy and labor are not urgent or emergencies. You usually have time.

If the information you received presents and option you want to move forward with, ask what happens next. How do you prepare? Are there side effects or other potential procedures that come along with this option? Do you have time to process your decision before you move forward?

Even if your pregnancy and birth don’t go exactly how you’d imagined, using your B.R.A.I.N. to navigate informed consent and decision-making can help you remain focused, respected, in control of your choices and empowered in knowing that no matter what, you did the very best!

Always remember that most decisions you’ll be faced with on this journey do NOT need to be made on the spot. There are very few situations in which you will not be able to take even a few moments to think through all of your options before making a decision.

I’ve also found that this acronym is helpful even outside of birth-related situations and can be used for just about anything, so it’s a great tool to have in your back pocket for the rest of your life!