One of a doula’s favorite tools in supporting someone who wants to make informed decisions in labor is to use the B.R.A.I.N. acronym.
Before we discuss how it can be beneficial, let me explain what it stands for:
- B: BENEFITS
- R: RISKS
- A: ALTERNATIVES
- I: INSTINCTS
- N: NOTHING
Using the B.R.A.I.N. acronym allows you to slow down the decision-making process. It allows an opportunity for you to explore how you feel about accepting, denying, or delaying whatever option is being presented. It can be used as often as needed and even to clarify a previously discussed option.
Let’s explore this decision-making acronym in real time.
You are in labor and feel like you may want to move forward with an epidural. As your doula, we would ask if you would like to walk through the B.R.A.I.N. acronym to help you answer any questions you or your partner may have. In addition, you will also explore how you feel about getting an epidural in this moment.
It starts with “B.”
What are the benefits of getting an epidural? Are you exhausted and need some extra rest? Have you hit your limit and want to eliminate the pain you are feeling? Do you find allowing your body to progress while you get a mental and physical break appealing?
Next is “R.”
What are the risks? The medical risks of receiving an epidural would be discussed with your provider or anesthesiologist, as doulas would talk more about the possible restrictions of having an epidural. Usually, it means your mobility is limited to the bed. However, it does not mean that movement is completely gone. It also may mean more monitoring of you or the baby. How do you feel about these restrictions? Are you ok with a change to your birth preferences?
The “A” is for alternatives.
What other options exist to get you through each contraction? Perhaps we explore more position changes, breathing techniques, or other comfort measures like getting into a tub/shower if available. Are these options in alignment with your birth preferences?
Next, we would explore the “I.”
Let’s take a look at your instincts. What is your gut saying? Deep down, what feels best to you? You may find that this may be something you need to discuss with your partner or your birth team, or you might feel very confident in how you are currently feeling. Is it possible you may regret this choice? Or are you feeling confident in this next step?
Lastly, we talk about the “N.”
What happens if we do nothing? Do you want to continue on the current path? Continue to explore your options for non-pharmacological pain relief. We can revisit this later if so desired. Your decision may also be influenced based on the other answers we gathered from our discussion.
The B.R.A.I.N. acronym is a fantastic way to make informed decisions in labor and help your birth team understand your wants and needs as you move through labor. It is also an excellent tool for making decisions as a parent to a newborn and beyond!
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