I recently wrote a handout for my childbirth classes (edited slightly for this post), and I am sharing it with you here. The words below, which are italicized, are not in the handout I give to class members, as I teach at a regional hospital.
The BRAIN Method for Informed Decision Making
When a health care provider advises a treatment, course of action, or medical intervention, remember to use your BRAIN and ask the following questions:
B - What are the Benefits of this intervention for mother and baby?
R - What are the Risks of this intervention for mother and baby
A- What are the possible Alternatives, both medical and non-medical?
I - What is my Intuition or gut feeling? (question for yourself)
N- What if we did Nothing, or did Nothing at this time and waited a while before intervening?
(Note: Believers have a special resource. "If anyone lacks wisdom, you should ask God, who gives generously . . . " James 1:5 NIV. Even if you feel unsure about your final decision, you can trust in a loving, sovereign God that your decision is in the plan He has had for you from eternity past. It will the the "right" one for you and your baby in His plan for your and your baby's life.)
EVERYTHING has risks and benefits. No one can control every aspect of labor and birth -- even the best doctors and midwives. One intervention can lead to another. This is known as the "cascade" of interventions." Some results of interventions are not immediately obvious, but show up in the first days of breastfeeding.
Your body is designed to give birth. Humans are the only "mammals" who doubt their ability to birth their young. Trust and learn to support the natural process. Try to intervene only if necessary. If you have been reading my recent blogs, you will know that doulas are labor support professionals who know how to support the mother who desires minimal intervention. Consider hiring one as a member of your birth team.
Sometimes there is need for medical intervention, including the mother's desire for pharmaceutical pain relief measures. Still, how labor and birth is handled should be based on the research evidence (from the body of research, ot just one or two of many studies). Care providers differ in education, experience, philosophy, skill, time management, and so on. These can influence the advice they give in non-emergency situations. That advice can affect your birth experience. Respectful, open discussion, based on the research evidence, is necessary to make an informed decision.
How labor is handled can affect breastfeeding. Breastfeeding affects the health of the mother and baby throughout life. Some intervetions are known to cause problems with the baby's ability to nurse. They can cause a delay in mature milk production, which can lead to formula supplmentation. Early formula feedings prevents the baby's immune system from setting up properly. Certain procedures, like putting baby on mom's tummy immediately after delivery and keeping it there until the baby has self-latched promotes successful breastfeeding. Labor interventions need to be considered in light of how they might affect breastfeeding.
Whatever the situation, discuss any concerns with your care providers until you are comfortable making your decision. Once you make a decision, OWN it. It is not right to make a decision -- whether or not it is in agreement with your care provider's preference -- and then turn around and sue him or her if the outcome is not what you wanted. If you want the right to make an informed choice, accept responsibility for that decision. Be prepared to sign a waiver, if necessary, for your care provider's peace of mind if your decision differs from his or her recommendation.
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