How to Feel Empowered in a Medical Setting: Use your BRAINS
Updated: Jan 30, 2019
In the doula community, empowerment and advocacy are essential. There is an old saying, “If you give a man a fish, he eats for a day; if you teach a man to fish he eats for a lifetime.” Empowerment goes hand in hand with this theme. If doulas were to ask the questions for you, and make the ultimate decision for you, they are taking away your most powerful tool—your voice. I strive to empower birthing people and their families by helping them to know what questions to ask. A useful acronym is, "BRAINS." I encourage my clients to learn how to use their "BRAINS." It is extremely useful, in any medical setting, especially in a birthing situation, when fatigue, hunger and discouragement set in. It is difficult to make decisions when not all of the options are fully understood.
B. What are the benefits?
In the medical world there is a fine line between benefits and risks. It is a constant balance. When a doctor/midwife introduces a possible form of intervention, it is typically followed by its benefits. An example of this is AROM, an artificial rupture of membranes or breaking the waters. A doctor/midwife will typically do this procedure in attempt to drop the babies head down, and put pressure on the cervix encouraging the cervix to soften and dilate. The benefit of this procedure can vary, for some it helps significantly. For others, it does not. It is important then to be able to evaluate the risks.
R. What are the risks? Are there any potential risks?
Most all interventions are followed with a risk. The risk might be statistically high, unlikely, or very small. But in order to make the best informed decision, the risks need to be weighed. Referring back to our AROM example, what are the risks? One risk includes possible infection after breaking the waters. Typically, after this procedure, doctors/midwives are not concerned for the first 24-48 hours. Chances of infection are small, but if labor has stalled, knowing your options is vital. This would be a good time to reevaluate the situation, are there any alternatives?
A. What are the alternatives?
Do you have other medical alternatives, or natural alternatives? You always have options. It is your body, your baby, your birth. No one can do anything to you without your consent. If they do, that is medical malpractice. Going back to AROM, what are some typical alternatives? Assuming that the reasoning for considering AROM is to help labor progress, this is a good time to ask you doctor or doula what other things can be tried first. To help labor progress it is important to support oxytocin. At this time you could consider nipple stimulation, a warm shower with relaxing music, and the list continues. Ultimately, in this moment, it is essential to look inward and ask yourself, “What do I feel intuitively is the next best step?”
I. What does your intuition say?
No one should underestimate gut feeling. Sometimes it is a challenge to peel back the fear and follow true, raw intuition, but when you do, it is empowering. Ask yourself, “What do I think is the next best step to take in this situation?” When fear begins to creep in, and you start having doubts, stopping and asking yourself, “Is that true? Is that really true? How would I feel if I didn't have that thought?" If you would feel, safer, more secure, or emboldened, then focus on the information you know to be most accurate. Intuition is a powerful tool. As birthing people, we are given this intrinsic power to protect ourselves and our children.
N. What if we do nothing? Can we have more time?
In a medical setting, when the words start to jumble together and the room starts spinning, the most empowering word is “stop!” You are in control. If you need more time to make a decision, take more time to make a decision. Especially early on in labor, if you need to think about it, then think about it. Typically, you have time.
S. Can I get a second opinion?
After weighing the benefits and risks, considering the alternatives, listening to your intuition and taking your time with a decision, it is always an option to ask for a second opinion!
You are in control of your birth. Asking the right questions is your most powerful tool to have and to use during the birthing process.
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