B-R-A-I-N* is an acronym for a 5-step decision-making tool that can help empower you to speak up, ask questions, communicate your needs, and come to a decision.

Benefits:
How is this beneficial to me, my baby, and my family as a whole?

Risks:
What are the risks?

Alternatives:
What are the alternatives?

Intuition:
What’s my intuition say? How do I feel about this? Do I have a strong gut feeling?

Nothing (or Not Now):
What happens if I do nothing? What if I wait to make a decision? Ask for time to decide.

For example, your doctor might suggest using a medication like Pitocin to induce labor. You might feel rushed to say yes, but have questions and feel overwhelmed with where to start.

Using this tool allows you to pause and slow things down long enough to make an informed decision. B-R-A-I-N reminds you to ask your doctor about the benefits, risks, and alternatives to inducing labor and to using Pitocin.

You might learn that inducing labor was recommended for a reason related to your baby’s health, or you might learn that inducing labor was recommended because you have been at the hospital for a long time. You might also learn that while there are important health reasons to induce labor, there is an alternative to using Pitocin that you were not previously aware of.

The tool then reminds you to take a moment to check in with how you are feeling and see whether you have any gut reactions or intuition regarding the decision. B-R-A-I-N makes room to consider multiple important things: your values, the facts, and your feelings.

Lastly, you would ask what could happen if I decide to do nothing or delay deciding for some time.

While you may end up saying yes to the doctor’s suggestion, going through the 5 steps means you are making an informed decision. The steps allow time for you to gather information, clear up any confusion, and make the decision that is best for you after taking time to consider various factors.

Because it can be challenging to advocate for yourself in times of stress and during heightened physical and emotional states, you can share the B-R-A-I-N tool with the people on your team. Consider asking your partner, friends, family members, or doula to use the tool on your behalf.
Remember that being an active participant in your healthcare is not pushy or dismissive of your doctor’s expertise; you have the right to make informed decisions.

Definition of Informed Decision Making: the provider teaches the patient about the risks, benefits and alternatives to the recommended procedure, intervention, or treatment. The patient must be competent, alert, free from mind-altering medications/pain, and the decision is voluntary.
Some Scripted Questions You Could Use:

Is there a purpose for this test?

What are these tests for?

How will this help me/baby?

What will this test/treatment change?

Are we doing this to make a change?

Will this increase my/his/her quality of life?

Ask yourself these questions:

Does this feel right to me?

What is my gut telling me?

Remember:

This is my choice.

I have the right to say yes or no to a test/treatment/medication/vaccine if I do not feel comfortable with it.

It’s a good idea to think ahead and prepare for questions you expect.