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How to use our B.R.A.I.N.


When in labor, feeling the contractions and the multitude of emotions that come with the situation, it can be difficult to make decisions on interventions presented by medical staff. If you have a birth plan that has been discussed with your provider during a prenatal visit, some situations can be answered and known before hand, but there will be information or possible interventions that will be discussed while at the hospital. When this happens I always recommend to my clients that they use the acronym: B.R.A.I.N.


B: Benefits, what will the benefit of this intervention be for myself and the baby

R: Risk, what are the risks involved with this intervention

A: Alternative, what alternatives are there to this intervention

I: Instinct, what is your gut instinct telling you, this is a very important step

N: Nothing, what will happen if we do nothing

(If more info is needed you can add a Pro/Con list)


I bring with me to every birth a booklet that I made that has every intervention and the B.R.A.I.N. answers associated with each. I don't typically bring it out, but I like to have it as a reference guide if needed. If you have a Doula as part of your team, they should be able to help you answer B.R.A.I.N. situations. A doula should be unbiased in their answers and provide evidence based answers to inform, but not make the decision for you. If you don't have a Doula, your nurse and doctor would also be able to answer any questions.


Below is an example on how to use B.R.A.I.N for two possible interventions


Nitrous Oxide

B: Decreases the perceptions of discomfort and may help bring relaxation and reduce anxiety

R: Risks are primarily to the birthing person and may include: sedation, dizziness, nausea and vomiting

A: Tub, shower, massage, relaxation, breathing, narcotic pain relief or epidural

I: Discuss birthing person's Instincts

N: Revisit in an hour and see if it is more appealing


Artificial Rupture of Membranes (Breaking your water)

B: Baby's head will apply to the cervix and help with dilation

R: Once your water breaks you are "on the clock"

A: Walking, squatting, position changes and continuing labor naturally

I: Discuss birthing person's instincts

N: Revisit in an hour and see if it is more appealing


Pros: If labor is stalled, breaking water can jump-start labor, works better after 2-3 babies

Cons: Starts the clock (18-36 hours if making progress), a high fever indicating infection could occur, high heart rate, prolapsed umbilical cord, more intense pain from contractions


Unless you are in a true emergency situation, there is always time to use your B.R.A.I.N., it will help you to feel more in control of your situation and make informed consent.



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