Using the BRAIN acronym as a decision making tool during pregnancy, birth and early parenting.

During pregnancy, labour and birth and the postnatal period, in fact, any time you are faced with a decision to make about your health care, it is really important to ask questions in regards to any suggested course of action or intervention so that you are fully informed and fully aware of the implications. Health care providers, especially doctors, are usually allocated very short appointment times, so if you can arrange your thoughts and questions sequentially, it means that you make the most of the short time you have with your health care provider and get the answers to the questions you are asking. If you think of a question you need to ask your health care provider, write it down in a safe place and bring your questions along to your appointments.

The BRAIN decision making tool is best implemented when there is time to think about a certain course of action or intervention, it may be of little benefit during an emergency situation. This is why investing in antenatal education and making a birth plan are so beneficial – you are then able to consider how “routine” interventions or unexpected scenarios might affect you as an individual and you also have the opportunity to research and discuss them further with your health care provider and support people prior to birth (when the last thing you will feel like doing is implementing the BRAIN acronym!).

The BRAIN acronym looks like this:

B – what are the BENEFITS of this course of action/intervention?

R – What are the RISKS?

A – Are there any ALTERNATIVES?

I – What are the IMPLICATIONS of following this course of action? Will it make further INTERVENTIONS more likely? What does my INTUITION say?

N – What if we do NOTHING and/or wait for a period of time before doing anything?

Common examples of times that you might use the BRAIN acronym to help you organise your thoughts prior to or after a visit with your health care provider might be:

  • Induction of Labour
  • Elective caesarean section
  • VBAC (Vaginal Birth After Caesarean section)
  • Medications during pregnancy/labour/postpartum period
  • Epidural during labour

This list is by no means exhaustive, you can use BRAIN any time you need to make an important decision.


by Amy Vaccaro, 3rd Feb, 2018.

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