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Pregnancy marks many women’s first significant introduction to the healthcare system. Suddenly you are making all kinds of health-related decisions for yourself and your baby, from whether or not to undergo a diagnostic test, to figuring out what pain management approach to use in labor. The information you hear from your care provider, your friends, and the media can be contradictory and at times downright confusing.

Whatever healthcare choices you are contemplating, you can positively impact your ability to make sound, personally appropriate decisions by learning to be an informed healthcare consumer. BRAIN is a simple acronym to assist you in gathering the information you need to make informed decisions about your own and your baby’s health care. Taken together, the BRAIN acronym provides a logical, comprehensive framework for eliciting information from care providers and creates a broad context for decision-making. This simple acronym is also useful in many arenas you will enter as an expecting or new parent: it can be used to look not only at health care decisions, but childcare related decisions, approaches to parenting, etc. Congratulations on your pregnancy and good luck with your decision-making!

What are the benefits of the particular diagnostic test, pain management approach, medication, procedure, protocol, etc. being considered? This is an important question to ask in today’s healthcare climate, where so many choices are available. Other questions might include: What problem will this solve? How will this be helpful? If a test suggests a problem, how serious is it? If a treatment is suggested: How is it usually done?

What are the risks of a given test, procedure, protocol etc? What are the risks relative to the benefits? Are there any side effects? What sources of information do you suggest I use to inform myself about this issue? If this is not successful, what is the next step?

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What other approaches might be taken? Particularly in pregnancy, where we are usually dealing with a healthy process rather than a disease process, there may be multiple approaches to a similar situation or condition. Teasing out potential options helps us to identify alternatives that fit with our particular circumstances, so that we feel empowered, rather than pressured, in the decisions we make. If alternatives are available, go through the BRAIN acronym for each one offered.

What does my gut say about a particular test/procedure/intervention/protocol? Intuition is an important and often overlooked piece of information: taking the time to listen deeply for what our intuition is telling us guides us toward decisions that are rooted in our own values and experience. Including intuition in your decision-making process leads to decisions that have an internally derived logic, integrity, and authority.

What would happen if I do nothing? Other questions might include: What would happen if we wait an hour? A day? A week? You might apply the first part of the BRAIN acronym to doing nothing: What are the benefits of doing nothing? What are the risks? What are the alternatives? What does my intuition tell me?

Going through your paces, perhaps multiple times if time allows, will give you a solid foundation to make the choice of informed consent, or informed refusal, about the many medical diagnostic tests and procedures that may be offered to you during your pregnancy.

This article was first published and on the OmMama website in 2009 and is shared by permission.


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