Informed Choice

Posted on September 23, 2010 at 3:45 PM

In labour we are often told “do not think about labour, just do what your body tells you to do”. This can be hard to do when you have decisions to be made in the middle of a concentrating on your labour. What might seem like a small ‘yes’ can quickly cascade into something else. It is very important to educate yourself, your partner and the rest of your birth support team, before labour on all of the potential outcomes of you decisions. This is where a Doula can come in handy. They can offer impartial information at a critical time in your labour to help you in your decision making.



When I was training to become a Doula we were taught the BRAIN thought process for decision making, and I will share it with you. It is a great tool to fully explore any option, dealing with childbirth or anything else you may encounter in your life.

Benefits  What are the benefits of us doing this? Will this solve a problem, or cascade to


Risks  Are there any risks associated with this? Do the benefits really outweigh the risks? What would the next step be if we follow this route?

Alternatives  Are there any? What are they? What are their benefits and risks?

Intuition  I am a huge believer that parents know best. They are also the ones that have to deal with any of the following emotions with making any decision.

Nothing  What will happen if I/we do nothing? What will happen? This can be the most important part and is often overlooked. You always have the option of doing nothing.


How many women that have given birth can actually say that all of these categories were covered when and intervention, test or procedure was done to them? Or was a lot of what happened done out of ‘routine’. Something as simple and routine as getting an IV. It is just part of the hospital routine. Not many Moms-to-be know that they have the option to not have one, or that they have an alternative known as a Hep-lock. Sure, it might be needed, and it seems like a good idea. No one told me of the risks, or that I have an option. So sure, let’s get one, just in case. But few realize that now they have this uncooperative pole to drag around and a hand that can’t be moved freely. But I wanted to get in the tub!! Can’t, I have to keep the IV dry, and I might get it infected. “Well, no one told me that!” Were you really given ‘informed consent’?


This is how any information should be presented to a mother in pregnancy, labour and the postpartum period. Why should we expect the Mom in LDR #1 to progress at the same rate as Mom in LDR #3? They won’t. And until Moms are given real information and allowed to make the choices best for them, not the doctor, midwife or nurse. Not the latest study, recommendation, or style. We will not be given true informed consent. In the next several articles, I will provide an in depth, unbiased information on common interventions encountered during pregnancy and birth. Please keep in mind that this information is not to replace medical advice, but as a platform for you to become informed, and to open discussion between yourself and your care providers.

Categories: Pregnancy, Labour

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