Let’s talk about a common fear that many of us feel as we approach birth: not being sure how to make decisions during labor. If you’ve ever found yourself feeling nervous about asking questions, asserting your preferences, or advocating for yourself during pregnancy or labor, you’re not alone. Facing these situations can be hard, especially for those of us who grew up seeing doctors as authority figures. Unfortunately, it’s a common experience to feel anxious—and sometimes clam up—around medical professionals, whether during a prenatal appointment or in the delivery room.
Medical settings (like your prenatal appointments or the hospital) can also make people feel anxious about their health. Some people experience white coat syndrome. White coat syndrome is when people have higher blood pressure in a doctor’s office than they have at home. This increase in blood pressure is linked to feeling anxious and can make it even harder to feel comfortable speaking up or asking questions during an appointment.
Whether you feel nervous about speaking up to care providers or worried about your health, you need a way to make conversations with your medical team less nerve-racking and more empowering.
That’s where the BRAIN Framework comes in. This simple tool gives you a structured approach to asking questions and making decisions, whether you’re in a prenatal appointment, in the delivery room, or even postpartum. It empowers you to get clear on what’s happening so that you can feel confident making a choice.
Let’s break down what BRAIN stands for and how you can use it to feel prepared for your birthing experience.
BRAIN: Your Five-Step Framework for Making Informed Decisions
When your care provider suggests an intervention or course of action, use BRAIN to assess your options. Here’s how it works:
- B = Benefits
Start by asking, “What are the benefits of this suggestion?”
This question opens up the conversation and allows your care provider to explain why they’re recommending a particular action. Remember, it’s okay to ask for as much information as you need. You’re the one giving birth! - R = Risks
Next, follow up with, “What are the risks?”
Every intervention has potential downsides. Asking about risks empowers you to fully understand what you’re agreeing to. Sometimes, knowing the risks can reveal that an intervention may not be essential for your unique situation. Don’t hesitate to explore these with your provider until you feel comfortable with the information. - A = Alternatives
The third question is, “What are the alternatives?”
There is rarely only one way to approach a situation in childbirth. Asking about alternatives opens the door to different options, some of which may be more aligned with your birth preferences. For example, if your provider suggests induction, ask if there are other ways to encourage labor or if you might wait a bit longer before making a decision. - I = Intuition
Sometimes, the best guide is your intuition. After gathering information, ask yourself, “How does this feel?”
Checking in with your intuition can mean pausing the conversation for a few minutes to tune in to what feels right. If you’re with a partner, ask for a moment alone together to talk it over. This time is yours to breathe, focus, and get in touch with what feels best for you. Trust that inner knowing—it’s one of your most powerful tools in birth! - N = Nothing
Ask, “What happens if we do nothing?”
In some cases, simply waiting or doing nothing can be the best option, and/or can give you more time to consider your next steps. If the situation isn’t urgent, your provider should be able to talk through the possible outcomes of holding off on a decision. - BONUS: You can also think of N as Next Best Thing—taking the next best step with the information you have at that moment. All we can do is use the information we have and our intuition to make the best decision we can in that moment. If we go through BRAIN, we can look back and know that’s exactly what we did.
Tip: Sometimes it can be hard to tell how urgent the situation is. If you’re unsure, you can ask the following question before launching into BRAIN: “Is this an emergency or do we have time to ask a few questions?” If it’s truly an emergency, they will tell you! Then you’ll know you did the best thing you could in that moment – let your care provider take action. More likely, there will be time for questions and you can use BRAIN.
Why BRAIN Is So Powerful
Using the BRAIN framework isn’t about challenging your provider’s expertise; it’s about being an active participant in your own birth experience. This approach gives you a way to navigate potentially tough conversations, gain confidence in your decision-making, and advocate for what’s right for you and your baby.
And remember, it’s not just for the delivery room. The BRAIN framework can be incredibly useful in prenatal appointments as well. Whether it’s a routine checkup or an important conversation about your birth plan, BRAIN helps take the guesswork out of asking questions.
Here’s the truth: you don’t have to know everything about pregnancy and birth to make empowered decisions. No one expects you to have all the answers or remember all the information before labor begins! Instead, knowing the right questions to ask can make all the difference. When you focus on asking clear, intentional questions, you’re setting yourself up for a birth experience that aligns with your family’s well-being.
Tips for Using BRAIN in Real-Time
- Practice with a Partner
Before labor begins, practice going through the BRAIN framework with your partner or doula. Walk through potential scenarios, and get comfortable asking these questions so it feels natural when the time comes. - Bring BRAIN with You
In the intensity of labor, it can be hard to remember the strategies you planned to use. To make things easier, there’s a printable BRAIN handout that you can access at the end of this post. - Stay Open, Flexible, and Collaborative
Think of communicating with your OB, midwife, or nurse as a collaborative effort. You’re all working toward the same goal: a safe, supportive, and positive birth experience for you and your baby. While advocating for yourself is essential, keeping the vibe positive (when possible) in your conversations with care providers creates a more supportive environment. - Enlist Support
Once your labor gets intense, it will most likely be your partner who is able to ask these questions. You may be too far into labor to communicate fully, so your partner should know how to use BRAIN as well. A doula can be invaluable, too. They can remind you and your partner of the BRAIN steps, make sure you understand your options, and support you in whatever decision you make.
Take Charge of Your Birth Experience
Feeling confident in the delivery room or during prenatal appointments isn’t about knowing everything; it’s about feeling empowered to ask questions and listen to your body’s wisdom. You have the right to make decisions that align with your needs and your baby’s, and you’re fully capable of navigating this journey.
Remember, this whole birth process is a journey. By trusting yourself, asking questions, and using tools like BRAIN, you’re preparing to meet each moment with courage, no matter how the birth unfolds. You’ve got this!
Ready to feel more confident and prepared? Enter your email below for a free printable that makes remembering BRAIN simple and easy! You should also share the printable with your partner so they can ask questions too.