The BRAIN Acronym for Childbirth

The BRAIN Acronym can help you make informed decisions for your childbirth experience and beyond. It is a powerful tool to prepare and plan for any event including your pregnancy, birth and parenting.

What does the acronym stand for?

The word “BRAIN” in this context is an acronym that stands for several key factors:

Benefit: Consider the potential advantages and gains that can be obtained from a particular decision. Assess the positive outcomes and how they align with your goals and objectives.

Risks: Take into account the potential risks and drawbacks associated with the decision. Identify and evaluate any potential negative consequences and assess their impact.

Alternatives: Explore and analyze alternative options. Consider different approaches or solutions that might achieve similar or even better results.

Intuition: What is your gut telling you? How do you feel about each of the options?

Nothing/Necessity: Determine the necessity and urgency of making the decision. Evaluate whether it is crucial to act promptly or if it allows for further consideration and evaluation. What happens if we/I do nothing? Have we/I got time to sleep on it?

By using the brain acronym as a decision-making tool you can ensure that your decisions are well-considered, comprehensive, and aligned with your goals and objectives as well as your individual preferences.

Download my Informed Consent Handout here.

How can I use the BRAIN Acronym for Childbirth?

Here is one example of how you may use the BRAIN tool for you birth planning/decision-making:

Example – Induction of labour

Benefits

• A method of bringing on the labour when your baby needs to be born soon(er) due to risk to them or you. NOTE: induction of labour often takes more than one day!
• The baby can be born at a time when specialist attention and facilities are available. For example, paediatrician for ‘at-risk’ babies.
• Social reasons: being able to “control” the time/date of birth a little more and being able to plan childcare etc around it a little better. NOTE: induction of labour often takes more than one day!

Risks

• Unless your body is ready to birth, the progress will be slow. It can take several days to start working and you may need a Caesarean Birth if the induction process doesn’t proof efficient
• Partners are not always “allowed” to stay for the whole duration of the induction process. Often they can only be there during the official or slightly extended visiting hours. So you may be “on your own” for a while.
• It can be very uncomfortable for quite some time and you may need more pain relief compared to a spontaneous onset of labour.
• Higher likelihood of an instrumental birth using a vacuum or forceps. As a result of increased use of epidural.
• Increased risk of above-average blood loss.
• Overstimulation of the uterus, increasing the risk of causing stress to you and baby
• Overriding of your body’s natural production of oxytocin (the hormone of love, labour and lactation). This results in decreased release of your natural oxytocin in response to your baby suckling at the breast. Furthermore, this can lead to difficulty establishing lactation in the first few days postpartum.

Alternatives

• Natural induction methods such as – nipple stimulation, spicy food, eating dates, hypnosis or acupuncture.
• Caesarean birth
• Increased monitoring of the baby and wait on spontaneous labour

Intuition

How does the thought of having an induction make you feel? Are you comfortable with this option?

Nothing

What happens if I do nothing and just wait? Depending on the reason(s) why an induction is offered to you the risks can vary. Ask your healthcare provider about your specific risks to you and your baby. Find out how much time you have got to think about it. Is this an emergency? Can we get a second opinion and/or sleep on it? Ask the question “What happens if we wait?”.

When creating your birth plan or making other decisions, remember to ask the questions. And importantly use your BRAIN decision making tool to make informed decisions and choices which are right for you and your childbirth experience!

Sources and Further Reading

• BirthRights: https://www.birthrights.org.uk/2021/09/17/birthrights-and-gmc-what-does-informed-consent-mean-in-maternity-care/
• EBB: https://evidencebasedbirth.com/evidence-on-due-dates/
• Marco Mirolli, Francesco Mannella & Gianluca Baldassarre (2010) The roles of the amygdala in the affective regulation of body, brain, and behaviour, Connection Science, 22:3, 215-245, DOI: 10.1080/09540091003682553
• NHS Barnsley: https://www.barnsleyhospital.nhs.uk/services/maternity/your-pregnancy
• Rydahl E, Declerq E, Juhl M et al (2019). Routine induction in late-term pregnancies: follow-up of a Danish induction of labour paradigm. BMJ Open 9:12. https://bmjopen.bmj.com/content/9/12/e032815
• Spinning Babies: https://www.spinningbabies.com/pregnancy-birth/techniques/birth-balls/
• Sara Wickham: https://www.sarawickham.com/iol/