Making decisions with BRAINS and HEART

Edited extract from The Positive Birth Book, by Milli Hill

When helping your clients formulate a birth plan it’s a good idea to encourage them to not only consider all their choices but to also think about what their labour and birth might look like if things do not progress according to plan A. 

Introducing them to the concept of making decisions in labour with B.R.A.I.N can help them to feel empowered and prepared.

B – What are the Benefits? Ask your HCP what the benefits are of the intervention that is being offered, and consider what you feel the benefits will be to you personally. For example, might breaking your waters get your labour moving and would this be a positive thing for you?

R – What are the Risks? Find out what the risks are that come with this procedure. Ask for the clear facts and the evidence upon which they are based.

A – What are the Alternatives? Are there other options or course of action that you could take? Ask what they are and apply your BRAIN to them too!

I – What does your Intuition tell you? Listen to your instincts and tune into your body and your baby. Trust that, deep down, you know the best course of action for you and your baby.

N – What happens if we do Nothing? Ask your HCP what will happen if you just wait and see what happens, for ten minutes, half an hour, or more. You might appreciate this time to take the pressure off, breathe, and reflect.

S – Space. “Please can we have some space to consider what you have told us and discuss our options.”

Bringing a new life into the world involves a strange mix of fully and consciously preparing and then completely surrendering to the process of birth. However, it’s really important to remember that even if birth deviates a long way from your clients hopes, there should still be elements from their original plan, for example optimal clamping, that they can retain in almost any circumstance.

They can use the HEART acronym to remind themselves of a few vital elements when birth doesn’t go the way they had hoped. Birthing from your H.E.A.R.T

H – How can I keep the important hormones flowing?

Oxytocin – known as the Love Hormone – helps with birthing, bonding and breastfeeding. The hormone of fight, flight and panic – Adrenaline – inhibits its release. It might help to dim the lights or ask for some quiet time alone together without interruptions – even for ten minutes – so you can get back in a relaxation ‘zone’ and kickstart your mammalian instincts. If there simply isn’t time for this, try to focus on love – love for your partner and love for your baby – and aim to banish adrenaline and welcome back oxytocin. Birthing with love, even in theatre, can mean better bonding and breastfeeding, and more positive memories after the event.

E – What Elements of my birth plan can I retain? Just because birth is not going the way you wished, doesn’t mean you have to completely abandon every single one of your hopes. If you wanted certain music playing, for example, might this still be possible? Or can it be played soon after the birth instead? Or if you wanted skin to skin, can this still be arranged? If not, ask why not. If something is important to you – try to keep it in your plans.

A – Baby in Arms as soon as possible. No matter how you birth, try to make sure your baby comes to you as soon as possible afterwards. Even if medical complications mean that this is not immediate, try to make sure that both you and your partner get to experience this unique time of meeting your baby. Try to get someone to take a photo as many mums say that they really treasure these pictures at a later date. Make this your priority. Everything else can wait.

R – Find your Resilience. When the going gets tough…call on a mum. Mums have strength and courage by the bucket load, and many of them first contact this warrior side of themselves as they struggle to bring their babies into the world. You may not feel strong as your birth plans fly out of the window, but you are. You may not feel strong in the days and weeks after you’ve given birth, especially if you’ve had a difficult or traumatic experience, but you are. You might need help and support to recover – and it takes strength to ask for this. But recover you will, and in that process, remember the strength that brought your

baby into the world, and draw on it as you move forwards into the many and various challenges of motherhoodT – Allow yourself Time. Birth is a big deal. Women remember minute details from their birth for the rest of their lives. Don’t be discouraged from taking what happened to you in your birth experience seriously. If you lost track of Plan A or even Plan B, you have a right to feel sad, disappointed, or traumatised. You have a right to grieve this loss. It doesn’t mean that you don’t love or appreciate your healthy baby. Take your time. You matter too.