A Closer Look at Advocacy in Birth

A couple of months ago, we released our Top 5 Tips for Advocating in Birth.  Today I’m going to go into more depth about this topic – and particularly deeper into the use of BRAIN – an acronym to help you remember questions to ask your care provider when interventions or courses of action are being suggested:

Benefits
Risks
Alternatives
(use your) Intuition
(what if you did) Nothing for a while.

So you are all prepared for labour, you’ve been through the DadSkills online childbirth classes, you’ve got great tools up your sleeve for helping cope with the intensity of labour and you’ve remembered to take along a small laminated card that reminds you about BRAIN – you are all set to advocate for your partner and your baby when required.

It is worthwhile now, before labour starts, to think about how you imagine situations might arise, and how it is that you think information will be presented to you.

Let me say that remembering to use BRAIN is pretty easy in a situation where a care provider gets down at eye level with your partner and says, “This is going on, we recommend that this is the next best thing, and this is what we would like to do.”  This type of approach invites discussion, you switch on and you begin to ask questions.

So what if things are not presented in this way?  What if staff are acting in a manner that gives the impression that there is no choice about what comes next, this is what it is and we’re doing it?*

This happened recently at a birth I attended.  The dad was a very confident, intelligent and well-spoken man and was not afraid to ask the tough questions.  However, the manner in which information was presented to him had him subdued.  It was not until I pointed out to him that it was possible there were alternatives to the suggested next medical path that he started to ask questions.

This had me thinking…  How could such a confident man be subdued in this way?  My thoughts are that it was in the way that the information was presented.  Information was not presented directly to my clients, obstetric staff would come into the room and talk with the midwife and tell her what they wanted her to do.  This was not put forward as a discussion, it was given as an order.

We would love the reality to be different, but things do happen this way sometimes in birth.  Your midwife will not always be in a position to present you with alternatives unless you ask her the questions. So by respectfully asking for some time, you may be able to ask her the questions to open the doors of communication and give her the opportunity to talk to you about alternatives.  If you are dealing directly with obstetric staff, then you can ask them the questions.

Let’s look at one more scenario.  You’re all prepared, something unexpected has been thrown your way and you remember to politely ask the staff to stop for a minute and go through BRAIN with you.  You ask the staff member the question “What would the risks of this be?” and you are given the answer “Minimal”, or “Nothing to worry about”.  I have heard these answers given, this is not a far-fetched scenario.   Is this an acceptable answer to your question?  No, not at all!  Medical professionals are compelled to obtain “informed consent” from their patients before any procedure is undertaken.  Giving an answer like “minimal” is not giving the information the birthing mum needs to be able to decide whether or not she will consent to a procedure.  It is also not acceptable to present a mum with one-sided information, or to present information in a way that will ensure she chooses the path they want for her.

So spend some time having a think about these things.  Think about yourself, how do you normally react to medical advice?  Do you question or ask for alternatives, or do you accept the information that is given to you?  If you are the type of person who would normally accept the advice you are given without question, yet you are planning on asking questions at the birth, I would suggest that you are going to require a conscious change of thought on your behalf for this to happen.

Your partner and your baby need you to be able to ask the tough questions.  I think, as human beings, we tend to not ask questions in a situation where we think we might look like idiots – birth is not the time to be concerned with such things.  Think of it this way, your baby is not yet born but it still needs you to be its parent, in the same way it will after it is born – and after your baby has been born you may be surprised at how protective you are!

 

[*Of course, if there is a genuine emergency presenting, there won’t be any time for discussion and it should be obvious – the room would fill with staff and your partner would very quickly be wheeled off down the corridor to theatre.  However, this situation is rare, and in any other situation there is always time for discussion.]

 

antenatal classes – prenatal classes – childbirth classes – dads to be – dad to be – online childbirth classes – pregnancy classes – birthing classes

 

3 Responses to “A Closer Look at Advocacy in Birth”

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  1. […] physically and emotionally – but also, importantly, supporting her and their baby through advocacy. After all, birth is just the beginning when it comes to advocating for your […]

  2. […] Don’t forget to check out DadSkills Top 5 Tips for Advocating in Birth and A Closer Look at Advocacy in Birth. […]

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