Joyful Families

Decisions, overwhelm and self advocacy

Decisions are an inevitable part of life. We make small decisions every day. Big decisions, like deciding to have a baby, may come easier to some of us than others. But we can all second guess ourselves when we’re made aware of the importance of the decisions we make.

As soon as you decide to have a baby you will start to be presented with more and more decisions. These decisions may also feel like they are more of a responsibility as they will affect your child as well as yourself. So if you feel a bit overwhelmed and tempted to go with the flow you’re not alone.

The trouble with the flow is it can take you places you didn’t want to go. Doing whatever you’re told may also seem like the easiest option but you are an individual and you may find some times you love the average recommendation and other times it makes you feel on edge and the suggested course of action may or may not feel like the right one for you.

It’s important to know that all of the medical care on offer to you throughout your pregnancy and birth is just that an offer. It may not feel like an offer when presented by someone who assumes you will do the same as most people but you are allowed to accept or decline. If you make a decision that isn’t the ‘hospital policy’ or usual way of doing things then you’re not being difficult or troublesome (and if you were so what, maybe it’s time to embrace not being a “good girl” but that’s a question for another time). Ultimately your healthcare workers aren’t the one’s who have to live with the decisions you make, that’s you. Your own health and your baby’s health don’t matter more to anyone else than they do to you.

Before we get too far into thinking about making decisions a quick note for the over-thinkers. If you take a lot of time and energy to make simple decisions in life like what to have for dinner or where to go on your daily walk then you might need to take a different spin on this whole thing. Pregnancy is a great time to learn a skill that will serve you well through your years of parenting -not sweating the small stuff. If you know you are or are at risk of being an over-thinker you may want to skip this and focus on connecting with your intuition and instincts.

This may all feel overwhelming but take a breath you don’t have to make any decisions instantly or without any support. You have people around you who love and support you and a medical support team too. You can ask questions and take the advice that feels right to you as much as you can ignore the advice that doesn’t resonate with you.

When decisions feel overwhelming or complex there are things we can do that help us have a clear head and feel positive about our choices. Talking things through with someone you trust, asking questions of the medical professionals responsible for your care, seeking out evidence based information sources and checking in with your gut instincts will all be useful. But ultimately you will have to trust yourself to make the best choice for you in the situation and with the information you have. Knowing both that you can change your mind if the information or circumstances change and that you can be kind to yourself even if in retrospect you end up wondering if a different decision would have had a different outcome.

One of the benefits of doula support is that your doula fully believes in you and that you are a trustworthy source of information about what’s best for you and your baby. Spending time with that positive energy can be infectious, having a doula can increase your self confidence and self advocacy.

Doulas and Decisions

Just to be very clear as your doula I don’t care which decisions you make. I don’t think any one choice is better than another choice. I don’t believe there are birth choices that are morally more correct. I actually don’t believe it’s possible for you to make the wrong choice. But I do very strongly believe that you should be allowed to make each of your decisions with all of the information you want (from evidence based sources) and with honest and forthright medical advice (from your care provider never your doula) when you ask for and have the right to expect it as a normal part of your care. I will never make decisions for you and I will always check in with you that you’re sure you want to stick to a decision and to let you know if how you feel changes you’re not stuck with something you thought you would want when you weren’t in labour.

The BRAIN acronym

One of the tools that can help when making decisions is the BRAIN acronym. This helps us remember types of questions to ask ourselves and our care providers to support our decision making.

Starting with B which stands for Benefits. If you’re considering a choice the first thing you will want to know is why it’s available, what good can come from making that choice. Why would I want to do this?

The R for risks is the other side of this coin. It’s rare that anything in life be completely risk free. We take a risk every time we cross the road or get in a car for example. It’s important to know what the risks are be they medical, safety, psychological anything that matters to you. Everyone will have a unique understanding of any risk and whether it feels right for them or not.

The A is for Alternatives. It’s possible there may be situations where there is no alternative but those are rare and probably medical emergencies when there will also be no time to have a discussion or a think just to react. Most of the time, there are several possible alternative courses of action. The risks and benefits of the alternative options can also be explored.

With the I for Instincts we move on to a question you ask yourself. With all the information you’ve gathered what’s your gut reaction to which is the right choice for you. Sometimes this is easy to feel and you’ll find that the information you’ve been given backs up what you thought your decision would be when you started this process. Sometimes it can be difficult to connect to your instincts especially in a world where we’re often encouraged to intellectualise our emotions and where we spend so much of our lives (particularly through our school years) doing as we are told rather than learning to trust ourselves. One thing you can do for yourself while you are pregnant is to get to know yourself better. Start to spend time each day quietly listening to your body, thinking about how it feels when you’re relaxed and how the feelings in your body change when you’re feeling, tired, in pain, stressed, on edge, etc.

Finally the N is for nothing. What would happen if we did nothing. Not making a decision is still making a decision, it’s just a decision to do nothing and it will have consequences just as the decision to do something does. Ask your care provider what are the risks and benefits of waiting for a while before making this decision and ask yourself if your gut is telling you that’s the right thing to do.

There’s a worksheet to help you work through the BRAIN questions in the resources section of this website. If you’re facing a decision you would like a bit more support or information while you make it then feel free to book a “power hour” with me. I’m really good at listening and asking questions that can help you clarify what you want and what choices will give you the best chance of getting that.