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The Red Tent

novel cover

Poster

The Red Tent of My Heart

(May Contain Spoilers)

I read the Red Tent, by Anita Diamant, when I was in nurse midwifery school.  It was was an assigned book for the last class I took before I switched programs.  I went tent camping with my husband and three children and threw it in my bag so I could keep up in class.  Once I started reading it I could not stop.  I was swept up into Dinah’s life.  Sitting in woods, by a fire I read about the lives of women.  I recognized the women from long ago in myself, my sisters, mother, daughter and friends.  It may have been the romanticism of reading the story while living in a tent, but I fell  madly in love with it.  I was already infatuated with midwifery and birth.  The way that Diamant described the interactions between women, birth and death struck me to the core.  Although I did not pursue the midwifery path, I still feel the burn of the call.  I get a glimpse of it from time to time in the hospital.  Women supporting each other in the most intimate way while walking the line between death and birth.  Although birth has become safer in many ways, birth attendants still feel and fear death lurking in the corners of every delivery room.  I believe that is why a lot of well meaning over medicalization has occurred.  Not all of it, but a lot.  The novel did a wonderful job capturing the beauty and struggle of a guiding women through childbirth.

I was giddy when I fount that the novel was being made into a mini series.  Lifetime did a decent job telling the plot of Dinah’s life.  They were’t able to capture the beauty of birth and midwifery as well as the novel.  The relationships between the women were recognized fully in the last few minutes, but were not given as much development as in the book.

I have recommended this book, over the years, to everyone that has the look of wonder in their eyes.  I recognize the look right away.  It is a look that belongs to a person that is in complete awe of birth and the power of women.  I am not the only woman that loves this story.  Red Tent communities have popped up all over social media and in real life.  Women crave the type of connections found in the red tent.  Many of us have few, if any, sisters, move far from our mothers, do not get along with our mother-in-laws and do not make time for our girlfriends.  Twenty-first century life can feel so isolating.  Births continue to bind us together.  I step into a stranger’s room and become a friend/sister/mother within moments.

The bond of women during the sacredness of birth is strong.  The trust they give me is an honor.  Like Dinah, I will carry all the special women from my life with me.  There is not a red tent for us to take refuge.  I will carry my red tent in my heart.  With it I will create the safe and beautiful places for my sisters to bring their babies into the world.

Generations of women learning, laughing and sharing together.
Generations of women learning, laughing and sharing together.

If you enjoyed the miniseries, read the novel.  You will laugh and cry and love all the things Dinah loves.

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10 Things that Labor Nurses Fear

All nurses have rational and irrational fears that haunt our waking and sleeping hours.

Here are 10 of the top labor nurse fears.

 

 

Realizing at change of shift you had a patient and didn't know it.
1. Realizing at change of shift you had a patient and didn’t know it.

 

 

 

 

 

 

 

 

 

Calling the father of the baby Grandpa by mistake.
2. Calling the father of the baby Grandpa by mistake.
Monitoring Multiples.
3. Monitoring Multiples.

 

 

 

 

 

 

 

 

 

Farting in a mother's room.
4. Farting in a mother’s room.

 

 

 

 

 

 

 

 

Calling in the OB because her cervix is complete and its really 1 cm and REALLY, REALLY thin.
5. Calling in the OB because her cervix is complete.                                                                             But its only 1 cm and REALLY, REALLY thin.

 

 

 

 

 

 

 

 

Falling asleep in the mother's room, at the nursing station, in the OR, or in the bathroom.  You are soon tired!
6. Falling asleep in the mother’s room, at the nursing station, in the OR, or in the bathroom. You are so tired!

 

 

 

 

 

 

 

 

 

Catching lice, scabies or any other critter from your patient and their visitors.
7. Catching lice, scabies or any other critter from your patient and their visitors.

 

 

 

 

 

 

 

 

 

Dropping the baby.  Those little guys are slippery!
8. Dropping the baby. Those little guys are slippery!

 

 

 

 

 

 

 

 

Not being to keep your game face on when the mom who has no drug history has a positive drug,  a mom whispers for you to check if the baby looks Asian , or a mom who bragged about her pain tolerance gets an epidural at 2cm.
9. Not being to keep your game face on when the mom who has no drug history has a positive drug, a mom whispers for you to check if the baby looks Asian , or a mom who bragged about her pain tolerance gets an epidural at 2cm.

 

 

 

 

 

 

 

 

 

 

The full moon, rain, and days that the OB offices are closed.
10. The full moon, rain, and days that the OB offices are closed.  

 

 

 

 

 

 

 

 

 

 

 

 

What fears about labor and delivery keep you up at night?

 

 

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10 Ways to Bring Back the Magic to Labor and Delivery 

All babies are special, but first babies have the unique gift of changing a woman and man into a mother and father.  There is something extra special when a family is welcoming their first child or grandchild. There is also something special about the first baby of the year. Nurses, all over the world, are betting on which mom will deliver the first baby of the new year.  Each hospital wants to be the first in the area to claim the New Years’s baby.  Newspapers will feature photos of the star newborn. The lucky first-of-the-year babies will be showered in gifts from hospitals and companies.

There is a lot of focus on the first baby of the year and nurses ensure that the birth is special and celebrated.  This is a fun tradition, but that feeling fades quickly as the never ending line of pregnant mothers stream in for delivery. Even the most benevolent and happy nurse can forget that every delivery is someone’s special day. Some days feel like just another ordinary day at work.  Nurses have bad days just like everyone else. The difference is that a labor nurse’s bad day can darken a family’s memory of their birth forever.

When labor nurses begin to lose sight of the magic of birth it is important to recharge, refresh and relearn what makes each birth special.

 

Here are 1o ways to bring magic back to labor and delivery:

 

1. Identify something you like about your patient. This may be difficult with some patients, but everyone has some redeeming quality. Find it.

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2. Smile. If you smile your patient will feel welcome and it can change your attitude as well.  Fake it till you make it.

 

funny ctm

 

3. Acknowledge and speak to all the people in your patient’s room. The mama is not the only one welcoming a baby into the world.  The patient’s family is important and they will appreciate being recognized.  Also they can be recruited to help get ice, hold legs and fan the patient.  The people in the room will be the ones that will be there to support the mom at home when she is tired and needs help. Include the whole family in patient education so that they can help mom and baby transition successfully.

 

CALL THE MIDWIFE - SERIES 3 - EPISODE 8

 

4. Include the partner or coach in conversations with the patient. A mother’s support person needs to understand and give input on the patient’s plan of care. The decisions are the patients to make, but they often look to their partner or labor coach for guidance.

Including the partner in the conversations with the patient establishes trust and is an element of family centered care.

 

lunch

 

5. Take lunch off the unit. This may be impossible at some hospitals.  If at all possible, leave the unit for your break. Go outside and breathe real air. Take a walk in the sunshine and absorb some vitamin D.

 

6. Use your relaxation skills to relax yourself.  You teach these techniques to patients every day, those same relaxation techniques can benefit stressed nurses!

 

7. Use your vacation days. Don’t hoard vacation days. People that take less vacation days have less job satisfaction.

 

vaca

 

8. Join your professional nursing organization. Keeping up to date on new research is exciting and stimulating. Challenge yourself and continue to grow in your specialty.

 

Call the Midwife - Ep 4

 

9. Go out of your way for your patient at least once a shift. They may not thank you, but you will know that you put in extra effort to make your patient’s stay better.

 

lice

 

10. When the baby is born take a few seconds to look away from the IV pump, computer and delivery instruments. Witness a new person take his first breath. Watch as a mother holds her baby’s for the first time. Look at a father’s complete reverence and amazement at the miracle that has just occurred.

 

Doris Aston CTM

 

My New Year’s wish is for all nurses to be reenergized in 2015.

Take the time to make every delivery special for your patients.

For nurses it is just another day at work, but for each mother it’s a day that she will always remember.

 

 

 

 

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Nurses are on the Nice List

I love the Nativity story. Regardless if you believe the baby in the story is the son of God or not, the story resonates. Picture a young, pregnant Mary searching with Joseph for a place to stay . To complicate matters, Mary’s birth time was near and she surely wanted to get off that donkey and put her feet up. Although there is no mention of Mary’s birth attendants, I’m sure she did not give birth alone. The local midwife, perhaps the lady of the too full inn, would have been called to Mary’s side. In the warmth of the manger the work of labor would be accomplished by a young mother, far from her own mother and sisters. The women around her would act as surrogate mothers, sisters and friends. In this sacred space a baby was born.

Over 2000 years later we continue to celebrate the humble birth. Much like the unnamed birth attendants that witnessed the first Christmas, nurses all over the world are welcoming babies into the world today. Even today there are times that there is not room at the inn. When labor rooms are full mothers are not turned away. Triage and PACU become makeshift labor rooms and when those are full, out come the partitions to provide privacy in the hallways. Nurses know that you can never “max” out on patients in labor and delivery. No matter how many women show up in labor they will be taken care of by the nursing team. Most days there are enough rooms and enough nurses, but even when it gets crazy, nurses meet the challenge and take care of the mothers and their babies.

Santa will make early and late deliveries to many homes. Special people are waiting, in hospitals all over the world, for each Christmas miracle that will be born today. Christmas babies will be greeted by smiling nurses and doctors that are missing their own little ones in order to care for others.

Thank you to all the first responders and healthcare workers that are working today to care for other people’s families. We are thinking about you while we enjoy our time off.

imageDon’t worry….Its your turn to be off next year!

Merry Christmas!

 

 

Digiprove sealCopyright secured by Digiprove © 2014 Carrie Halsey
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The Villain of Labor and Delivery

One of my favorite parts of being a labor nurse is to help a mom through unmedicated labor. Not all experiences are the same. It can be the best of time and the worst of times. The labor nurse has the supporting role in the drama of birth. She plays her part and then melts into the background so that the stars, mom and baby (dad too) can shine.

The best of times.

A mom was having terrible back labor. My arms shook with each contraction as I gave her counter pressure for two hours. Every time my arms would ease up on the pressure she begged me to please keep going. I usually would have her partner take over this physical intervention, but there was not partner in this delivery. That hurt my heart and made it more important that I help my patient in the way that she needed. When the baby changed positions the back labor subsided. She progressed into transition. Transition is the time that women change their minds about wanting an epidural, being pregnant and that they ever liked the baby’s father. Her eyes locked with mine and she reached for my hand. She asked me to not leave her. So I stayed. I stood by her side and tried to forget that I had not eaten all day, that my bladder was full and my charting was getting farther and farther behind. I was present with her through every contraction. I praised her through every break in the pain. When it was time to push she did amazing. Soon she was rewarded with a quick pushing stage and a healthy baby on her chest. It was easy to forget my aching arms when she asked me to lean in and take a picture with her and her new baby. I was pleased with her satisfaction with her birth. I was thankful that everything went well for her and her baby.

I love when I can play my designated part in the story. I don’t like when I am forced into the villain role.

 

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The times that test.

Another nonmedicated mom was not the grateful variety. She was suspicious of everything I did. This is always difficult for me, as a nurse. I am 100% supportive of my patient’s birth plans. I do everything in my power to ensure the safety of the mother and baby, provide an environment that the mother desires, carry out the doctor’s plan, and fulfill my legal and hospital mandated responsibilities. These are difficult responsibilities to juggle at times. When I am crouching on hands and knees, chasing fetal heart tones while a mom is bouncing around, changing positions and barking orders to her family, I deserve a little respect. When I am plunging my hand into the bath water mixed with vernix and other bodily fluids to make sure your baby is not stressed from the heat of the water, I am not trying to control you. When I am holding your hair while you vomit and it gets on me, when I wipe away your poop so you don’t know it happened, when I breathe in your body odor right next to my face because you need someone to lean on, I’m doing it because I am on your side. When you get to the point where you are asking me for narcotics and its dangerous for the baby I am going to say no. When this mom got to her breaking point she demanded I give her medications and it was too late. She was so angry I stepped back a bit because I was afraid she might hit me. I knew that the baby was coming. I knew that if I gave her what she wanted the baby likely would not breathe when he came out. I let her rage and continue to labor. Her baby was born within 30 minutes and was perfect and beautiful and breathing.  She never will never know that I was scared of her or that her words hurt me or that I gave up time with my family to stay late to help her.

Not every birth is fun or rewarding.  Sometimes my thighs hurt from squatting by my patients side. Sometimes I’m exhausted from trying to help.  Sometimes I stay after my shift for an hour to finish the charting that I couldn’t do while I was helping my patient accomplish her goals. When my patient is happy with her delivery it makes me happy.

Mamas thank your labor nurses. We are on your side. It is our job and we love it, but it is not easy.

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Men Need Not Apply

 

what now

 

If we, as women, want equality in the workplace, why are we sabotaging our fellow nurses? Why do we call males in the nursing profession “male nurses”? Using this phrase insinuates that nursing is a female profession. It is true that in recent history nursing has been dominated by females. Currently about 10% of nurses are male, but that number is growing. Women have fought for status among our male physician colleagues. We wanted to be respected for our knowledge, training and experience. Our sisters, daughters and friends became medical doctors by an increasing number. Gender stereotypes in medicine have been torn to bits. We do not refer to women MDs as “female doctors”.  Yet we cling to our gender biases in the nursing field. This bias is clearly evident in the obstetrical field. In the land of labor and delivery, female nurses continue to dominantly out number male nurses. This may be more design than accident or patient preference.

It starts in nursing school.

Beginning in nursing school, men are cautioned to be respectful of mother’s wishes to be cared for by women only. This warning is appropriate and justified as some cultures and religions forbid men from caring for women. Other women may have experienced sexual violence or simply prefer women only care givers. Outside of these exceptions, it should be presumed that the gender of the nurse does not matter. The hypocritical bias against men in labor and delivery is especially apparent during nursing school.  It is common for a male student to be shooed out of a patient’s room that not only has been to a male doctor, but has male residents rounding on her. The message that we are giving our fellow nurses is clear.  Male doctors are respectful and take care of patients appropriately, but a male labor nurse is, for lack of a clinical term, creepy.

I have heard the argument that men don’t understand what women need in labor, because they can’t have babies. This is a belittling and backwards notion.  If that concept is extrapolated out to other fields of nursing, then only cancer survivors can work oncology, the mentally ill can only work psych and diabetics only can teach about diabetes. There are many women that have never, and will never, have babies that are wonderful labor nurses. I have met many of these ladies and I am proud to call them friends and colleagues.

As a clinical instructor, I spoke to a patient and asked permission for a male student to take care for her during her delivery. This is not an action that I wanted to take, but what was required of me by the unit. The sweet lady agreed graciously. Her labor nurse went right in after me and sabotaged the whole plan by “clarifying” that this was a MALE nurse and he would be there for the delivery and was she SURE that she wanted a MAN in her room. When the question is posed in that way, patients may begin to feel embarrassed and feel like they should say no. Her doctor was male, which made the situation more preposterous. The student was gracious about the situation, but his learning suffered because of a nurse that felt justified in blocking him from the experience.

Is our culture biased against male nurses?

There is a cultural bias against males in OB nursing.  It begins in nursing school and is reinforced in the hospital setting. I have had multiple conversations with floor nurses, hiring managers and physicians regarding hiring males into labor and delivery. The push back is quick and strong. We don’t need men here, we don’t want men here and our patients shouldn’t have to have men in their deliveries. A survey was conducted to gauge perceptions of males in obstetrical nursing revealed that this is not what patients, nurses or men prefer (McRae, 2003). According to the study most pregnant women would accept a male OB nurse. Up to three quarters of the labor nurses surveyed had positive attitudes toward male labor nurses. Few men had worked in obstetrics, 6.8% and most said they would not want to work in OB. Male nurses did site nursing school as the reason they were not interested in OB. These results can be viewed as a tremendous positive for men who would like to pursue obstetric nursing. With very little representation in the specialty, men enjoy a favorable opinion from both mothers and current labor nurses.

Social Media weighs in on the topic.

I quick polled two of my online social groups. One is a mothers group and one is for labor nurses. The majority of the mothers reported that they would be comfortable with a male labor nurse. The ones that stated that they would  uncomfortable explained that they were exceptions. They agreed that males should be free to be OB nurses and probably would be good at the job.

Brittany Renee Dunevant summed up her feelings this way, “Women have a male doctor (OBGYN), so what is the difference? If he knows what he is doing, then he is the same as a female nurse to me.”

The labor nurse group had similar feelings. All respondents agreed that males should be OB nurses. About 46% of the nurses had worked with male OB nurses. Half of the nurses said that although there was no official ban on male nurses, it was an unspoken rule in their labor unit.

Erin L. Hollen is a perinatal nurse, certified childbirth educator and  breastfeeding counselor.  Erin discovered that she had some hidden biases that the survey brought to light. Upon reflection she observed that a male nurse may have a positive affect on fathers. Speaking of fathers Erin shares “…if they see that you can still be supportive of a woman in this situation and still be ‘masculine’ maybe they will participate more.”

Is labor and delivery a secret, girls only club?

In many hospitals the answer is yes. The new question is: How will we break down the gender bias that we are perpetuating with each new class of nursing students.

Answer: Let male nurses into OB. No questions asked.

 

McRae, M. (2003). Men in Obstetrical Nursing: Perceptions of the Role. MCN, The American Journal of Maternal/Child Nursing, 28(3), 167-173. Retrieved November 22, 2014.

 

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STAT ibuprofen and an Ice Pack (For the Nurse)

belly kissI am extremely sore today!  I am not in pain from working out at the gym, playing soccer with my kids or golfing. I am sore because I labored two unmedicated births yesterday. Tired feet and sore backs are standard fare for a hospital nurse. Swollen legs are also common, due to long hours standing in an operating room or by a critical patient’s bedside. It may be surprising that laboring a mom, that wants a natural delivery,  is a full body work out. My shoulders are stiff, my arms are aching and my thighs are sore.

Birth is magical regardless of the mode of delivery or the use of pain medications. That being said, I love unmedicated births. I love helping a mother work through the process of labor and accomplish her goals. I love the moment that the baby is born and is placed on mom’s chest as she sighs with relief. I love all of it, but it can be intense for the nurse.

Confession time, patients with epidurals are generally less work for nurses.  Plain and simple, an epidural and a urinary catheter make my job a lot easier. Monitoring the baby is easier, since mom is generally resting and immobile. There are no hasty trips to the bathroom between contractions, because the catheter is draining to gravity on the bed frame. I can relax at the nursing station, charting comfortably while watching my electronic fetal monitoring strips. I am reassured that my patient resting comfortably, with the her call light within reach. Transition consists of some rectal pressure or napping, occasionally vomiting and shaking.

Moms that go natural need their labor nurses more. Transition is different without an epidural. Mom’s have looked me in the face and begged me to cut their babies out during contractions. Then, in between contractions, insist that they don’t need pain medication. I have learned to go with what my patients tell me when they are not contracting. I know my patient, with an epidural, is complete by watching the early decelerations on the monitor or because she suddenly says she needs to poop. I can tell when my natural mom is completely dilated by the involuntary pushing she starts to do at the peak of her contraction and the change in her demeanor from desperation to intense focus.

I have been in that patient keeping her nurse busy. During my first unmedicated birth, I begged my nurse to help me during transition. She thought I meant medication, but I wanted her presence. I knew I could have the baby without drugs, but I did not want to do it alone. I needed her there, to silently bear witness of my labor and remind me that it would not last forever. She ended up catching my baby during change of shift. The doctor was trying to gown up for the delivery. He had one glove on when the baby shot out. It made me secretly happy that my attentive nurse had been the one to catch my baby.

Now its my turn to catch precipitous deliveries and bear witness to women as they labor. When I am lucky enough to care for two moms in one day that are skipping pain medication I am elated. I am also worn out!

 

 

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Birth Plan Basics: What Should I Wear in the Hospital?

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I am frequently asked about the patient gowns that women are given to wear in labor.  Mothers want to know if they should and/or have to use them.

Comfort is important.

Many moms worry more about how their feet will look or shaving their legs before labor begins than what they will wear in labor.  It is good to feel comfortable in labor.  If getting a pedicure before delivery puts a mother at ease, then she should get one! The clothes a laboring woman is wears during the hours of labor and birth may have a bigger impact on her comfort than the color of her toenails.

What are you allowed to wear in the hospital?

You do have a choice!  I have labored mothers in everything from being absolutely naked. to being covered hear to toe. You are not required to wear a hospital gown.  You can wear whatever makes you feel comfortable.  There are some restrictions in the operating room.  If you are having a scheduled cesarean section or end up there after laboring, you will need to wear the hospital gown.  Hospital gowns are preferred in these situations due to infection risks and the types of monitoring equipment used in the surgery.  If you still would like to wear something else to surgery discuss your options with your nurse or doctor.

Pros and Cons of the hospital gown

Pros:

There is a fresh one waiting whenever needed.

You don’t have to worry about getting blood, poop or vomit out of it later.

Some are designed for breastfeeding or monitoring ease.

Cons:

They are made to accommodate a large variety of sizes and usually do not fit well.

Modesty can be an issue, especially while walking in the halls.

Hospital gowns can make you feel like a sick patient and less empowered.

What are my clothing options?

Occasionally I have labored a mother whom was only comfortable completely naked.  These were all patients that were laboring unmedicated. I provided modesty when she requested it with sheets. Tank tops or breastfeeding tanks are popular.  Sweat pants, shorts or yoga pants are easy to slip off for cervical checks and are comfortable for labor.  Skirts are comfortable, modest and do not need to be taken off for pushing.  There are specialty lines for labor clothes for example: http://www.prettypushers.comThe specialty clothing is designed to accommodate monitoring equipment and maximize utility and comfort.  If you do not want to pay the specialty price, there are plenty of other options.  In my most comfortable delivery I wore a breastfeeding tank and a maxi skirt with a wide, elastic waist band.  The ultrasound and toco monitors fit in the band so that I did not need to wear the monitor belts.  I moved around very comfortably and always felt modest.  When it was time to push it was easy to pull the skirt up and out of the way of the delivery.  I did not plan on wearing the skirt again, but I was happy to find that the evidence of delivery washed out easily.  I wore that skirt multiple times in my postpartum months.

Postpartum Tips

If you choose to wear the hospital gown for labor and delivery you can still wear your own clothes after delivery.  It is good idea to bring 2-3 pairs of comfortable, stretchy clothes with you for your postpartum stay and the drive home.  The hospital’s maternity underwear are disposable and great for giant pads.  Some moms prefer to bring in their own underwear or brief type panties.  Hospitals will often provide slip resistant socks for their patients.  You can bring in your own socks or slippers if you wish.  Breastfeeding moms will spend a lot of time with the baby skin to skin during the first few days.  Nursing bras are not vital for the hospital unless you feel uncomfortable without a bra.  You may want to wait to buy nursing bras until after your first week at home since your bra size will likely change.

 

The bottom line.  

Its your bottom and you can cover it however you wish!

 toilet

 

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Birth Plan Basics: Using BRAIN

image“Well, you are the expert; we will just do what you tell us.” Admittedly it is nice to be regarded as an expert, but these are dangerous words. There is something about wearing a white coat and a stethoscope that grants healthcare professionals great power over their patients. Intelligent women and men come to the hospital and abdicate their decision making power at the door.

Your perinatal team has varied knowledge, training, experience, bias, fear, and motivation. They are experts, but they are not perfect! They have seen a lot, but they haven’t seen everything. Some have not read a new research article in years, some haven’t slept in 2 days, and some had a maternal death patient with similar risk factors as yours. Sometimes they just want to go home on time and your labor is taking too long. Some of them are biased towards low intervention, others have never met a patient they didn’t want to take to the operating room.

When you are admitted to the hospital you will not know what is behind the smiling faces and monitoring machines. In most cases what you see is what you get. Doctors and nurses that are working hard to make ensure you and your baby make it safely through labor and delivery. There are many paths to that outcome. You need to be a part of the decision making.

The first step is to get educated prior to the delivery. Taking a prenatal class is an excellent way to prepare for childbirth. I personally recommend the Hypnobabies course, but there are many other programs available. Check with your local hospitals. They often offer low/no cost courses and you will be able to learn more about how labor is approached where you will be delivering. If you do not have time to attend a traditional class, there are self study options or online courses available. AWHONN, INJOY, and Evidence Based Birth are websites that have great information.

The second step is to make a birth plan. If a written birth plan is not appealing, you can still take time to discuss with your support person and your doctor/midwife your thoughts, goals and wishes for your labor and delivery. Having a mutual understanding can help make decisions during labor easier.

Third: Use your BRAIN! Every decision you make should be collaborative between you and your healthcare team. The most important person in the equation is you. Each time a decision is required, use the simple decision making tool BRAIN.

Benefits: What are the benefits of the intervention?brain

Risks: What are the risks involved? It is important to explore this and get the full list of risks. Many times healthcare providers will mention the most common or the most devastating risks. You need to be told all the risks to be able to make an informed decision.

Alternatives: Are there alternatives? Sometimes there are no alternatives, but in many situations there are alternative interventions that can be attempted. Find out your options and if you have an alternative in mind, suggest it.

Intuition: Take a minute to think and discuss with your support person. What is your gut telling you? Doctors and nurses use intuition to care for their patients too.

Nothing/not now: What if you did nothing? What if you waited an hour or three? Time can clarify most situations. In other situations doing nothing may cause a bad outcome for you or baby. How does doing nothing affect this particular situation?

Being empowered and educated will help you have the birth experience that is best for you and your baby.

Remember to use your BRAIN!