Informed Decision Making
Lisa Baker is a childbirth educator and mother of two in Calgary, Alberta. You can reach her by email at firstname.lastname@example.org
If you are expecting a little one, chances are you have been doing some reading on the topic. Whether you receive weekly updates in your inbox or have a nightstand full of thick books, you have likely gathered some knowledge on the topics of pregnancy and childbirth and perhaps have formed some opinions on what kind of care you would like for yourself and your little one. You are one of a newer kind of patient, an informed consumer. Individuals like you have created a paradigm shift in the field of maternity care.
We are living in an information age. Knowledge is shared with the click of a button and easily accessible to anyone with a computer, television, smart phone, or library card. In the field of health care this access to information has changed the patient-doctor relationship. At one time, most patients would come to the doctor with little or no prior knowledge and trust the doctor to provide them with all the information they need. The doctor would decide on a course of action and the patient would accept this as the best choice. Today many patients want to play an active role in making healthcare decisions. In this situation, decision-making is a shared responsibility between the physician (or midwife) and patient. Instead of being the only source of information, the healthcare provider is a guide to help navigate through the plethora of good, bad, and ugly tidbits of information to make a decision that is right for the patient. In this situation, patients are going through a process known as informed decision making.
To make a truly informed decision, you need to know some essential information about the intervention being offered to you. Here is a handy acronym to remember the questions you may want to ask when making an informed decision: iBrain.
- information – what is the intervention, how does it work, and when do I receive it
- Benefits – what are the benefits to my baby and me
- Risks – what are the risks to my baby and me
- Alternatives – is there another option that will lead to the same outcome
- Intuition – what is my gut feeling on this
- Nothing – what would happen if I choose not to have this intervention
Ideally, you will gather as much information as you can before you go into labour by asking questions at your prenatal appointments and childbirth preparation classes. However, it is hard to anticipate all possible situations in childbirth and you may be faced with an unexpected decision to make on the big day. In this event, remember iBRAIN to help you make an informed decision. It is also important that your support person is aware of this acronym, as it may be that person who is doing most of the talking as you near the end of your labour!
How much you will partake in informed decision-making will depend on you, your healthcare provider, and your particular labour and birth. There truly is no right or wrong answer. Many mothers are comfortable allowing their healthcare providers to make medical decisions on their behalf. Others prefer the opportunity to discuss medical options and then make a choice. What we do know is that when a mother’s voice is heard and she is able to have a sense of control over her birth, she is likely to remember her birth experience as a positive, empowering event. For more information on informed decision-making, visit Childbirth Connection.
In this next blog series, we will use the iBRAIN framework to discuss typical medical interventions commonly used in Canadian hospitals. We’d love to see your questions on this topic so please send them along.