Childbirth is ultimately unpredictable. We can make birth plans, seek out the best providers, hire doulas, take classes – but, in the end, things can happen that are still out of your control. A downside of having a very specific birthing goal in mind is that it is harder to adjust if needed.  It can also be quite difficult and overwhelming to be faced with making a decision in the midst of labor, especially if it goes against what you originally wanted.

A helpful tool you can use in making informed decisions is…

your B.R.A.I.N.!

That’s right, your B.R.A.I.N. can assist you in making well-informed decisions at a moment’s notice – whether it’s during your pregnancy, labor, postpartum, or other life situations.

Here’s how it works…

informed decisions choices

So, let’s walk through an example where using your B.R.A.I.N. may help you.

You have been in labor for many, many hours without medication. Your birth plan was to have a non-medicated labor and delivery but you are feeling drained and exhausted. “This is really hard,” you think. Your care provider mentions that an epidural may help you get some needed rest before it’s time to push. Part of you feels that you really want to avoid medication, as planned. But another part of you feels that you just need a break to get through the rest of it and wonder if the epidural would help you.

Your mind can begin spinning with thoughts, unsure of what to do. Simultaneously, you are powering through contractions and drained to your core. How do you make a decision in this situation?

It’s important to note here that during labor, your body naturally wants to “shut off” your thinking brain. Doing so allows the proper hormones and bodily processes to flow the way they need to during labor. So it can be beneficial to use as little thinking power as needed to get back to that “non-thinking” labor state.

Using your B.R.A.I.N. can help you think through the things you need in order to make an informed decision to streamline the decision-making process.

Your list may not look anything like this list, because your feelings may be different. Be honest with yourself and others to achieve the best birthing experience for yourself.

“Should I get the epidural?”


  • It may help you rest for a while to regain your energy
  • It may help you relax, which can lead to further dilation and labor progress


  • It may slow labor down, causing slower progression
  • It may lead to further interventions, such as oxytocin to speed labor back up
  • Risks of procedure: infection, headaches, misplacement, etc.
  • Must remain in bed / Limits mobility


  • Hydrotherapy (tub, shower) – do they allow it?
  • Can you increase or change the comfort measures being used? – massage, movement, hip squeezes, counter pressure, etc.
  • Other pain medications – nitrous oxide (laughing gas), IV medication – do they offer it?


  • What is your gut telling you?
  • Do you lean a specific way naturally without any necessary reasoning?

Nothing / Need Time

  • What would happen if we do nothing right now?
  • Do I want to wait 2/5/10 more contractions and reevaluate?
  • I need more time to think about it

After considering all of this, you should begin to have an idea of which way you lean. You should discuss the benefits, risks, and alternatives with your care provider to understand the medical benefits, risks, and alternatives involved. But even just knowing to ask for these things can help you through any medical decision you may face, even outside of labor and delivery.

While we hope your labor and delivery go exactly as planned/wanted, it’s important to always be prepared and educated.

Knowing how to explore options and what questions to ask your provider can enable you to feel confident in whatever decisions you make.