Informed Decision Making

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by Sarah Abigail Ejigu

abby logoAre you pregnant?  Chances are your OB or Midwife will have forms for you to fill out and papers to sign.  Imagine you are in labor, arriving at your hospital triage and you still have papers to sign, even if you preregistered!  What are you putting your name on? What are you agreeing to?  Did anyone go over this with you in a way you can actually understand?

It is the responsibility of our care providers to afford their patients what is call Informed Consent. In the medical field, Doctors, Midwives, Nurses and Nurse Practitioners, and various Clinicians are familiar with Informed Consent and can be held accountable to include this in their practices. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Ethics/Informed-Consent

In pregnancy, we mothers are most open and sensitive to receiving information.  Even the usage of the term Informed Consent implies that we will *agree* to move forward with whatever proposed measure that may be mentioned by our trusted care provider.  Some may not necessarily be so trusting and would rather approach this process with the mindset of Informed Refusal.  Both are valid, and to be neutral, nonjudgmental and unbiased, this Doula prefers the term Informed Decision Making.

When navigating our way through choices regarding our health, it helps to gather our thoughts in an organized way so that we clearly understand our priorities.  As your Doula, I use a simple acronym to guide this thought process.  BRAIN

Benefits: what are the benefits of any proposed measure or intervention?

Risks: tell me the drawbacks and potential risks also.

Alternatives: what other options do we have in this situation?

Intuition: given the above information, my gut is telling me…

Need more time? or do Nothing: take your time!  it may not be necessary to decide now.

We are definitely conditioned to sign consent forms and liability waivers when interacting with care providers, and we often do this without question… but inquiring minds want to know what exactly is expected of us when we put our signature on those papers, and how we and our babies may be affected by our decisions.  Using our BRAIN gives us power in this decision making.  And it’s no inconvenience to engage with your OB or Midwife in this way.  By exercising Informed Decision Making, you’re taking control of your choices and building a trusting relationship with your birth team.  Tell me more!  NO guessing, NO assumptions, YES please and NO thank you.  It’s YOUR birth & YOUR baby, the power is YOURS.

Learn more from Doula Abby at her website Abyssinia Birth Services.

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(Yes, that’s CHOCOLATE!) When #Pregnant, We’re Just Different: How To Maintain Sanity

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Pregnancy brain? Hormonal, x35,000? Feel like a complete MENTAL CASE?

All things pretty common when we’re pregnant.

Thoughts like:

“If I JUST had a big hunk of extra sharp cheddar cheese RIGHT NOW, everything, and I mean EVERYTHING, would be fine!” (And add to that, a few (?) pieces of chocolate, and we’re set!)

“If anyone else calls me on the phone,  I WILL HUNT THEM DOWN, STEAL THEIR PHONE, BREAK IT, AND THROW THE PIECES IN THEIR FACE!”

“I AM NO LONGER HAPPY THAT YOU WILL BE THE FATHER OF THIS CHILD!”

Woh, Nelly.   What happened? I was fine (well, most of the month, anyway) a month ago, six months ago, nine months ago.

What happened, is, for sure, hormonal changes. What exactly, and why exactly? Not clear. But we need to give ourselves a break.

The whole truth is this: When we are pregnant, we are, in many ways, simply a DIFFERENT PERSON. We have a different makeup.

We could theorize that we are in need of more protection ourselves, as we’re protecting a most fragile being, increasingly growing inside of US.

And modern day culture, which does not encourage a woman to rest for anything,  fuels us an uphill battle.

We feel like we should do it all. Be pregnant, and run a marathon, while keeping a full time job, fully managing the house, and of course, taking care of any children we already have. Not to mention keeping up a good marriage. It’s a lot. Guess what? It’s too much.

Ladies, our priority is to take it easy, however we need to, in our own pregnancies. For some women, this means energy levels aren’t much different (at least perhaps until the end of pregnancy;), and others feel a huge energy drop just after conception.

The most practical tips are simple:

1. EAT.

Eat well. (Whole grains, fruits, veggies, PROTEIN. Did I mention that extra sharp cheddar cheese? I seem to have needed that for weeks one pregnancy.)

EAT FREQUENTLY – you might prefer smaller meals, 6-7 x/s day, including middle of the night. (My husband LOVES to joke about my 3am escapades. Where’d those last two, three, four pieces of gourmet pizza go?)

2. DRINK.

DRINK WELL. (Tea, whole fruit juices, not sugary ones, and water.)

DRINK FREQUENTLY.

3. If you feel up to it, EXERCISE.

Break a sweat, work the muscles. Doesn’t have to be what you did pre-pregnancy, not even close – depends on how you feel. Just follow your body, and you’ll know what feels good during, and afterward. YOU, AND ONLY YOU, KNOW.

4. BLOOD TESTS.

Your prenatal care provider should be sending you for regular blood tests to monitor you. Iron levels, for example, can affect energy levels.

5. HOMEOPATHY/HERBALIST/DOCTOR.

If you feel like you’re drinking & eating well, exercising to your beat, and you still feel depressed, or overly low on energy, consider a good homeopath and/or herbalist. They will screen you well and determine some good supplements for you, which often do the trick. If you have a history of needing antidepressants, and/or feel that none of the above solutions are working for you, consider speaking with a doctor about medication suitable for pregnancy.

Overall, know that you know yourself. Give yourself your time to yourself. Baths, reading, napping all over the place, hire a maid (the money will come back to you), whatever you need.  (Wanna laugh? Read “The Girlfriend’s Guide to Pregnancy” by Vicki Iovine. A must.)

Relax. Drop your shoulders.

And above all, there’s no need to explain nor apologize. Just do your thing, and those around you will get it. And they’ll ultimately be happier for you, and with you. And hey, you can always remind yourself it’s for your baby.

Feel great, feel healthy,

Chaya

This article first appeared on Easier Birth.

chaya doula

Chaya Valier – Israel

Chaya is a doula with 9 years experience as well as over a year of informal midwifery studies with local homebirth mentors; considering going to nursing school and then midwifery school in Israel. Specialize in assisting women who prefer to birth without drugs, and at the same time happily support whatever the situation might be. Main focus is on relaxing the body in order to facilitate the easiest, quickest births, all the while trusting in the mother’s instincts as the central, pivotal, and overall best guiding force. www.easierbirth.com @valierbirth