Using your BRAIN: Soliciting Informed Consent

Using Your BRAIN: Soliciting Informed Consent
So I am going to be teaching (mentoring) Documentation and Charting to the new group of students going through Nizhoni Institute of Midwifery. Of course, since this is the first time I have been asked to teach this module, I have to figure out what I’m going to say and how I’m going to have a fun spin on things. I am an intra-personal learner so me teaching it is as much as a benefit to me in reviewing the basics of midwifery as it is for the women in the class learning it the first time. I do know that I’m going to start with discussing charting as storytelling, and that it is good to know who the story might be for in the future. However, unlike verbal storytelling, this is a story, that once written, cannot be changed. It is also a story that can be quite different than the mother’s story or father’s story or even the midwife’s or physician’s story since it doesn’t include emotions, mental processes, transformations, or even triumphs.
So I of course learned something new preparing to teach….and basic. In my Birthing From Within childbirth class we discuss using our BRAIN to help in formulating questions to ask before, after or during the birth. It is an acronym for Benefits, Risks, Alternatives, Intuition and Nothing. This can also be a good role-playing moment whether it be for induction or where you want your kid to go to school or immediate postpartum decisions such as when or if to cut the cord. As another BFW mentor so wonderfully pointed out, as parents, you’ll be better received in asking the questions if you personalize them. For instance, instead of asking, “What are the risks?”, it can be personalized to saying, “So what would go along with that?” or “Is there anything else that we could do or that you might suggest before ____________?” or “How would that change what we are doing now?” or “What else would have to be done if I went ahead and ___?” or “What would happen if we waited an hour and then made our decision?” At the same time, I remind couples that they are only as smart as the people with whom they are asking the questions. That person’s world’s view helps frame how they answer the questions. Ok, but at least they know that certain resources can be limited..
In any case, back to informed consent. BRAIN (except for the Intuition part) is really just asking for and guiding them to give informed consent. (Okay, maybe some of you just said, “duh.”) Somewhere in my mind I had delegated informed consent to be equated with speeches, small print, and signed waivers (not that a good documentarian isn’t writing this all down). What my “aha” was is that BRAIN wasn’t just soliciting information to make decisions, it was creating a mechanism to fill in the void for the lack of informed consent given by care providers. I know this is small, but really BRAIN is just another way of saying, could I have some personalized / individualized informed consent over here.

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