Ep 77: Informed and Shared Decision Making

Informed and shared decision making is an evidence based practice that is proven to increase client satisfaction, increase positive relations among the care team, and increase levels of trust. In this episode with Doula Rachael, you will learn the benefits of informed and shared decision making and the things you can do now to help you navigate your pregnancy, birth, postpartum, and beyond with more ease and confidence.  You matter, your birth matters, how you feel while giving birth matters and your birth has the potential to change you forever (good or bad and everything in between). The goal is for you to have the tools and resources to ensure you have the best chance at having the best and safest birth possible. 

This podcast was created from a desire to share conversations and interviews about topics from pregnancy and birth to motherhood and the importance of a healthy body and mind through it all.  Our goal is to bring you fun, interesting, and helpful conversations that excite you and make you want to learn more.  We hope what we share will make an impact and help someone else along their journey.  We believe that when you are aligned in body, mind, and your intuition, you can conquer anything!  If you like what you are hearing and you don’t want to miss our newest episodes, be sure and tap subscribe. Your support is greatly appreciated.

Transcript

0:08

Hello and welcome to the aligned birth podcast. doula Rachel here and today I am sharing with you a topic near and dear to my heart. It is something that I spend a lot of time. My co doula partner and I spend a lot of time talking with our clients about to help them prepare for birth in a meaningful and effective way and it is informed and shared decision making. So today we're going to talk about what is informed and shared decision making. Why does it matter? What are the benefits? What's the evidence tell us and then you're going to learn how to achieve it so that you can have a birth that is meaningful and satisfying and empowering. Let's dive in.

0:53

So first, I wanted to begin by talking about the definition of informed and shared decision making. So through the course of care, the provider so your midwife or obstetrician, communicate evidence based information engages you the patient and an exploration of your respective values, knowledge and experience and elicits a preference based on the results of that exploration. So to break that down, this is where the provider offers information based on what's happening with you. You have an opportunity to ask questions, explore, state your preferences, you know, ask for more time, and then together you work towards a decision that aligns with you and meets your individual and unique needs. Okay? This isn't always the case in maternity care. And so it is something that we have to learn about and practice so that you can have the best chance of having the best birth possible. So maternity care in the United States is becoming increasingly complex. And procedure intensive, and patients often have inadequate knowledge to make informed decisions. So informed and shared decision making is an evidence based practice that is proven to increase client satisfaction, increase positive relations. Among the care routine, and increased levels of trust. And who doesn't want that right. This feels like it should be a baseline of care. But unfortunately, it's not and there are many reasons for that. I don't believe that it doesn't exist because providers are out to create bad experiences at all. I think our medical care system is currently not structured to support this type of individualized and time intensive care that you deserve. So you have to advocate for it. You have to if you want to achieve it, and providers want you to have that experience. I believe that in my heart, this is not I don't think that providers don't want that. It's just the structure of the care system doesn't always foster it. So we have to push for it right.

3:11

So in an effort to combat this, I want you to aim for informed and shared decision making during your pregnancy, birth and beyond. So learning this practice now doesn't just benefit you now it benefit you forever. It is a tool that once you learn it, you can use it for anything that comes down the road, going to the doctor for yourself, the pediatrician for your baby, you know your partner is sick and you have to go the doctor with them. You can use inform and shared decision making tools to seek the best care possible. So my goal is for you to know that you are the consumer. You have every right to ask questions. You have to advocate for yourself and choice of care provider matters. We can't have that collaborative, informed and shared decision making without a provider that you trust. If it is just one sided in you pushing for informed decision making and a provider who doesn't support it, you're not going to get very far it's gonna be a lot more resistant and hard.

4:17

So this idea or this approach might feel new to you might be new territory for you and that is perfectly normal. If if you feel insecure with this idea and doubt that you can or should, which I'm putting showed in quotation marks. Initiate this practice with your provider. Please know you are not alone. When I was pregnant with my first nine years ago, I learned about informed and shared decision making and the tool that I'm going to share with you here I learned then and before that point, so I was 29 years old. Before I had 29 years of my life before that I had not known that as a patient. I had a right to ask questions to be an active participant in my care. So what I learned during my first pregnancy was being an active participant made a huge difference in the care I received and my outcomes and how I felt during that process. And so that is why I care so much about giving you the tools and talking about this with you so that you have that opportunity to because sometimes it just takes like a little bit of drip of an idea. Or maybe you hear over and over again over time for it to resonate and for it to make an impact. And so I talk about this concept a lot in an effort to hopefully impart on people over time. They have these rites that this matters and makes a difference in their outcome during pregnancy birth and beyond.

5:52

So if you're feeling like oh my gosh, I don't know where to begin. I feel very nervous asking questions to my provider. I don't you know, have the confidence to that. Please know, you're not alone. And I was there too. So I what I'm talking on and teaching on has been many, many years of growth and evolution.

6:09

It's like a muscle right? We have to exercise it. So that's what I want to encourage you to do. Just take baby steps and just kind of like any major life event that you plan for are prepared for you know, you got to do your research, you got to ask questions. You got to do everything you can to have the best birth experience possible. Birth is no different than planning for a big vacation or planning for a wedding or any other type of event that you might pour a lot of time and effort and energy to birth is no different. You do not have to surrender all your feelings, your rights, your personal preferences because those matter. You don't have to surrender your opinions or your innate wisdom that you have. You do not have to let all that go because you are pregnant. Like this is the time to actually tap into those things, to strengthen those things to find them and let them shine because doing that now gives the potential for you to be able to tap into those things later in life. Like through postpartum through motherhood, right.

7:17

It's a great opportunity to increase your confidence in yourself as a mother and as a person. So what can you do? So how can you prepare now for what is to come? So that you can have the best birth possible that is my goal for you to have the best birth possible? And I will say that this is not about giving birth a certain way. This is not about having an unmedicated water birth or having a perfectly calm peaceful birth or whatever it is. It's not there's not a right way to give birth. And that doesn't equal empowerment or satisfaction. It's how you feel through the process of pregnancy, labor and birth, how you're treated, how you advocate for yourself how you navigate the unprinted unpredictability of birth. That's what helps you feel good on the other side of this. That's how you end up feeling empowered and satisfied and confident. It's that you took control over the process and you initiated your autonomy and your rights during this process. Because birth is unpredictable. We can't We can't tie our satisfaction to one particular outcome and one particular way of giving birth. It has to be that we're going to do these things, certain things to help achieve, you know, autonomy and independence and, you know, whatever it is that you need to feel good along the way. That's the goal.

8:48

Okay, so, I want you to feel safe, healthy, satisfied, empowered, no matter how your birth unfolds.

8:56

You have to view yourself as the consumer the one in the driver's seat, the one who knows your body, your history, your needs and your baby better than anyone else. This may not come easily and that is okay. Your awareness of it is the very first step and then keep moving forward and taking the next step and before you know it you'll get there. And so I want to also counter what I'm saying here with you in the driver's seat. You are the consumer you are in charge of your body, your baby your experience, and then working with a provider that you trust, who you know, will have your best interests at heart who will listen to your concerns, fears and questions who will evaluate your individual unique history and, and preferences and then together y'all can make a decision. That's like the full picture right? And so that leads me into choice of care provider matters. Significantly, right? So you want to seek a provider who you are in alignment with, like, on all things not just oh, I like this provider. Like you have questions that you walk through and you ask them and they're giving you answers that you feel good about the the feeling and inside of your gut is like okay, I feel good with this person, even if it's not 100% You feel very strongly good with this person. If you're having any sort of, of red flag or doubt or even yellow flags. That's an opportunity to ask more questions or maybe seek another provider. Listen to your intuition. If you're asking questions, and they're not giving you information that you feel good about or they're dismissing you, or they're only giving you one side of the picture like that's a red flag. So seeking a provider who is willing to work collaboratively with you and look at you as an individual is really important to achieve true informed and shared decision making.

10:51

So you want to have a provider who offers you all the information like paints the whole picture for you, gives you an opportunity to ask questions and then answers your questions in a meaningful way. And then ask you how do you feel about this? So you've I've given you the information and my recommendation, my professional recommendation, you've asked your questions, like I've answered your questions. Now. How do you feel about all this? Where does that leave us? How do you want to move forward? And that is a game changer versus a provider telling you something's going to happen. Right? Even if the thing they're telling you is going to happen is what needs to happen.

11:39

It should be done in a way of like, okay, this is what I'm seeing. This is where we've been, this is where we are, this is what we've already tried. This is what I think would be best to help you move forward and your labor or if this is something that comes up during pregnancy, okay, so and then giving you a chance to respond and react and then giving you time to think about it. Like that type of collaboration of care has really really important like they're you're part of it. You are an active participant in your healthcare, not a passive receiver of medical care. Okay. That is my goal is that you see yourself as that and you seek out a provider who is going to support you in that way so that you can have the best chance at having the best birth available to you. Right.

12:26

Okay, so your innate wisdom.

12:29

Plus, having a trusted provider equals the best chance of having a positive satisfying, empowering, safe, healthy birth experience. Okay. So how can you achieve this? You can achieve it by all the things I just said with choice of care provider. That's one way or the other is a cool tool. It's an acronym that we share all the time. I think I've shared on this podcast several times we talked about with our doula clients a lot. I talk about it in my childbirth education class. I mean, if I have an opportunity to share about the brain tool I do. And so the word is brain. So you could be like, use your brain is the reminder, the kind of like way you can remember it, and it is benefits, risks, alternatives, intuition, and now are nothing. So I'm going to put those in a question format for you. So what are the benefits of this procedure or this intervention that you are recommending? What are the risks?

13:31

What are the available alternatives? What so it's not just what are the alternatives? It's what is available because there might be some things you've already tried. The place you're giving birth might only have certain options available. So whether you're home or the hospital or based on what hospital or person or you're at, like, not all alternative options are available. So the key there is what available alternatives do I have to what you're offering. Even if you don't choose them? It's important to know your options.

14:03

The eye is for intuition. So this is a really important time for you to check in. What is your gut telling you? How are you feeling about this thing? And you may not know you really there are moments in labor that it's not you're always going to feel perfectly confident and tapped into your intuition or wisdom throughout the whole course of labor. I just encourage you to constantly sort of checking in and saying, Okay, what's my gut telling me what do I feel in my heart? How do I feel about this thing? And you might have doubt you might check in with yourself and say, I don't know. And that's okay. So just want to normalize that but if you're constantly checking in you, human Well, how did I feel about it before and how do I feel about it now? Right. Sometimes if you wait a little bit of time, you can notice that the difference in how you felt about it previously versus how you feel about it now, and that is growth, like that's something to be aware of. So I'm just encouraging you to do that. And then the n is do we have to do this now or what if we do nothing so the end can be now or nothing? And that is really important, because if it's not emergent, and it doesn't have to be done now, then maybe you could just ask for more time and then choose the intervention. If in X number of time one or two hours or one or two days, whatever you're working with, like that something hasn't progressed or change. It's like, okay, well, at least I gave that some time. And I know that now is right, the right time to do the intervention or the thing.

15:26

Or what if we do nothing? Like you're, you're offering an intervention, but my question to you is, what if we do nothing? That's a great question. And all of these are open ended questions and so ideally, avoiding lengthy yes and no questions can give the space for them to give you more information. So you can ask, you know what if we do nothing then what? Right like if there's no real harm in doing nothing, then maybe doing nothing as the answer. Sometimes it's just you need more time. Sometimes need more patients you need to, you know, there's just not doing you don't always have to be doing something to the birthing person during labor. That's really important to remember.

16:02

Now, if you say what if we do nothing then and they give you some compelling reason? Like okay, doing nothing is really not an option. Okay? Then you can decide that it's worth it to do the thing, right. It's like keeping you in the driver's seat here. And then after you've gathered all this information, asking for more time is really crucial. So if it's before Labor has begun, maybe you're asking for a day or two. If it's during labor, maybe you're asking for an hour and you want you know, the providers and nurses and everyone to leave and then you take the time to think about it by yourself or with your partner or with your doula or everyone together, and then you make the decision. Then you can either ask the provider to come back and say, Okay, I'm ready to do this next thing, or wait for them to come back and maybe you get maybe by another hour to three hours before they make it back. Because it's not that emergent, and maybe you don't no longer even need that intervention, right? So it can be more on your terms. That's the goal with asking for more time. And you can use this like I said, during pregnancy, if there's tests or procedures or interventions that come up during pregnancy, you can use this obviously during labor, birth, postpartum infant care, your health beyond, I mean, the list goes on with where you can use the brain decision making tool. And so I want you to remember that informed and shared decision making is an evidence based practice that is proven to increase your satisfaction, increased the positive relationships among the care team and increase your levels of trust and therefore increasing your the overall outcome for your birth experience when you are when you practice and receive informed and shared decision making and I also want to remind you that you are the consumer.

17:46

You have every right to ask questions. You have to advocate for yourself. Choice of care provider matters. And I want you to begin now begin implementing this tool. Now. There's no time like the present. So wherever you're at in your pregnancy, or postpartum, you can implement this. It's never too late. You matter. Your birth matters. How you feel while giving birth matters, and your birth has the potential to change you forever. Good or bad and everything in between. Let's do everything we can to ensure you have the best chance at having the best and safest, most satisfying birth possible.

18:28

Thank you so much for listening. I hope you enjoyed this information in this episode. If you liked what you what you've heard here, we'd love if you took a screenshot and shared it on social media, you can tag us at alligned underscore birth. If you're feeling really generous and you really love what you heard today, if you could leave us a rating and review. That would be awesome. You can do so in the show notes of this wherever you wherever you have found us and are listening to us you can leave a review, leaving a review for our episodes and our podcast. help more people find us and listen to us and help us be able to continue doing what we're doing. We love this. We love sharing and creating. We also love the feedback. So we'd love to hear from you in that way. And so, thank you so much for listening. Please be sure to tune in next week for a brand new episode. Have a beautiful day.

Transcribed by https://otter.ai