Podcast: 7 Steps to Confident Decision Making with host, Megan Rossiter

7 Steps to Confident Decision Making with host, Megan Rossiter

MINI SERIES

Decision making is a guaranteed part of your pregnancy, birth and postnatal experience. But it can feel like a massive responsibility when you're not really sure where to start. It's often much easier to just 'do as you're told.. often, you don't even realise you've GOT a choice in the first place.

This episode is one you can come back to, time and time again, any time you're feeling stuck, any time you're facing a big decision.. And use it to guide you to make confident choices that feel right for you, your baby and your circumstances.

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TRANSCRIPT

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Hi, everyone, welcome to our mini bonus series of The Birth-ed Podcast.

I have once again, the most incredible lineup of experts joining me to explore a huge breadth of pregnancy, birth and postnatal topics, from cesarean recovery, to BMI, to mixed feeding, to positive hospital birth, and pretty much everything in between, coming up for you in series four.

But if you are listening to this in real time, so April, 2024, you probably know by now that this week sees a huge shift in the support that I offer here at Birth-ed.

As we wave goodbye to the old Birth-ed hypnobirthing course and welcome in the Birth-ed method.

Across this week, I'm going to share a deeper insight into the Birth-ed method, what makes it different and how it can help you to have an empowering and satisfying birth experience.

I wanted to put together this episode as one that you can come back to time and time again, anytime you're facing a decision in pregnancy that's making you feel stuck, which let's face it, can be pretty frequent.

I know in my first pregnancy, we had big decisions to make along the way.

Where to plan the birth was a big one.

We shifted from planning at birth center at the start to home birth, then actually ended up giving birth on a labor ward.

We had to make big decisions around induction of labor.

I turned it down twice before eventually accepting.

In my second pregnancy, again, big decisions about whether or not to have growth scans, whether or not to attend appointments with an obstetrician.

And when you don't know that literally everything in pregnancy is a choice, it's very easy to get swept along, doing as you're told, and then arriving at the end of pregnancy with your plans kind of made for you, or in a position where it then feels very difficult to advocate for yourself or change plans because of everything that has led to you to this point.

On the flip side, knowing that everything's a choice can make things feel really overwhelming, really high-pressured, quite scary, and we can end up flapping and panicking, and because it all feels like too much, we end up just doing as we're told anyway.

So I'm gonna share with you my seven steps to making confident choices in pregnancy, birth, and parenthood.

So you can play this back whenever you need, whenever you're making a decision.

So number one is breathe.

When we are presented with a decision, be that in pregnancy or in birth, especially if it's something that we weren't expecting to hear, we panic.

And what this actually means is that our body shifts into something that we call the sympathetic nervous system.

Basically, it shifts into your stress mode.

And when we are in our stress mode, you cannot make rational, considered decisions.

I'll summarize this super quickly, and we do go into this in much more detail within the birth-ed method itself.

But basically, when you shift into the sympathetic nervous system, it stimulates a response that you might have heard of called the fight-or-flight response.

I call it the fight-flight-fawn response.

And the fawn bit of this response is the evolutionary protective response that makes your head nod, your mouth agree, and before your brain has even realized what you're saying yes to, your bodies are trying to keep you safe.

And safe here usually means anything that doesn't require confrontation.

So we do not want to be making decisions when we are in our stress mode.

We want to reset the nervous system.

And generally, a really quick and simple way to do this is by controlling your breath.

Four slow, deep breaths in through your nose and out through your mouth will help shift you out of the stress system and into the calm mode.

And this is where you need to be if you are hoping to make any rational and considered decisions.

In the birth-ed method itself, we teach a few more grounding techniques that can be really helpful to reach for here.

To get you quickly back to this place of calm.

Okay, the next step, use your brain.

Yes, obviously you're going to be using your brain when you're making decisions, but this brain is an acronym.

It stands for benefits, risks, alternatives, instinct, nothing.

So imagine brain written down the side and those words coming off it.

And this is a good starting point to help you work out what questions to ask, what information to seek out to ensure you have got a full picture before you make any decisions.

So what you're asking here is what are the benefits of doing or accepting this recommendation?

And what are the benefits of not doing it?

Similarly, what are the risks of not doing or accepting this recommendation?

What did I just say of not doing?

What are the risks of doing or accepting this recommendation?

And what are the risks of not doing it?

Alternatives, that's literally the question.

And if we don't do this, what else could we do?

There will almost always be several alternative options than a black or white yes or no, but they won't all be routinely offered when you're being asked to make a decision.

I stands for instinct.

What you're thinking here is what does it feel like you should do?

What makes you feel most safe?

Don't underestimate this one.

It is pretty powerful when we give ourselves space to tune in and listen to that intuition.

And the N stands for nothing.

What if we did nothing?

And that's nothing in terms of time.

So asking yourself, what if we did nothing for a day or a week or half an hour, depending on what it is you're making a decision about?

And this is what we can come back to every time we make a decision using your brain.

Okay, so that's steps one and steps two.

Step three is gather your information and think critically.

So you want to be considering where is this information coming from?

There are some fantastic, reliable resources you can turn to for most things.

Some of the easier access ones like The Birth-ed Podcast and The Birth-ed Method.

Some fantastic books and blogs from midwives like Dr.

Sarah Wickham, Dr.

Rachel Reed, a fantastic website called Evidence Based Birth.

And you can even dive into guidelines and research yourself from places like the RCOG, that's the Royal College of Obstetricians and Gynaecologists, or ACOG in America.

Nice guidelines and Cochrane reviews.

There's a list and links to all of those places within the Birth-ed Method course companion.

But what we are aiming for here is don't just ask on Mumsnet.

Think about where that information is coming from, how reliable it is, and how relevant is it to you.

Building your critical thinking skills is a big part of the Birth-ed Method.

You don't need to suddenly know how to read and interpret medical research in order to give birth.

But knowing where to turn to, who to ask, what questions to ask, that is going to help you get the most from your care providers and help you make a decision that feels right for you.

Step four is never feel like you have to make a decision on the spot.

If it is a decision that's being made during pregnancy and you are in an appointment, you can simply say, thank you so much for the information.

We're going to go away and make up our minds and we'll let you know what we decide.

That might be that you go away for half an hour.

It might be that you go away overnight.

You might go away all the way until your next appointment, depending on what it is that you're making a decision about.

Ideally, you want to go home.

Definitely step outside of a clinical setting.

We automatically feel much calmer, much more confident when we are in a familiar environment.

If it is a decision that needs making during labour itself, you can still ask for 30 seconds, where it's just you and your birth partner, to have a little chat, a little discussion about whether or not you want to accept whatever it is that you're being offered, working out if you've got any questions that you want to ask.

There is very rarely not 30 seconds in birth.

And making decisions separately and on your own takes away some of that sort of pressure and anxiety that we sometimes feel when we're facing someone that is important or in a position of perceived power.

It gives us back some of that power in the birth space, especially if we aren't in our own home at this point.

So step four with don't make decisions on the spot.

Step five is write it all down.

This mainly goes for decisions that need making during pregnancy.

So if you're going to an appointment with a midwife or a doctor and you've got specific questions that you want to ask, it's really common to sit in front of somebody of importance.

It's called White Coat Syndrome and it's that thorn mode again.

And we all just go, Oh no, I didn't want to ask anything.

And you just nod along to everything that they're saying.

And sometimes we miss asking or communicating the things that were really important to us.

If before you go to this appointment, you write down everything that you want to find out and write down what it is that you want from the appointment and what you want to communicate during the appointment, it takes far less assertiveness or courage to read off a piece of paper than it does to look somebody in the eye and directly question what they're saying.

And this really does help.

I mean, just because this is my actual job, it doesn't make me immune from the kind of stress and nervousness you feel when going into these appointments.

I remember in my second pregnancy, we had a few things that came up in a 20-week and a 24-week scan.

And I had done all of the steps above, done all of my research, and I'd come to the decision that I wanted to decline the rest of the growth scams that had been recommended and decline these appointments that had been scheduled for me with an obstetrician.

And I had to call the head of the midwifery team that I was under and I remember basically trembling and crying because I was so nervous.

I am a very, very emotional pregnant person.

And I had what I wanted to say written down, both the kind of clinical evidence side of stuff that I wanted to say and also just the kind of emotional personal stuff I wanted to communicate.

And I know that if I hadn't written it down, I would never have been able to get what I needed from that conversation.

So writing things down just makes sure that you get all of your questions answered and makes it easier for you to put across your perspective and your preferences in a way that feels as comfortable as possible.

So following on from this, tip number six is to approach these conversations from a place of curiosity.

Often conversations around personalized decision making and advocacy make it feel like we have to set ourselves up for battle or a big fight or an argument.

Sometimes conversations around saying no or making plans out of guidance in some way.

Make it feel like you need to be quite aggressive or confrontational to get what you want, which if you're anything like me, makes you want to curl up in a hole and never speak your mind ever again.

But the alternative to stamping your foot and shouting, no, no, no, doesn't have to be, okay, I'll just do as I'm told then.

Asking curious questions like, okay, so you're recommending this, that or the other, you know, a scan or induction.

I wonder if you could just point me in the direction of any more research or reading I could do about that before I make up my mind.

Or that's interesting that you think I should do this.

I'm actually really keen to do this instead.

I think I'm just going to take some time to weigh up all of my options.

Can we chat a bit about how my wishes for home birth or water birth, not having an induction, whatever, can be best supported?

If you're getting the vibe that the person you're speaking to in this way just isn't going to engage back in a positive, gentle conversation, and you will generally be able to work this out quite quickly with your excellent people reading skills, then just ask instead to chat to somebody like a consultant midwife, a birth choices midwife, potentially just a different midwife or obstetrician who might be better placed for the warmer, more nuanced kind of chat.

Finally, tip number seven is allow it all to settle.

So once you have made a decision, give yourself a little moment or a big moment to get your head around the decision.

So if you're in labour and you've decided to accept an instrumental birth, just take 30 seconds where you ask for quiet, you have a kiss and a cuddle and you go, right, this is our new plan, we're going to make it amazing, we're about to meet our baby.

If it's a case of accepting an induction, you can say, look, I'm just going to go home for half an hour, I'm going to have a shower, do the washing up and then we'll come back in.

That's actually what I did when I had an induction with my first baby.

I was like, okay, I've decided it's the right thing to do, but I'm going to go home, make sure that it really does feel like the right thing to do.

I'm going to wash my hair because a shower is a really good way for me to kind of wash away feelings of stress.

There's washing up in the sink.

We haven't bought any snacks.

I want to go to M&S and buy some food.

So you never have to do anything instantly.

Take your time to allow it to settle.

Get your head around it.

Get yourself back to a place of calm.

And often that is enough to completely change your perspective about how you feel about what's happening.

Even if your plans are changing, it stops you getting kind of swept away with things, stops you getting to the end of the birth and looking back and being like, God, what just happened?

Like, that all just happened without me even really realising what was going on.

So just taking that moment to pause and allowing that to settle in your head can be an absolute game changer.

Okay, so in case you need to come back to this episode when you're facing a tricky decision and you don't want all of my spiel in between, in summary, the seven steps to confident decision making are step one, breathe and reset the nervous system.

So decisions are made from a place of calm, not a place of panic.

Step two, use your brain, benefits, risks, alternatives, instincts, nothing.

Step three, gather your information and think critically.

Step four, step outside or go home to make your decision.

Step five, write down your questions and anything you want to communicate.

Step six, approach the conversation with curiosity.

And step seven, allow new plans to settle.

Now, two of the four pillars of preparation in the birth-ed method are choices and communication.

So like this, helping you actually make up your mind and following on from here, giving you tools, confidence and approaches that you can use to actually advocate for yourself and make them happen.

Because knowing your options and making your own choices is really only step one.

Feeling confident and supported enough to make them happen is the crucial next step.

So whether you're wanting to ask for a cesarean, plan a home birth, you want an early epidural, you don't want vaginal examinations, whatever it is, the birth-ed method is there to help you first work out what it is that you actually want and next to communicate this with your care providers in a way that isn't confrontational.

So if that sounds like the kind of preparation that you think you might need, and you're not already signed up to the birth-ed method, then doors open officially on Friday the 26th of April 2024.

I cannot wait to have you as part of your community, and support you to get the kind of birth that you really need.