Danger, Risk and Opportunity

Birth is Dangerous!

or is it?

‘Danger’ and ‘Risk’ are sometimes used interchangeably, but they actually mean very different things.  To use ‘danger’ when you mean ‘risk’, could be very damaging.  The Nocebo Effect is a very real phenomenon, and the words we use are very powerful.

Using ‘danger’ when you mean ‘risk’, and ‘risk’ when you mean ‘chance’, overstates the issue.

Using ‘chance’ when you could use ‘opportunity’ could understate an issue.

Let’s put it in context.

There was danger she could birth at home.
There was a 
risk she could birth at home.
There was a 
chance she could birth at home.
There was an 
opportunity she could birth at home.

Understanding risk: evaluating your options

When you are evaluating risk, you are making an informed decision. Understanding what the risk really means can be frustrating and confusing. For example, you might hear:

a 1 in X chance,

or x% chance, or

‘twice as likely’

…and it can be hard to know what it really means for you. Twice as likely could mean that instead of 1 in a million, you have a 1 in 500 000 chance or a 0.2% risk becomes 0.4% – still very low.

If you have a ‘low risk’ pregnancy, and feel well and prepared, you will view risk differently to someone who is considered ‘high risk’. If you are considered high risk, you will consider how you feel, what the risk is, and what interventions are likely to be considered. Some will decide the risk is not really significant, and so opt to do nothing (wait and see), others will decide the risk is too high, and opt for some or all possible interventions.  Keeping in mind that once a decision is made to use a particular intervention, the pathways will change. The ‘do nothing’ option allows more time to consider all the (remaining) options. Sometimes the choice is clear to accept an intervention. The key is knowing your options, and the pathways they lead to, in advance.

It is a very personal decision. It is important not to rely on a single source of information (be it a person, or a pamphlet or a forum). Find various sources; consider using a doula to help navigate the information. A doula can guide you towards reputable sources of information, but will not influence your decision or advise you on your decision. Section two provides you with questions you need to get started. Knowing the questions is the first step to discovering all of your options. The more information you seek, the more likely you are to find even more questions you need to ask, and be able to come to a truly informed decision.

When weighing up risk, the BRAIN guide is useful tool.  Here ‘risk’ could mean ‘chance’ or it could mean ‘danger’.  This tool helps determine the context.  When no, or a very low, chance of a negative outcome is determined, then we start to see opportunity.

For example:​ 

You are approaching your ‘due date’ and are offered an induction.  You are healthy, the offer is based only on the estimated date.

The Benefits to you: meet your baby sooner.
The Benefits to baby: none
The Benefits to the care provider: scheduled ‘delivery’, easier to ‘manage’.

The Risks to you: cascade of intervention, possible emotional and physical trauma
The Risks to baby: possible time in NICU, possible exposure to intervention drugs (which may have long term impacts), possibly born premature.
The Risk to the care provider: none

The Alternatives for you: wait
The Alternatives for baby: wait
The Alternatives for the care provider: wait

Your Intuition: what do you feel most comfortable doing (you will meet your baby soon…)

Doing Nothing:  In this case, ‘nothing’ means simply waiting.

There is no risk.

Listen carefully to your care provider.  
How do they use the word ‘risk’ or ‘chance?
Do they ever use the word ‘danger’ when they really should say ‘risk’ or ‘chance’?
Do they give you the time and space to make an Informed Decision?

Do they encourage you to ask questions?

Do they make you feel safe?
Or do they make you feel fearful?

You can change care providers.  Consider your options and choose the one that makes you feel most relaxed and comfortable.  This will be the one that is most safe for you.


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