Kirsten Fisch
Co-Founder at - Momentum Health NetworkKirsten Fisch, MSN, RNC-MNN, IBCLC, LCCE Kirsten is a women's health nurse who specializes in high-risk pregnancy and postpartum care. She is certified in Maternal Newborn Nursing, a board-certified lactation consultant (IBCLC), and a Lamaze Certified Childbirth Educator. She works with women from conception through the postpartum period. Passionate about empowering women throughout their reproductive journeys, Kirsten combines evidence-based care with compassionate support to promote the health and well-being of mothers and babies.
One of the most important things I teach families is this:
You always have a voice in your care.
Throughout pregnancy, labor, and the postpartum period, you will be offered many interventions: some routine, some urgent, some optional, and some unexpected. How those options are presented, discussed, and decided upon matters deeply. The best care happens when decisions are made with you, not for you.
This approach is called shared decision-making and it is the gold standard for respectful, ethical healthcare.
Shared decision-making means:
- You receive clear, honest information
- Your values and preferences are respected
- You and your provider decide together what feels right for your body and your baby
But in the middle of contractions, long hospital stays, or stressful moments, it can be hard to know what to ask. That’s where a simple, powerful tool comes in:
The BRAIN Acronym
BRAIN is a quick framework families can use to advocate for themselves during critical moments in pregnancy and birth.
B – Benefits
What are the benefits of this option for me and my baby?
R – Risks
What are the risks or downsides, both short-term and long-term?
A – Alternatives
Are there other options I can consider right now?
I – Intuition
What does my gut tell me? How do I feel about this choice?
N – Nothing / Not Now
What happens if I do nothing or wait a little longer?
You do not need a medical degree to ask these questions. You only need the reminder that your body, your baby, and your values matter.
A Real Example of Shared Decision-Making
I recently cared for a pregnant patient who was hospitalized for monitoring before her baby was due. Hospital policy recommended that all patients in her situation have an IV placed “just in case.”
From a medical perspective, this policy made sense. But from her perspective, the IV felt painful and intrusive. She was afraid of needles, and every few days the IV would stop working and need to be replaced. Meanwhile, she wasn’t receiving any medications through it, it was simply there as a precaution.
She asked thoughtful questions.
She weighed the risks and benefits.
And ultimately, she declined the IV at that time.
This wasn’t her being “difficult.”
This was her practicing shared decision-making.
Whether she realized it or not, she used BRAIN. She considered the benefits, the risks, the alternatives, her intuition, and what would happen if she waited. And together, we created a plan that respected both her safety and her comfort.
That is what empowered care looks like.
You Are Allowed to Ask Questions
Sometimes families worry that asking questions will make them seem “difficult,” “uncooperative,” or “challenging.” I want to be very clear:
Asking questions does not make you a problem.
It makes you an informed participant in your own care.
You are allowed to say:
- “Can you explain why this is being recommended?”
- “Do I have time to think about this?”
- “Are there other options?”
- “What happens if I wait?”
These are not confrontational questions.
They are responsible ones.
Shared Decision-Making Is a Safety Tool
Advocacy is not about refusing care. It is about understanding your choices and participating in them. Many families feel more confident, less fearful, and more satisfied with their birth experiences when they are active partners in the decision-making process.
Using BRAIN:
- Builds trust with your healthcare team
- Reduces fear during high-stress moments
- Helps your care align with your values
- Creates clearer communication
- Supports safer, more personalized care
A Final Word to Families
You deserve care that is not only medically sound, but also respectful, collaborative, and centered around you.
You deserve to be heard.
You deserve clear information.
You deserve time to think when time allows.
You deserve to be part of every choice about your body and your baby.
And when the moment feels overwhelming, remember:
Just use your BRAIN.
Kirsten Fisch, MSN, RNC-MNN, IBCLC, LCCE Kirsten is a women's health nurse who specializes in high-risk pregnancy and postpartum care. She is certified in Maternal Newborn Nursing, a board-certified lactation consultant (IBCLC), and a Lamaze Certified Childbirth Educator. She works with women from conception through the postpartum period. Passionate about empowering women throughout their reproductive journeys, Kirsten combines evidence-based care with compassionate support to promote the health and well-being of mothers and babies.
