What is the BRAN analysis? I have heard you speak about this, but I can’t find a simple explanation of what it means that I can share with my clients. Can you help?
Yes I can. I first wrote about this in 2002 in ‘What’s Right For Me: making decisions in pregnancy and childbirth’. (The 2002 edition is now out-of-date and out of print, so that link points you to the shiny new 2018 edition).
The BRAN analysis is a decision-making tool tool that you can use when faced with a decision – including those which you may have to make quite quickly or when under pressure, for example when you are in labour or making a decision about medical treatment.
If you can remember the acronym “BRAN” and what this stands for, you can remember the key sorts of information you need to seek. It works best when you are considering some kind of action or intervention (for example whether you want a particular drug, screening test or intervention such as induction of labour), but the same principles can be applied to other kinds of decisions as well.
The BRAN acronym stands for:
What are the Benefits?
What are the Risks?
What are the Alternatives?
What if I/we do Nothing?
For instance, if someone experienced nausea during their pregnancy and they were offered a drug that might help, using the BRAN acronym to analyse the situation could lead them to ask the following questions:
- What are the benefits of this drug? What percentage of people does it help?
- What are the risks of the drug? What are the side effects? What immediate effects will it have on my body? Could it have any long-term impact on me or my baby?
- What are the alternatives to taking this drug? Are there herbal or other alternative remedies that I could try first?
- What is likely to happen if I do nothing? Does nausea eventually go away for most women? By what stage in pregnancy, on average?
Over the years, the BRAN acronym different educators has been altered and expanded to include other important elements of decision-making. One popular expansion turns BRAN into BRAIN, where the ‘I’ stands for Intuition and invites us to consider what our intuition or guts are telling us to do. In other versions, people add an S to make BRANS or BRAINS and, depending on who you hear it from, the S can either remind people to ask with a Smile or that it’s OK to say ‘Scuse me, I need time to think about this and discuss it with my family. (And there are probably more variations; please feel free to share below!)