When faced with questions about medical intervention surrounding childbirth or other healthcare events, remember the acronym B.R.A.I.N.S.
(PRUnderground) March 7th, 2025
For women who have recently had their first baby and enjoy being a mom, they might be wondering when a good time is to talk about family planning, or whether to have another child or how long to wait between pregnancies.
Before the six-week postpartum visit is a good time to think about family planning, because that visit is an opportunity to talk with your doctor or midwife about how your body is healing physically and how you’re doing emotionally.
The six-week postpartum visit is also a good opportunity to talk to your provider about birth control options, since it’s possible to get pregnant once you resume sexual intercourse, even if you’re breastfeeding. Breastfeeding is not a reliable form of birth control.
“At six weeks postpartum, the cervix is still a little dilated, so placing an intra-uterine device (IUD) can be more comfortable, if you’re going to go with that form of birth control,” said Erin Packer, BSN a nurse and childbirth educator at Intermountain Health.
Packer teaches childbirth preparation classes for both first time moms and for parents who are having another child and would like a refresher course. Intermountain Health’s Childbirth Express Course is taught in-person at hospitals and is also offered virtually in one Saturday, so Packer says it’s the best course for parents who have already had one or more children.
During the refresher course, Packer shares studies that look at outcomes for moms and babies as related to spacing between births.
“Research shows that waiting 18 months after childbirth to start trying to have another baby allows enough time for a mom’s hormones to get in sync after the fluctuations that occur during pregnancy, the postpartum period and breastfeeding,” said Packer. “It also allows enough time for abdominal muscles and pelvic floor muscles to heal, and for bone density and regeneration to occur.”
According to Packer, births spaced quite close together can put mom at more risk for pregnancy complications such as placenta previa – where the placenta can cover part of the cervix, which can lead to severe bleeding, putting both mom and baby at risk – or a preterm birth and complications for baby, such as needing to stay in the neonatal ICU.
“Pregnancies spaced close together may also be difficult on mom’s mental health,” said Packer.
What to expect during childbirth the second time around
During the class, Packer and other childbirth educators share information about how every pregnancy, and every labor, delivery and recovery are different. But she says there are some things that are more typical for a second birth than a first.
“With second births, labor can go quicker. First time moms average 12-18 hours of labor. For second-time moms, labor can be much shorter, since a mom’s body has experienced childbirth before and the muscle memory knows what to do,” said Packer.
“First-time moms average about 20 minutes to 3 hours of pushing. The length of pushing can be affected by if a mom has an epidural to help with pain relief. The pushing time for second-time moms can be shorter, even as short as just 2-5 contractions of pushing,” she added.
According to Packer, the in-person childbirth classes are more hands-on and offer more opportunity to connect with other parents-to-be. The virtual class option is more flexible and can be done from anywhere with an internet connection.
“I also tell moms that if breastfeeding didn’t go well with their first baby, and they want to have a better breastfeeding experience the second time around, tell the hospital nurse, you’d like extra support on breastfeeding, and they can ask for a lactation consultant to visit you in the hospital,” said Packer. “Every baby’s anatomy is unique, and breastfeeding may not necessarily be easy.”
In the childbirth preparation classes, Packer also teaches parents-to-be that there may be situations that come up during pregnancy, labor or delivery where they need to make a decision about whether to have medical intervention or what type and when. This can be overwhelming for parents.
“When a provider is proposing a plan of care. You have a choice, ask questions, ask for time to think about it,” said Packer. “I teach parents to use their brains, or rather to remember the BRAIN acronym when faced with medical decisions to help them know what questions to ask and how to find their answers.”
Tips for making medical decisions
Benefits – Ask what the benefits are for this type of care?
Risks – Ask what the risks are for this type of care?
Alternatives – Ask if there are other choices or other types of interventions?
Intuition – What does your intuition (gut, heart, or feelings) tell you is the best choice?
Nothing – It’s ok to say I don’t want to do anything right now.
Space – It’s ok to say I (we) need some more time to ourselves to think or pray about this.
For more information about childbirth education classes visit the childbirth education page at https://intermountainhealthcare.org/services/womens-health/childbirth-education-classes or call your doctor or local hospital.
About Intermountain Health
Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a not-for-profit system of 34 hospitals, approximately 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For up-to-date information and announcements, please see the Intermountain Health newsroom at https://intermountainhealthcare.org/news.
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