A day with a newborn doesn't have to be hectic and tiring, as it is often depicted. New moms can be confident, efficient, and prepared, if they have the right help! That's where a postpartum doula comes in. But what does a postpartum doula really do?​ Well, lets take a look at an average day.

​8:00 AM: ​My husband wakes me up as he leaves for work. Geez I'm tired.. The baby was up probably a million times last night. It seems like no matter what he is just not content. I remember that the doula is coming by at 9 and feel much better. I guess I should take advantage of the sleep while I can!

9:00 AM I wake up to a soft knock on the door. Yay! The doula is here! I roll out of bed and answer the door in my PJ's. My doula wont judge me, and I know that. I tell her about our broken sleep last night and she lets me know the baby is going through a growth spurt. Oh duh! that's why he's eating 24/7. I feel so much better now that my doula has assured me my baby is acting normally and it will soon go away. The doula says I should go take a shower and she will take care of the baby.

10:00 AM ​I take a hot, long, relaxing shower. I even take time to shave my legs, which hasn't happened since probably the second trimester. My belly was so big I couldn't reach! I go into the kitchen and am greeted by the smell of bacon. Now this is how I want to start everyday! On the table, there is a plate of scrambled eggs and bacon waiting for me. The doula has the baby in the sling and he is happy and content. The dishwasher is unloaded and I hear the laundry going. How does she do it?

​​10:15 AM ​ I gobble up my breakfast while the doula sets me up a nursing area. She grabbed some water, a snack, the TV remote, phone charger, and the book I'm reading. I get settled on the couch and she hands me the baby who is starting to get hungry. We talk about my plans and goals for the day. She explains that her goal is to work herself out of a job. She is going to lay the foundation and equip us to be the best parents we can. We set a goal of one chore per day, to keep me feeling accomplished and productive, and one outing a week, to keep me sane. She notices that I hold a lot of tension in my shoulders while I'm nursing and helps to correct my position. Wow! That's much more comfortable!

10:45 AM We talk a little bit about my labor and delivery and my postpartum doula listens as I admit I really wasn't all that happy with the birth. She doesn't tell me "well you have a healthy baby!" Or "You should have done this or that." She just listens and holds space for me to work through my feelings. As the baby finishes up, we hear a large PBBBBBHHHTTTT. Oh great.. another poopy diaper. My doula offers to change the diaper which I happily accept. I changed 4 poopy diapers yesterday and am glad for a break.

11:00 AM The doula returns with my baby, he is in a new outfit. She explains that he got some poop on his clothes and the changing table, but how in the world did she change him without any screaming?? And why isn't she covered in poop? I always manage to get it all over myself. She sets up a blanket for tummy time and shows me how to get on the ground and talk to him, so he likes it more. While I admire my happy, clean, and cute baby, she throws the poopy stuff in the washer.

11:30 AM Time for a little nap. The doula shows me a trick for swaddling the baby and settles us into bed as she goes to make us some lunch.

12:30 PM My husband arrives home for lunch just as we are getting up. We sit down to eat as the doula takes the baby so I can enjoy a hot meal with two hands for once. This is so nice, I never want her to leave! When we finish, the baby starts to get hungry. My husband really wants to give him a bottle of pumped milk. I'm a little nervous about nipple confusion and bottle preference, but the doula let's me know she will teach us the proper way to bottle feed, so that our breastfeeding relationship isn't compromised. I relax as she instructs my husband on how to pace bottle feed and the baby happily drinks his bottle. My husband kisses me goodbye and is back to work.

1:00 PM The doulas shift is coming to a close but I'm feeling confident and relaxed. She reminds me of my chore goal for today and I'm able to get it done quickly and easily as the baby naps in the swing. This parenting thing is easy! Why was I so nervous? My doula lets me know she does overnight care as well, which could really help during the growth spurt. She says she will bring the baby to me when he is hungry, then when he is done nursing she will take him back to the nursery to change his diaper and get him back to sleep. I never even have to leave my bed! I schedule her to come over tomorrow night. Sounds like just what I need! As the doula leaves I realize that I feel renewed, and energized. I'm ready to tackle the rest of the day.

To schedule a shift with a postpartum doula, contact Miranda at soonertatedoula@gmail.com

I'm introducing a new format for classes! Most classes are taught in a private, in home setting. This has some extra benefits, like ease and comfort for you, however there are also benefits to group class settings. If you are interested in learning in a group setting, or interested in earning your class for free, consider hosting a semi private class! Interested couples would open up their homes one night a week, to a small number of other couples. This number is set by the host family. You can invite one other couple, or five. Totally up to you! For each couple, you receive $100 off of your class fee. For example, if you host a home birth course ($300) and you open your home up to three couples, your class is paid for! If you receive over your fee amount (four couples for example), you may put the $100 discount towards any other Sooner State Doula fees. Birth services, postpartum services, or other classes! Yippee! To learn more about class options, check out the class page, or contact me below.

​Happy Birthday my sweet Elaina Mae. You are a blessing and have brought so much joy to our family.

 The Oklahoma Health Care Authority (OHCA) has released a new report showing Oklahoma's Cesarean rates. Want to know how your hospital stacks up? Check it out here!  

Over the last twenty years, the C-section rate has continued to steadily increase without any improvement in maternal or neonatal outcomes. OHCA publishes these rates in an effort to help lower cesareans that are not medically indicated. 

Individual provider rates are published, however they are referred to with a confidential ID number, so the public does not know what numbers belong to what providers. 

Hospital rates are also published. Overall C-section rates range anywhere from 16.7% at the Chickasaw Nation Medical Center to 47.6% at Adair County HC Inc. The average rate is 30.2%. This is roughly 1 in 3 women.

Lastly, rates are published by region.

Rates like these are about average for the USA. Nationally, the rate is 32.2%. When compared nationally, United States rates are on the higher side. 

​Stay tuned for part two, how to lower your chances of a cesarean birth.

1. Your choices are ENDLESS!

​Whether you want to give birth in a hospital, birth center, or at home, Norman has you covered. There are a number of providers who can accommodate those wishes. Norman offers one of the few birth centers in the state, Community Midwifery Services (CMS), located right off Main Street!

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2. There are VBAC options.

Even though VBAC isn't yet offered at the Norman Healthplex, it is an option at CMS and with home birth midwives who serve Norman families. As more and more women are looking for VBAC providers, Norman is answering that need.

3. The care providers are fantastic.

Every nurse, doctor, and midwife I've worked with in Norman has been fantastic and committed to helping families towards their birth goals. The care providers here really want to see you happy and successful!

4. There are no restrictions on midwives.

The state of Oklahoma has no legal restrictions on midwives. This provides a very unique benefit to Oklahoma families. Midwives here are not bound by strict rules and regulations and are free to serve your family in the way that fits you the best. If you don't want to do a certain test, no problem! There is a midwife who will accommodate that. Say you have a breech baby but still want to attempt a vaginal delivery.. no problem! There are midwives here who are expertly trained to handle that. Say you are looking for a home birth after 3 cesareans...Not a problem! There are midwives who will support you.

5. You have many childbirth education options.

Whether you are a hypnobirthing gal, or a Bradley method mom there is a class in Norman for you. The Healthplex and CMS offer classes and there are many private childbirth education teachers as well. Sooner State Doula offers childbirth education as well as cloth diapering, baby wearing, and breastfeeding classes.

6. Norman has an amazing mom and birth community.

​Peer to peer support can be so helpful during the transition into motherhood. Luckily in Norman there are a number of local moms groups and a thriving birth community.

With the baby care market now racking in over $47.7 BILLION a year, its no wonder buying a baby shower gift is harder than ever. Even with a registry, buying the right gift can still seem like an impossible task. Most parents register for upwards of a hundred items or more. How is the gift giver to know what is the best gifts, and what are the worst? Sooner State Doula can help :)

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1. Diapers and wipes. YOU CAN NEVER HAVE ENOUGH! Just make sure to ask if the parents are using a specific brand or type. You wouldn't want to get a cloth diapering mom disposables! You may be worried about what size to get, but fret not. Most big box stores will exchange an unopened pack of diapers for a different size.
2. Consider going in on a large gift with a couple of friends. A car seat is one of the few absolutely necessary baby purchases, and it's often one of the most expensive. Because of safety concerns, parents cant save a few bucks by buying secondhand either. Imagine the weight off the parents shoulders to know that a large purchase is taken care of! Other big ticket items you could consider splitting with friends could be a stroller, crib, baby carrier, swing, rocking chair, or high chair.
3. Basket of essential healthcare items. If you have children, I'm sure you remember at least once in their childhood, running out to the store at 2 AM to get something while they were sick. It's inevitable. Help the parents be prepared by giving them a care basket of things they might need! You could include a nose frida, thermometer, boogie wipes, saline spray, gas drops, gripe water, Tylenol, baby vicks, and maybe even something special for the parents like a chocolate bar. Those long nights with a sick baby can be rough!
4. This gift idea is unique and by far my favorite! Consider giving the parents a gift card for some type of take out place. Maybe your favorite pizza shop, or a great chinese takeout. Or create them a few of your favorite freezer or crockpot meals. These are invaluable those first few weeks at home! 
5. Another unique and free gift idea is to let the parents know what days and times you are available and your number to call if they ever need or want a baby sitter. You can include this in your card! Every momma needs a break now and then and by giving her this information ahead of time she will know, you are there when she needs you!

Extra! For a mom planning to breastfeed, I love to give the book The Womanly Art of Breastfeeding. It's a fantastic breastfeeding book that covers every possible thing you could need to know as a breastfeeding mother!

1. After market car seat accessories. Many people don't know that it is actually unsafe and even voids the car seats warranty to use after market accessories. After market accessories are anything you can buy separate from the car seat itself. Strap covers, head pillows, different seat covers etc. If the car seat doesn't already come with these things you should get them from the car seat manufacturer, not from a 3rd party brand.
2. Wipe warmer. The logic behind the baby wipe warmer is that baby wipes may be too cold for baby’s butt, and the cold temperature will make the little one fussy during changing times. Perhaps, but babies are always fussy during changing time. It’s just the way of diapers and babies and poopy messes! Most parents never end up using the wipe warmer. Its just an extra unnecessary step.
3. Changing table. Just another unnecessary big ticket item! Parents learn pretty quickly that anything and everything can be a changing table. The ground, the bed, the couch etc. An on the go changing pad would be a better used alternative, or even a muslin swaddle blanket. They are super versatile and breathable. They can be used to change your baby on, as a nursing cover, or as a swaddle.
4. Newborn clothes, especially uncomfortable ones! Little tiny baby jeans are super cute, but also super unrealistic. A newborn is much more comfortable in a gown or onesie.
5. Baby laundry soap. There are a fewsoaps that may be strong enough to irritate baby’s skin, but they’re fairly few and far between. You’ll find that the average soap sold at the supermarket will be just great to wash baby’s onesies and clothing. You won’t have to worry too much about allergic reactions in your little one.

Truly, the best gift a new mom can receive is the love and community of the people who care about her. New motherhood is full of so many changes and emotions that your presence really is that important to her. However, if you want to shower the new parents with gifts, now you can travel to the store with ease! 

If I had a dollar for every time I'm asked if a doula is just for natural birth, I would have a heck of a lot of dollars. This is a common myth that needs to be stopped in its tracks! Every mom can benefit from a doula. Whether she is planning an induction, an epidural, a home birth, or yes, even a cesarean. 

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​Informational Support
A large portion of the doulas role during a cesarean birth is to provide informational support. A doula can help you and your partner know what to expect with a cesarean section and help create your birth plan. A birth plan will help you organize your thoughts and feelings and help you feel more in control. Most people do not realize that they have any options during a cesarean birth but a doula can inform you of these.

Here are some options you may have for a cesarean birth:

• Partner present/Doula present 
• Epidural/Spinal
• At least one arm free 
• Lower drape/ clear drape/ no drape for mom to view delivery 
• Breastfeed in OR 
• Infant with mother in OR and recovery 
• Describe events 
• Double/ single suture
  
• Video/Pictures 
• No bathing or dressing of baby 
• Initial wipe down towel given to   mom for smell/fluid transfer 
• Environment
  • Special Music 
  • Aromatherapy 
  • Only essential talk 
  • Only essential lights 
    

Emotional Support
Your doula can help relieve fears before, during and after the surgery. If you are disappointed that you have to have a cesarean section, your doula is there to discuss your feelings with you and your partner She will help you practice relaxation techniques, and talk to you during the procedure to keep you calm. Your doula can help keep your partner calm so that they are effective support for you during the birth. The doula will empower you to advocate for yourself in the ER by reminding the surgeons of your birth plan and wishes.

After the birth, your doula is there for you while you process your feelings. Whether in the recovery room, the postpartum room or at home, its great for moms to have someone to talk to. Your doula can refer you to resources like ICAN and other support groups. 

Physical Support
Just having an extra set of hands can be a bigger help than is realized after a cesarean. If dad wants to photograph and touch his baby while the baby is in the warmer, the mother is left alone on the surgery table. If the baby must go immediately to the NICU, and dad goes with the baby, the mother is also left alone. This can be an extremely scary time to be alone - the procedure continues for around 45 more minutes as the surgeons suture you back up, and you may continue to feel discomfort and concern for your baby. The doula can stay by your side throughout all of this to keep you calm and comfortable.

The doula can also help with breastfeeding after birth. This is no small feat after having major abdominal surgery! The doula can help you navigate how to hold your baby and get the baby to latch, in addition to all the regular breastfeeding support typically provided postpartum. 
You will be surprised how much having this kind of support can really help with your recovery!

,Last week you vetoed the Parental Rights Immunization Act. This bill would simply require doctors make the "Epidemiology and Prevention of Vaccine-Preventable Diseases: Vaccine Excipient and Media Summary" available. This is a four page document listing ingredients and substances used to make the vaccine. The bill also asks that doctors discuss risks and benefits, the vaccine injury compensation program, and give parents a VIS sheet (vaccine information statement), which is already required by federal law.

As a doula, I deal with informed consent a lot. I teach clients what informed consent means, I give them specific questions to ask to obtain informed consent, and in the labor and delivery room I empower them to make their own informed decisions. What is currently being given to parents is not enforced and is not informed consent. When I took my own daughter to the pediatrician for shots, I was not given a single VIS sheet. In fact, when she was born I was given the Hepatitis B consent form slipped in with my discharge paperwork. It didn't matter if I consented to it or not, because they had already given my daughter the the vaccine just minutes after she was born, two days before. 

The VIS sheets are sometimes loosely referred to as informed consent forms, but this is not true. VISs are written to fulfill the information requirements of the National Childhood Vaccine Injury Act, not as informed consent forms. The VIS pales in comparison to a vaccine package insert. The VIS includes little to none of the important information I would give my clients as a doula.

HB3016 is a common sense bill. Of course parents should be made aware of ingredients in vaccines. We are made aware of what ingredients are in our foods and other medicines. Why not vaccines? 

As a mom to a child with food allergies, this is extremely important to me. Mary, if your daughter was allergic to beef, neomycin, or yeast, wouldn't you want to be aware those things are in childhood vaccines? If you know you have a family history of an allergy to eggs maybe you would want to delay the flu vaccine just a little while longer... That is your right as a parent and you should be made fully aware of the ingredients so you can make an informed decision.

You boast that you have signed "every pro life bill that has come to your desk", but this isn't true. HB3016 would make parents aware of the use of aborted fetal cells in the manufacturing of some vaccines. In essence, this is a pro life bill. You vetoed it.

I would also like to address the Oklahoma chapter of the American Academy of Pediatrics which appears to be instrumental in your veto, you copied their action alert almost word for word in your reasoning for vetoing the bill. The bill requires doctors make 4 pages available, not 34 as they led you to believe. The 4 pages only have to be made available in some way, whether that is on a computer screen or posted on a wall in their facility. They are not required to give a copy to every single parent. We do not believe this bill will result in lower vaccination rates. In fact, literature supplied by the American Academy of Pediatrics is clear that trust established between pediatrician and parents is the single biggest driver of vaccination rates. Scaring, shaming, blaming and firing have been proven to negatively affect rates. HB3016 opens up meaningful conversation about vaccines, allowing parents and doctors to discuss their concerns and establish trust. 

I am angered and upset that you pandered to special interests instead of your constituents. Myself and other directors for the Oklahomans for Vaccine and Heath Choice made the trip to your office where we were only allowed to speak with a secretary. We brought, in hand, exactly what  HB3016 requires. You did not even discuss your concerns with the authors of the bill, instead they had to hear your concerns through the grapevine. I write this open letter to make the facts of HB3016 known, and in the hopes that the next time you are being pressured to veto a common sense bill, you would maybe think about it as a mother and future grandmother, as a pro life woman, or as a human with a basic right to informed consent

Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences. For the majority of birthing women, these needs are not met. Most women today birth in the hospital where they are attended by nurse. The nurse meets the couple that day, typically knowing little to nothing about their birthing wishes, goals and past. The nurse is attending many other couples as well, and may go off the clock during your birth, meaning you will get a new nurse and have to start forming a relationship all over again. Doulas can fill this gap that is missing in modern birth but they are only utilized by 3% of birthing women! When continuous labor support was provided by a doula, women experienced a:

31% decrease in the use of Pitocin
28% decrease in the risk of C-section
12% increase in the likelihood of a spontaneous vaginal birth
9% decrease in the use of any medications for pain relief
14% decrease in the risk of newborns being admitted to a special care nursery
34% decrease in the risk of being dissatisfied with the birth experience
25% decrease in length of labor
40% decrease in forceps deliveries
60% decrease in use of epidural pain medication
Reduced incidences of maternal fever
Reduced the amount of septic workups performed on newborns
Resulted in higher rates of breastfeeding
Resulted in more positive maternal assessments of maternal confidence
Resulted in more positive maternal assessments of maternal and newborn health
Resulted in decreased rates of postpartum depression


Why are doulas so effective?
There are 3 main reasons why we think doulas are so effective. The first reason is the “harsh environment” theory. In most developed countries, ever since birth moved out of the home and into the hospital, women have been giving birth in conditions that can often be described as harsh. In the hospital, laboring women are frequently submitted to institutional routines, high intervention rates, personnel who are strangers, lack of privacy, bright lighting, and needles. Most of us would have a hard time dealing with these conditions when we’re feeling our best. But women in labor to deal with these harsh conditions when they are in their most vulnerable state. These harsh conditions may slow down a woman’s labor and decrease the woman’s self-confidence. It is thought that a doula “buffers” this harsh environment by providing continuous support and companionship which promotes the mother’s self-esteem.

The third reason that doulas are effective is because doulas are a form of pain relief. With continuous support, women are less likely to request epidurals or pain medication. Why are women with doulas less likely to request pain medications? Well, women are less likely to request pain medications when they have a doula because they just don’t need an epidural as much! Women who have a doula are statistically more likely to feel less pain when a doula is present. Furthermore, by avoiding epidural anesthesia, women may avoid many medical interventions that often go along with an epidural, including Pitocin augmentation and continuous electronic fetal monitoring.

Hodnett, E. D. (2002). “Pain and women’s satisfaction with the experience of childbirth: a systematic review.” Am J Obstet Gynecol 186(5 Suppl Nature): S160-172.
Hodnett, E. D., S. Gates, et al. (2012). “Continuous support for women during childbirth.” Cochrane database of systematic reviews: CD003766.
Hofmeyr, G. J., V. C. Nikodem, et al. (1991). “Companionship to modify the clinical birth environment: effects on progress and perceptions of labour, and breastfeeding.” British journal of obstetrics and gynaecology 98(8): 756-764.