Being On Call
I’ve spoken to a few other birth workers lately about the way we manage being/living on call for long periods of time and how important it is to take breaks from on call life from time to time. I thought I would share a little about what this looks like for those who may not understand, either people wondering what it’s like to be a birth-worker or even those wondering what the on call fee is for in your contract… So, to be ‘on call’ for me looks like being available to my clients 24 hours a day from 37 weeks gestation until baby is born.
My phone is always on, always charged and always nearby enough for me to hear it if it rings or dings. My bag is packed, and in the car which is full of petrol and ready to go and I often prepare snacks in a lunch box before bed just in case that night is ‘the night’. I try not to stay up too late to avoid ending my day feeling shattered, just in case that night is ‘the night’ but I inevitably do sometimes stay up too late and then go to bed hoping that it won’t be ‘the night’!
That’s not where it ends! My husband needs to also have his phone on him all the time and be available for me to contact if he has gone somewhere without the kids (except for work). If we want to take a weekend day trip I need to make sure that wherever we go I will have mobile reception. Sadly, this counts out a couple of the beautiful reserves just near where I live that I love to go to. If I take my kids to a birthday party or play date out of town where, again, there is no mobile reception (which has happened a few times lately) I need to get the number of the host and make it available to my clients in case they need to reach me.
I make appointments and go about my days as usual, hoping that when birth happens, it will just fit into the flow easefully. It most often does, which is super reassuring and validates that despite mine and anyone else’s efforts there is some other higher power orchestrating the way it all unfolds. This has become clearer and clearer to me over the past 6 months or so. This is some of what being on call looks like generally for several weeks at a time. I’m sure I’ve missed some things though and would love for other birth workers to add anything else that comes to mind for them. Now I’m going to share more specifically what it looks like to be on call for a family when labour is imminent, as this takes the on-call life up a few notches.
Birth is (usually) more predictable than you might think. Although I am often on call for weeks at a time, usually for multiple expecting families, the reality of being on call is the most intense when labour is just around the corner. The closer a mama gets to her due date, the more frequently we’re in touch and if she reaches and goes beyond her due date, we’re generally in touch at least every couple of days. I know when the body is starting to give signs that labour is getting close, and/or when early labour has started and that is when being on call gets real.
That’s when I start thinking and planning a couple of days ahead, figuring out what to do with the kids and who I can call on to help me fill gaps if I need to leave in those awkward hours between when my husband has left for work and I can drop the kids to school or day care, or similar awkward hours at the end of the day, or if labour starts on a Thursday which is my only day without childcare available for my little one. There have been a couple of those lately.
To highlight what this looks like even more, I will talk about a client from a couple of months back who at 41 weeks lost her mucous plug and started contracting. It was a Wednesday, and I was in ceremony holding space for another mama. It was good to have the information that something was happening but I knew I wouldn’t need to rush off anywhere. I was thinking about the following day though as it was Thursday and I needed to call on my community for help. That evening, after further updates about progressing contractions I arranged for a friend to look after Lana during the day and my husband made arrangements with his work to work from home in order to drop Lana off at a decent hour (he usually leaves super early) and to make sure Oliver got off to school ok.
It was all lined up so I packed my snacks and lunch and went to bed after a final update from the labouring mama around 10pm. I triple checked my phone to ensure it wasn’t on silent and went to bed. I woke up several times in the night to check my phone, surprised I hadn’t heard from them and wondered if they might have had a reprieve from the contractions and fallen asleep. At 5.30 when my husband usually is getting ready to leave for work I phoned the hospital to check if this family had maybe gone in already but they hadn’t heard from them either so I assumed that yes, they must be asleep which meant that labour must have slowed down. I suggested my husband go to work as usual and went about my morning. Eventually I heard from the family who confirmed what I had thought and I spent the day with Lana and a friend.
The following night was much the same for me, waking up several times checking my phone and thinking about the following day in which I had a ceremony planned for another mama who was travelling from out of town and had accommodation booked where I would be doing her ceremony. I worried about needing to go in the early morning to the labour and not being able to see the ceremony through. However, labour was still slow and sporadic so I went ahead with the ceremony, stopping a couple of times to exchange messages with the family about where they were at, and to my relief got through the five hours of ceremony with no problems.
That afternoon I washed all of my gear and hung it up to dry, expecting once again that I would be called away overnight. Things did seem to pick up and around dinner time I was getting ready to leave to join the family but once again things slowed down, and I went to bed early again hoping for them that it wouldn’t be much longer. Another night passed, no phone calls or major changes so the Saturday morning when my husband went to the market with Oliver, I cleaned the house and changed some things around in the kids’ spaces and checked my phone regularly. By this point I was starting to feel a little stressed, and had a mother blessing planned for another client the following day, which I was to facilitate, and I worried I may not be able to make it. Surely labour would be picking up soon. In fact, that afternoon there was a shift and I left around 3pm to join the family, not knowing how long I would be gone, if I would sleep that night, if I could get to the mother blessing the following day, or anything much else at all.
As it happens I wouldn’t sleep, I would be gone for about 24 hours and I wouldn’t make it to the mother blessing the following day, which I would communicate to the mother in the early hours of the morning when I would step outside the birth suite for a moment to message her after it becoming clear that birth was still a while away. Then birth happened, I was no longer on call for this family. Often though, one birth happens and I’m still on call for others, and it just goes on and on until maybe a baby arrives sooner than expected and I get an unexpected break from being ‘on call’. In this instance I was already having a planned break for a couple of weeks and went to bed that night with my phone off and a great relief knowing that I would wake up in the morning in the same place I went to sleep and that when I kissed my kids to sleep at night I would just say I’ll see you in the morning, instead of the usual I’ll see you in the morning, unless birth happens tonight.
Being on call for an expecting family is intense. I only charge a very small $100 fee for being on call and lately I’ve been reflecting how utterly insufficient this is for the toll it takes on my life and my family’s life. I will be taking this into consideration when I reassess my packages later this year. I’d love to hear accounts of others who work ‘on call’ too!!
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