Living On Call

Over the years I've heard many doulas talk about things they do when they're on call - how they live their lives, what rituals they perform when they're anticipating a birth. Many doulas do this work part time. Many are married women with spouses who support the family, or substantially so. A few have other jobs and do births here and there. Doulas who do a handful of births each year sometimes have an "on call" period, typically two weeks on either side of a woman's due date when they guarantee their availability. So, there's a clear division for them between on call time and off call time.

I'm a full time doula. There is no such division in my life, and that's a problem sometimes.

Honestly, I've never really understood the concept of the on call period. I've had enough clients go into labour before 38 weeks that I wouldn't dream of going away for the weekend, for instance, when someone is 37 weeks without having their knowledge and approval well ahead of time and having backup in place. I've chanced it the odd time when I've had a month with no due dates - I've gone away for a weekend right after the last birth before a break. But it's hard to enjoy those breaks because it means I'm going to have trouble paying bills that month. But I digress...

What this means is that I've mostly lost the sense of anticipation that comes with being hyper aware of being on call. It's just how I live my life. This means that all other plans are subject to cancellation. We go to concerts and events, but we no longer have a symphony subscription because we were just too likely to miss evenings.

For quite awhile I was very cautious about alcohol use, but I've loosened up on that one. I tend to stick to just one glass of wine or one beer, however. It's not that I'm making any life-or-death decisions - I'm not a brain surgeon - but just because of the way it smells. Pregnant women sometimes have incredibly sensitive sniffers.

Whenever I start up with a practitioner who charges for missed appointments, I explain that I live on call and that I may need to cancel without providing 24 hours notice. I'll call and leave a message in the middle of the night if I'm on my way to a birth and I've got a morning physio appointment, for instance, but that's the best I can do. So far, everyone's accepted this and I haven't been charged for missing things. So far.

I do not cancel life and sit by the phone when someone's due date is close or has passed. I understand the new doula who finds it difficult to sleep when a client is close, but you can't live that way. Eventually the novelty wears off and it gets easier. I don't even cancel life when someone's in early labour anymore. Birth is unpredictable, and I often get to go to an interview, teach a class or attend a dinner party between the first "heads up" phone call and the "you need to come now call. I have a pager and a cell phone, so I carry on until I actually have to leave.

The cell phone is always charged. There are extra batteries for my pager in my purse, in my birth bag, in my desk and in my bedside table. (An aside: Why do pagers always, I mean *always*, start doing their chirping death dance in the middle of the night?) I live in a big city with 24 hour gas stations, so I don't worry about making sure the car is full at all times. Putting in ten bucks worth of gas really doesn't take very long these days, you know?

I do tend to have my birth bag and cd player in the car all the time. I don't think I've ever been called to a birth where I had to worry about going in inappropriate clothing because of not having time to change. Usually I'm at home when I get the call to come - because most of the time that's during the night. Babies like the night, the little dears! However, I have a couple of t-shirts in my birth bag and I could always ask to borrow a pair of scrub pants at the hospital if it were desperate, I suppose. I don't wear a lot of girlie shoes (with the occasional exception of something like The Red Boots ), so that's unlikely to be an issue. When I'm working with my contractor sweetie on a job site I usually have a change of clothes with me. I can do a birth in almost anything, but stained workpants and steel toed boots really aren't going to cut it. If I'm home then I wear my Crocs and a particular necklace for luck (yes, really, I know), but I can live without them.

Some doulas take two cars when out with their families when they're anticipating a birth. I've only done this when I've actually received a heads up call and I know there's a strong likelihood of having to go and leave everyone else behind. Otherwise they drop me at the client's home or at the hospital, or I take a cab, or the kids take transit home, or whatever seems easiest at the time.

It's just life.

It is hard, though, to be aware of this in the back of your mind all the time. I feel guilty if I stay up really late, have an extra drink, or god forbid get out of the house without my pager. (Actually, in the last instance I've been known to call home and get one of my kids to wear it so they can call me if it goes off.) And it's really hard to not be able to go anywhere. My sweetie loves camping, and although he doesn't get to do it much, summer being his busy season, he'd like me to come when he does get the chance. For that we'd have to go to some lame campsite just barely out of town and we probably would have to take two vehicles.

When I have a holiday or a conference or some such in the future, I tell potential clients about it at our initial interview. When I have a weekend out of town within a couple of weeks of a woman's due date I usually don't get the job. For my annual two weeks off in the summer I keep five or six weeks free of due dates in order to minimize the chance of missing someone. But each summer for the last three years I've had a client go into labour while I was at the cottage. It sucks to miss a birth. I have two repeat clients that are due within two weeks after my cottage time this year. I just couldn't say no because they're repeats, but they're going to have to meet the backup before I leave because I'm *not* racing home from the cottage for anyone this time. One year I found myself actually wearing a pager at the cottage because a client really wanted me, not my backup. One year I went a day late because someone went into labour the evening before I was supposed to go. This year I'm taking my two weeks come hell or high water!

I've been toying with the idea of taking one week per month off call, and making that part of my contract. If I just told families that I'm off call the third weekend of every month, or something like that, I could get some time to clear my head and shake off that on call awareness, as well as time to get drunk and stay up all night snogging. But I'm worried that clients wouldn't like it. Do any of you doulas or midwives do anything like that? Does it scare off clients? Do they use the backup if they need to?

Sigh. Apparently I'm going to use this blog to process things that are frustrating me. But I can be funny, too! Just wait! Really!