Being on call 24/7 is the reality of caseload midwifery. Otherwise what is being done is team midwifery.
I have been case loading for 12 years. It works really well for me. With 4 women a month (and 4 back ups) this means that I will at worst case scenario lose 8 nights sleep each month. The reality is that probably only half of the births will make me lose sleep. Generally I work 9am to 3pm so that I am there before and after school for my children. Any school functions or social events get put in my diary first, no negotiating shift swaps, I simply don't book work then. If it is something that I absolutely do not want to miss I tell the women that are due and my midwife colleagues that I'm not available from 6pm until 10pm on Wednesday and they should call their backup midwife. None of the women have needed to do this. They just wait for me. I find the women incredibly respectful and they don't call me in the middle of the night unless it is an emergency. It does take some getting used to being on call all the time and I often talk about it in terms of a Zen existence. Living in the now. I get on with my life knowing that all could change in a moment. Now I'm eating dinner but I could be called to a birth, it doesn't stop me from eating dinner. Now I'm at the movies, but I could be called to a birth, but I'm enjoying the movie. I'm in the now and open to what the future holds. I love it. I love the unpredictable nature of it. I have great family and friend support with my children, so I can go to attend women without any worry. That is vital. The payment stuff is tricky and really needs a good solution but we don't have a good solution here yet. You should not be getting a pay decrease as reward for your increased responsibility and service to women. Sally Westbury Homebirth Midwife "It takes courage to remain a true advocate for women, challenging authority and sacrificing social and professional acceptance. It takes courage for a woman to choose a caregiver who will truly advocate for and empower her." -Judy Slome Cohain -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.