Midwife mamas: balancing act?

[Maggi315]

All you midwife mamas with little ones (or former little ones), how do you balance your work and home life? What does your week look like? I try to do most prenatals monday mornings and 2 saturdays per week. Plus an occasional visit here at my home (thought that would be great and solve alot of problems, but causes me lots of stress and my kids don't behave well during the visits). Add into that the phone calls, paperwork, general business stuff, births, working with apprentices, postpartums, etc. and I feel very scattered and torn most of the time. Right now, I am doing about 2-3 births/month plus 2-3 private lactation consults/month.

I have lots of other ideas I want to do and expand, but I know now is not the right time. It has been painful, but I have had to turn down several speaking engagements at conferences, opportunities to work with others on projects, and more.

Any tips? Anyone want to share what their typical week looks like-I know that "typical" is a funny word to use when being a midwife. Am I just disoganized? How many calls do you receive typically in a week? I seem to get tons from potential clients, other HCP/midwives/docs, current clients, lab results, state calls and other general business calls. If I get 2-3 calls a day just from clients, I feel like I can't get anything else done around the house.

I'm obviously just venting today. I have had a rough week with several difficult client problems, difficult docs, husband out of town, and I feel like I haven't been able to spend any time with kids, and temper is short. Not the mama I want to be! Feeling crazy:

[Wittyone]

:

This type of question is why I popped into this forum - it's almost the one I was going to post. I'm a student CNM, mama to a 13 month old, and very part time RN at a birth center. I feel like I am constantly juggling, never caught up, resent my job though I love it when I'm actually there, etc, etc. I'm trying to envision what life might look like once I'm practicing, homeschooling, possibly having more children...I'd love to hear how others schedule/balance/organize their days, weeks and lives

[MidwifeErika]

I don't know what to tell you... I am an apprentice and am feeling out what a tough balance it can be at times. Like yesterday, I was gone for 13 hours.... 2 weeks ago I had a 17 hour workday. I came home exhausted and my kids just needed me so badly.... my youngest latched on and I couldn't shake her off for hours!

I am apprenticing with 2 midwives and they are fairly low volume at about 1 birth a month between the two of them. I live an hour from one and 40 minutes from another, so travel time does take up big chunks of my day. Every Tuesday is prenatal days and some Tuesdays I am only gone for 4 hours and others are like yesterday and both midwives will have appointments and I will be gone for 8-12 hours. Since it isn't my practice, I don't have to try to make time for the phone calls, emails, bills, etc. I am trying to take on a few things for each midwife to help them out since they are teaching me, but I still won't have that responsibility that they have to each client and to the business overall. I can tell you though that I am having an impossible time finding the time to study. This is something I am really struggling with. Between the kids and my being gone, I feel bad picking up a book... this morning I need to go swimming with the kids instead.... know what i mean?

I can tell you that my house is a mess as I spend very little of my time taking care of that (once a week my husband and I attempt to clean it up again for the next week), my school work is sliding, and we don't eat too much for homecooked meals anymore. So, my balance isn't so great.

Would it be possible to take a week or two off of prenatal visits to just have a break to stay at home and take care of everything there? Do you have help for some of the office work? Maybe for taking phone calls you could let them go to the answering machine and if they are urgent then pick up, but otherwise find one time to return all calls each day, one right after another? Would that work? So it doesn't take up your entire day taking a call here and one there?

I hope you are able to find some down time to just relax and reorganize a bit. You sound like you could use a bit of a break.

[Charmie981]

I'm not doing 2-3 births a month, but here are some things I do already:
1. After 3 births, my kids get a treat. I might bring home a dollar store toy for each them, a movie for everyone to enjoy (and then we'll sit down right then and watch it and eat popcorn!), or I might take them for ice cream or to IHOP as soon as we get home. Three births is many months for me. So for you, the number might be more like 8 or 10 births. Basically the idea is to make it a rare treat that is directly related to how many births you do. The midwife who taught me this said that her kids cheerily sent her off to births because they looked forward to finding out what their treat was. And they kept a tally of how many births she had done, so they knew when the treat was coming.

2. Set aside a time to return non-emergent phone calls. Unless it's a client who is due calling me, I don't answer the phone. My voice mail says to leave a message and I will return non-emergent calls within 24 hours, or to call back in 5 minutes if it's an emergency and I haven't returned the call. I know midwives who use an answering service and have the non-emergent messages held so they can call in and get them at a certain time each day. I'll probably do the same when I get to that point. My being on the phone ALL THE TIME really wears my kids down and it would be worth $60/month not to have that happen. I also ask my clients to use e-mail as much as possible because its easier for me.

3. Make sure your clients know you have kids and that your kids come first. I say this at every appointment and its often evident when I have to interrupt a phone call to interact with my child. There is nothing wrong with saying "hang on one moment, client" then removing the phone from your ear to discuss whatever is going on with your children. This is within reason, of course, because all children go through a stage where they interrupt phone calls just for the fun of it, but there are also genuine pressing needs that come up while you're on the phone. Deal with them then.

4. Cluster your appointments so that you can have as much time as possible with your kids. I'm not in a place where I'm doing appointments every week right now, but I had stuff spread out all over the calendar. I'm working to consolidate appointments so that I have one long day every two weeks rather that a couple of appointments each week. It makes all the difference in the world for me when I can have a day off!

5. After a long prenatal day, bring home dinner or take the kids out to dinner. In our house, it has been known since the days of my apprenticeship that prenatal days are "eat out" days, and its in the budget. Its sanity money for me AND the kids. I just am not on my best game after a long prenatal day (in my apprenticeship, they were sometimes 16 hour days!) and I don't have the energy to cook.

6. (decide how you and your clients feel about privacy issues surrounding this) Ask your clients if you can take a picture of the baby to show your kids. I use my cell phone and send the picture to DH's phone for him to show the kids while I'm charting after the birth. It helps my kids to actually SEE what I'm doing. They have usually met my clients at least once or twice over the course of the pregnancy, so I can say "Mrs. X is going to have her baby today and I'll see if she'll let me send a picture to you!" As I get busier and they don't know my clients, this will probably fade out, but for now, there's a name and a face to go with "why mama's gone" and it helps a LOT.

[mwherbs]

I have to say that I could not do it- well I did when I had 2 kids but not too comfortably and by the time #3 was less than a year old I pretty much slowed down to doing less than 6 birth/year and did it that way until our youngest was 13/14 raising kids and doing midwifery are both labor intensive jobs and I really don't know how to be comfortable balancing the 2-- but I also a different generation and did not expect to be a working mother either. Working midwife moms I knew basically took babies everywhere with them- prenatals and births alike-- actually anyone too little to be left at home all the time would be at most prenatals- and babysitters for older kids when at births--

[Earthy Birthy]

I have just got to the point where I can't do it anymore. I needed to take a break, or I would've gotten really burned out. My unexpected pregnancy was actually a blessing (in more ways than one), in that it has allowed me an excuse to step away from birth for a while. I needed time to re-examine what being a mw means to me. My apprenticeship was a very hands-on time, with a very hands-on mw. I am experiencing a very big shift in my personal philosophy regarding how I view many of the things that I took for granted as being a "normal" part of being a mw.

So, my last client gave birth in March, and I have referred anyone who called me since then to the other mws in town. I needed time to focus on myself, my birth, and my kids (although I am a very cranky pg momma right now). As for midwifery, I do plan to return to it sometime, but I just don't know when that will be... We are also looking to make some major life changes (dh is looking for a new job, which will mean a move), and I just don't know where that will leave my midwifery career...

So, my life is one big ? right now, but I'm finding this to be a very interesting thread, and I love to see the suggestions that some of you have for balancing family and midwifery. It is so hard to be so passionate about two monumentally important things, isn't it?

[JunipersMom]

I've just got the one two year old right now... I'm only taking one client due a month because that's all I can do and still give both my family and my momma's quality time and my energy. I bring my babe to prenatals and postpartums and leave her with daddy for births. I just answer my phone when it rings and help how I can - then when I get time at home I chart.
So far its worked out fine - but add another babe to the mix and we will probably have to re-evaluate.

[Maggi315]

I am definitely trying to cluster things, but I do find in this kind of work, that doesn't always work out well. Here's a sampling of my day/week:

Yesterday:
-sterilize equipment
-repack birth bag and go over par levels, get order ready for next week
-submit all the icd-9 codes and appointment dates for several clients
-f/u with lactation consult
-talked with mom and doc about baby with continued weight loss
-broke my toe (not midwife related, just one more fun thing to do!)
-returned 2 calls from state about birth certificates
-returned call from overdue client about tomorrows visit, bloodwork, etc.
Today:
-baby 2 weeks ago, continued weight loss, talked with mom and doc yesterday, going to do daily weight checks and "official" LC visits this week-she comes here, that's a plus
-sick client with stomach bug, haven't called her back yet
-another client, early pregnancy, cramping and slight bleeding, haven't called her back yet either
-saw overdue client at my house today, did blood work, GBS test, etc. Sent her to lab for 24 hour urine container, and had to get order for another ultrasound. Spent alot of time on phone with various people: labs, ultrasound, other midwife
-2 new clients: one email/one call: haven't returned either one
-send out new client info packet for someone due in January
-set up appt. for tomorrow to get birth certificate notarized and file

Tomorrow's plans: go get certificate notarized, "office day" my secretary comes for 2-3 hours and we try to update everything: quicken, labs, files, clean office, etc. See and weigh 2 week old baby. Deposit about 6 checks in bank (I desperately need to do this!!!) And hey, possibly another birth!

I know I sound like a whiney kid, after all, this is what I desperately want to do and I love it. I did schedule off next week, no prenatals and no office day, only emergent calls, so I will probably feel better after that. We are thinking of going away for a few days, but with 5 kids sometimes that's not a vacation, it's more work and stress.

I did put out there that I need some help and am thinking of hiring another midwife to work with me and take call and prenatals. That way, I can only work about 1/2 time. but I would hate someone to move across the country when I don't have any promises as to volume of work.

We also have been considering moving my office out of the house, but that would increase overhead and probably just add to the stress.

Thanks for letting me vent!!!! I absolutely love my work, love the women, love my family, and I don't think I'm ready to let it go, I think I just need to be able to take a step back, kwim?

[Maggi315]

just wanted to update this, see if anyone else has ideas.

i have just hired another midwife to come help me and I have an apprentice who will be on board come august. that will lighten my load enormously. i hope to cluster most visits on mondays, make a set time to return calls, get more organized so I can give more to my secretary to do and do postpartum visits during my sons naptimes.

I realize that I will probably never be able to quit midwifery and even if I did, i would still work (although much better hours!)so I need to just try to simplify things, get rid of the excess and most of all try to find some housecleaning and babysitting help!!

[Zoo Loo Naturals]

I know the 5 kids thing...boy do I!

I've got my family to where we all are in this together. All our lives and our individual things are a part of the whole family's life. It's enriching, encouraging, loving. No one's needs go unmet and we all have a voice. Alot has come to us through trial and error and I see the uncomfortable things as an occasion to change, rearrange and find a new way. Life is good like that.

That said everything is always in motion and ebb and flow.