[Charmie981]

Just wondering. I've done eight births in my first year and only two were in the same month. The next year was looking bleak but is getting busier and I already have two months with two clients each. I think three is my absolute max, as I have no backup and my apprentice probably won't be ready to primary by then...<br><br>
What do you do? What is your backup arrangement? Right now I just pretty much pray that I don't have two moms go into labor at the same time. I feel like it's not very likely because it hardly ever happened in my apprenticeship even though we had 5-14 per month in that practice. And even when it did happen, it was an early labor piggybacking with a late labor (as in, mom was pushing and the other mom would call with early labor contractions, so we'd catch one baby and then one of us would go to the next mom's house while the other did the postpartum for the first mom).

 

[Defenestrator]

I think that one of the reasons why there has been so many views and not so many answers is that this is not an easy question to answer.<br><br>
So, without changing anything, I think that taking on one person every 2 week period would be pretty reasonable (adding a week or so to the due date of primips might be more accurate when planning). But I think that trying to change your situation might be a better option. Here are some ideas:<br><br>
Find a backup, even if she is several hours away. Offer to pay her an unreasonable amount of money to come to your labors so that she will truly be willing to get up in the middle of the night and drive to where you are. It might break the bank if you have to do it very often, but you probably won't. Building a relationship with her might also help strengthen your position in your own community. I have found that once a midwife has worked with me in a backup capacity she is more likely to refer clients to me, even if we have only talked on the phone.<br><br>
Train your apprentice in labor-sitting. Teach her how to do vaginal exam, take vitals on the mom, heart tones on the baby, assess for normal bleeding, and how to judge contractions. If you do have two labors at the same time, you can send her to the slower/earlier one. If you absolutely have two women birthing at exactly the same time, you might be faced with transporting one. In the short term, until you find another solution, you might want to present this possibility to your clients so that it is not a huge surprise when it happens.<br><br>
Consider asking your clients to labor at your home in the rare case of two women in labor at the same time. Yes, I know this is probably illegal, but I think it is defensible as an emergency plan.<br><br>
I think one of the important things is to make a plan for what you would do if there are two women in labor and share that plan with your clients early in their pregnancies so that they have a sense of what to expect. If the choice is between using you and planning a hospital birth, they might still choose to use you and take their chances. I think that I would.<br><br>
You are right, though, about it being unlikely that two women would be in labor at the same time, even with a client load of 4-6 per month or higher. I think that if you have some plan in place, you can safely take many more clients than you do now.<br><br>
Good luck in your growing practice!

 

[Charmie981]

Defensanator, thanks for the answer. I know it's a commonly asked question and a difficult one.<br><br>
I think I'm going to tell the clients that have others due in the same month that they need to be open to the option of coming to my office/birth center to birth, should there be two moms in labor at once. A backup is really impossible for me until my apprentice is done, as the closest midwife is 4 hours away an in a practice that is VERY busy, or 1.5 hours away, also in a really busy practice and not licensed locally. My apprentice has spoken of taking a month or two to get more experience at a higher volume practice and I'm very encouraging of it. After she's done, she and I will be each others backup and it will be so nice!<br><br>
So I think two a month will be comfortable and three a month will be "full" for me. That's the most women I could possibly have in labor at the birth center at the same time, so that makes sense. Should they ALL go into labor at once, I would still be able to conceive of possibly attending to all of them. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/yikes.gif" style="border:0px solid;" title="EEK!">

 

[riomidwife]

I am practicing solo right now, with back-up, and three a month would be max for me. I do not want to be practicing solo forever- hate it!!

 

[JunipersMom]

Personally - I'm only taking one client due a month right now because I have a 2 year old nursling... My family cant take more than that <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> I also try to keep one month a year open so that we can vacation or visit out of town friends etc...<br>
In my apprenticeship I've had 3 births in one day - but that practice had two primary midwives, two fully trained apprentices and one new apprentice. We usually had between 8 and 10 women due each month ~ and it seemed like they all went into labor in the same week!<br>
If you feel overwhelmed - cut back a bit. It can be very hard to say no to families, but you want to give the most attention and care you can to the clients you do take.