Being ON-CALL...

fearlessbirth · 04-28-2006, 10:01 AM

I am just curious as to how you ladies do the on-call thing. Some doulas I know, and midwives, too, say they are on-call (meaning they make no other plans and leave cell phone or pager on at all times, 24/7) for 2 weeks (edited) prior to EDD and 2 weeks after (edited). (I originally meant to say 2 wks not one. lol

I guess I am wondering if you all do this as well? What if you aren't 'on-call' yet and a client goes into labor 2-3 wks before EDD and they can't get in touch with you (middle of the night, say)? If THAT happens then do you still keep the money they've already paid? Is that considered something that the doula has no control over, therefore still gets paid for prenatals, etc? Am I making any sense?

Should I just keep my cell phone on all the time if I have clients, whether or not they are immediately due in the next week or so?

Thanks for your input!

moncton doula · 04-28-2006, 12:03 PM

I do have my cell phone on 24/7 during "on call" time. I guess I would say I am reachable 95% of the time anyway by cell phone. I do limit my planning somewhat during my official 2 weeks ahead of due date...I stay home from canoe trips or generally anything that would make me more than an hour from hospital during that time. But I don't sit home...I just carry my phone with me.
As far as before the "on call" period...I'm not sure how I'd deal with payment...haven't come accross it...I would probably refund or not ask for the final payment (which I consider the birth hours). If I had allready done the prenatal appts. I would keep that money.

susan1 · 04-28-2006, 12:10 PM

on my contract it states two weeks before the due date and two weeks after the due date. I am also reachable 90% however I can be reach the other 10% by another phone. All but one have been in labor before I am too be "on call". Not sure on the money I think I would just leave it up to the mother/couple. I have not had to deal with money.... yet.

Susan

gemasita · 04-28-2006, 12:34 PM

I am on call two weeks before until the baby is born. I have had a couple of moms go into labor before I was on call but I was able to make it there just fine. If I had been out of town, I would have not had them pay the balance, just the deposit (which they would have already paid me). I consider that compensating me for my time I've spent with them up to that point.

When I am on call, I don't sit at home either but I stay near a phone and don't go out of town. If I have a committment during my on call time, I let them know that before we ever sign the contract and I let them know that I have a backup doula (or I will attempt to find one if I don't have one). Then they know exactly what the situation is before they sign. If I can't find a backup, then they know that in the event that I can't make the birth, they would be on their own (and again, wouldn't pay anything beyond the deposit).

I think most people just want to know WHAT the situation is so honesty is the most important thing (before they sign up with you).

DL · 04-28-2006, 01:12 PM

Tomorrow is my first day on-call for my present client; while on call, I keep my cell phone with me and on while I'm out. At home, I rely on my home phone (bad cell signals at my house).

Today I am going to visit my Dad 1 1/2 hours away (I won't be visiting him during official on-call time unless it is an emergency). When on-call, I aim to not go further than an hour away. I did have one client labor & birth on the day before on-call time back in Dec. For that case, a back-up attended her, as that was my last day on my anniversary trip; there was no cell signal at our cabin (came home later that day to discover my client had her baby!). If noone had been able to attend her, I would not have charged her the balance, which I collect two weeks after the birth and consider that payment for labor support & postpartum visit. My Retainer, I would keep; I consider that as payment for prenatals, any other support they've received from me (i.e. phone/email), and placement on my calendar for on-call time.

No, although I usually do have my cell phone on me while out, I don't worry about it if I forget it while I'm not on-call. In those times, I expect them to leave a message or voice mail if I don't answer and I'll call them back. For most times, they'd be able to get me on my cell and I would be able to make it to them ok. You know...you have to draw a line somewhere (that is...one day being totally free, and the next starting your on-call period). You can't expect to worry about getting to them in a moment's notice for the entire 9 months!

fearlessbirth · 04-28-2006, 01:36 PM

Thanks guys! That's what I was wondering about. I have a new client (as of last night...yay!) who is not due until May 31 BUT Wednesday night went to the ER in labor and the gave her a shot to stop to ctx. While I don't know if she'll 'wait' until I'm on-call to go into labor, I wondered if I would feel guilty if I missed it. BUT, that said, don't want to sit around putting my life on hold, and then you know the baby will go to 41-42 wks.

Thanks for being my sounding board and, once again, giving great advice and insight!

tlcdoula · 04-28-2006, 03:37 PM

I keep my cell phone and pager on at all times. Whether I am home or away from home the cell phone and pager are always on, and if I go anywhere I make sure that both of them are with me. If a client goes into labor early I would make every effort to be there or my back up would go. I wouldn't not go for a client because she gave birth early or late. In fact once a client went into labor early and I was very busy, but I dropped everything and went to her side and then my back up came and relieved me when I "had" to leave due to a committment. I think it is important to our clients to know that they can contact us regardless of when they need us. Personally I believe that it is part of the service (just my opinion for my clients

As far as a client not being able to get in touch with you at night - why would this be? Wouldn't she have your home phone number? I think if you commit to being at her birth and you don't make it then she doesn't have to pay for that portion, but what it all comes down to is what your contract states. Mine states that I will refund money if I miss a birth due to a precipitous labor or an error on my part. So I would decide what works best for you and just make sure it is in writing. If you will NOT be available before the two week period make sure your contract states that, but be aware that this might scare people because they want your services and having a baby early or late is pretty much out of their control unless they choose an induction.

MothertheMother · 04-28-2006, 05:03 PM

I let clients know that I will immediately available to them during the on-call period but before that time it may take me longer to get to them. In other words I have childcare arranged for every situation during on-call but before that time I may not have it arranged. So they know I will still be able to attend them I just let them know the window of time is bigger.

capandcradle · 04-28-2006, 07:23 PM

Cathy, I've never missed a birth and haven't had any trouble being reached by phone or cell. I don't have a 2 or 4-week window, I know a mom will need me if her labor is premature or postdates. I just don't take clients when I won't be available.

Getting up in the middle of the night and leaving at the drop of a hat is just par for the course. Having reliable childcare is a must.

Anne

DL · 04-28-2006, 07:23 PM

I would like to clarify that although I don't worry so much about having to have my cell phone with me at all times while not on-call, I do tell my clients that I will get to them as soon as possible if they were to go into labor early. I definitely would want to be with them, unless there was just absolutely no way that I could make it on time (preciptitous labor and/or I'm too far away to make it). Whenever I am to be far away, I always tell my clients that that'll be the case ahead of time. My contract also covers what Michelle's does about how we would deal with missing births because of precipitous labors or due to errors my part. For those cases, I wouldn't charge the balance of the fee that would normally be due 2 weeks after baby's birth (that balance would be 1/2 the total fee, as my non-refundable retainer is the first 1/2 of the total fee which would've already been paid at contract signing).

1stimestar · 04-29-2006, 12:44 AM

Quote:

Originally Posted by susan1

on my contract it states two weeks before the due date and two weeks after the due date. I am also reachable 90% however I can be reach the other 10% by another phone. All but one have been in labor before I am too be "on call". Not sure on the money I think I would just leave it up to the mother/couple. I have not had to deal with money.... yet.

Susan

So, if a client went over 2 weeks past her due date would you then not be on call for her?

1stimestar · 04-29-2006, 12:52 AM

I am on call 2 weeks before DD till birth. I had one client who went into labor at 30 weeks so 10 weeks early. I was in a class when she called my job. (I was a teacher for the Adult Learning Programs of Alaska). I was so poud of her that she told them who she was and what was going on and that she needed me. Of course my job knows I am a doula and that if I get called I will have to leave soon but I always make sure that I have my work in order etc. But of course at that early time I didn't have a substitute teacher set up. My Executive Director came and got me out of my class and told me to hurry up and go call my client and get "out there". She would take over my class for me. That was so cool as it was a 3 hour class.

Anyway, client had to be medivacced to our large town when they could not stop the labor. I offered her back 50% as my contract states but she wouldn't hear of it. (It was at a discount rate to begin with.).

When I go on call I just keep my cell with me and carry on with life in general. I don't go out of town except for like today. I wanted to go about an hour out of town and wasn't sure my cell coverage would be too good out there. I just let my client know that I was going but would be back in an hour and would be checking for messages if my bars got low.