I was heading West along Burwood Highway in the morning traffic at about 8am, coming up to Springvale Road about 5 minutes from home when the dreadful realisation hit me in slow motion. I was heading for a post.
A near miss, I am thankful to report.
But this is an experience which is an integral part of the life of any midwife who accepts the need of women in her care to come into spontaneous labour, at any time of the day or night. The small number of midwives who practise privately in my part of the world, and the small number of women who plan homebirth, adds distance to the midwife's work terrain. A midwife has to accept travel: our 'village' is a virtual space that links the homes and lives of our clients with our own.
Those micro-second sleeps can kill. The risk potential is increased by the fact that I have a bottle of oxygen in the boot of the car, and other road users could also be at risk of fire in a collision.
The scenario about which I am reflecting now had several points of increased risk that were specific to this particular birth: I had been called out before midnight, and the mother had given birth around 5 am. The home was about 50 minutes' drive from my home. I followed my usual precautions for driving after a night's work: slowly eating an apple to keep some energy going into my body; listening to the radio; having the fan blow on my face ... After the 'scare' I phoned Noel and we talked until I drove into our yard.
I have no way of predicting which mothers will labour and give birth at night, and I discourage my clients from trying to 'know' this. One mother told me her five children had all been born in daylight hours. Her sixth was not!
This risk of falling asleep at the wheel is not about private practice or home birth. I remember a similar near miss about 25 years ago, when I was driving home after a night shift at the Women's hospital. That experience prompted me to explore ways of keeping my mind active and functioning when driving home after a 'night out'.
What have I learnt from this experience?
When I encounter combined risk factors of distance and sleep deprivation after a birth, I will consider other ways of getting home. This could include a taxi, or another person (who has slept the night) driving, or finding a place to sleep for a few hours before heading home.
I hope this post supports other midwives in their own understanding of our work, and planning for our own safety as well as that of mothers and babies in our care.