Life being what it is, this may sometimes happen for any and all midwives, indeed for any birth attendant regardless of where they're catching babies (it even happens in the hospital!). I keep my client load low to minimize the chances of having to clone myself. And, fortunately, the greater San Diego area has a robust and supportive community of midwives. I have relationships with several other midwives whom I trust and respect to back me up on those rare occasions when I am at another birth, just as I am available to back them up in the same situation. Sustainable home and birth center birth practice depends upon the proverbial village!