K.A.
Thankfully my parents have never been more than around 15 minutes away. My mom comes over and watches/plays with the kids while I shower or get some things done. Sometimes she'll do the dishes for me while I sit with the baby on those clingy days.
My husband is also around a lot to help. I try to schedule any of my appointments so that either my husband or mother can come along and sit with the kids while I am with the doctor or something but they aren't too far away.
With my first 2 kids my in-laws were right down the road, they moved out of state before my third was born. My MIL came to my rescue now and again when I neeed another pair of hands.
My brother and SIL also live in a civil range of us and they have come to my aid when I have really needed it.
But, truthfully, my kids just go with 99% of the time. Yes, it gets interesting when I have all 3 by myself but it can be done.