Midwives in Southern California are working hard to keep up with growing requests for home birth and midwifery services during the COVID-19 pandemic and Nikki Helms is one of those brave midwives.
Wife and mother of two, Helms has worked as a midwife and postpartum doula in the San Diego community for over 15 years and is currently striving to deliver care and information during the pandemic. A significant part of her work involves providing customized, in-home childbirth education and newborn care classes for families that are in difficult and different circumstances.
She also emphasizes the importance of full-spectrum postpartum care and is spending much of her time outside the delivery room explaining how different birthing options can benefit people from all backgrounds, as well as dispelling some of the misinformation surrounding midwifery and home birth.
How are Midwives Adjusting During COVID-19
Like many midwives, these days Helms is receiving more inquiries for home birth since many people are afraid of contracting COVID-19 at hospitals and also want to know their birth team will be present for the birth.
She says her practice hasn’t changed much during the pandemic outside of taking extra sanitary precautions such as wearing masks, keeping a separate pair of shoes for work and immediate washing of garments after client care. Helms also mentioned that she’s waiting on more research regarding the potential vertical transmission of COVID-19 through fecal matter before she continues with water-births. She noted that in the meantime, some colleagues are using shoulder-high gloves to work with a mother during a water birth.
“Midwives are practicing social distancing like everyone else, but being home gives me more time to connect with clients and we can use Facetime and Zoom to talk through their birthing plans and how they’re feeling throughout the process,” she says.
Some organizations such as the California Association of Licensed Midwives provide N-95 masks to practicing midwives when masks are available, as they are in short supply as the virus progresses.
“As midwives, we have to be crafty and adaptable to different situations because people birth in many different settings. We are used to different home situations and client preferences, which is really important right now.”
Changing Birthing Plans During COVID-19
Although most health professionals are advising that expectant mothers stick with their original birthing plans, fears surrounding COVID-19 and new hospital visitation restrictions are still causing expectant mothers to look at alternatives.
She says part of the reason that changing birthing plans later on becomes a challenge is that expectant mothers lose the time to explore their options. “Depending on your area, there might only be a couple of practicing midwives, so even if you want to change plans later, it could be tough,” she says. “Planning ahead is crucial so people have time to find the right midwife for them and make a plan they feel comfortable with.” Helms has already started receiving requests from expectant mothers with due dates in October and November.
She explains that there is a significant transitional process that comes with having a home birth. “It includes a lot of communication around how they’re feeling about the switch and their concerns which you could miss out on by rushing into a new plan.” Helms also talks about the importance of receiving this type of care and having an open line of communication before, during and after the birth of their babies so that mothers feel supported throughout the journey.
Part of Helms’ professional focus involves postpartum care for the baby and mother, which she says is an important part of the process that some miss out on. “It’s a lot of talking and checking in so clients feel heard and know they have power over the decisions being made,” she says. “Then after a baby is born we’re still checking in on the physical and emotional health of mothers and babies.”
Before working as a midwife, Helms was trained as an EMT. She says the majority of calls she receives from prospective clients have to do with safety and planning for unexpected circumstances and she assures that most midwives are trained health professionals with access to the necessary medical equipment. “We always do a dry run as a part of the planning, so I visit with you in your home, talk about where you’ll keep your birthing kit and where things are in the home,” she says. “There is always an option to go to the hospital if you decide to.”
Affordability of Home Birth
Many midwives, including Helms, are willing to work with families and expectant mothers who can’t pay for everything at 36 weeks into the pregnancy, which is often the standard. “It depends on the midwife, but we talk about it before-hand. Most midwives are willing to work with you.” Midwives are also scheduling payment plans and applying discounts to help affected mothers pursue the birthing plan they feel most comfortable with regardless of their financial situation.
Despite the large numbers of people looking into home birth, Helms stresses the importance of carefully considering the birthing plan that is right for you and not jumping into a new plan out of fear. “We want people to know about their birthing options and feel empowered to make a safe choice they feel comfortable with,” Helms says. “Having a home birth comes with a different mindset, so it really helps to have that time to understand the process and figure out if it’s a good fit before making a quick decision.”