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Birth centers vital amid maternity ward closures

With recent closures of hospital birthing wards, the role of birth centers has become increasingly essential, especially for women of color.

Nikki Helms is a midwife. She owns San Diego Community Birth Center, the county's only Black-owned birth center. She said it's a lot of responsibility, especially now.

"We've lost a birth center. We've lost two maternity wards. So my doing this work has become that much more important as maternity care starts to kind of disappear from the hospital system," Helms said. "So, you know, I need to be here."

Since 2021, at least four San Diego hospitals closed their maternity wards or announced plans to do so, including Palomar Medical Center Poway, Paradise Valley Hospital, Tri-City Medical Center and Scripps Chula Vista. Best Start Birth Center also closed in March. El Centro Regional Medical Center in Imperial County closed its maternity ward last year.


“A lot of folks are in what's considered a maternity-care desert. You know, there's no place you can go that's convenient to you and get that type of care during your pregnancy,” Helms said.

Mothers and their babies came to the center from across the county for a recent lactation class, a weekly gathering.

Valeri Felix gave birth to her son, Oscar, at the center last year.

“I just know that my biggest fear was the mortality rate for black women, and I wanted someone who understood,” Felix said.

Felix said her mother almost died giving birth to her. Black women are nearly three times as likely to die of pregnancy-related causes than white women. She said having a Black midwife calmed her worries.


“It just made the process a lot more relaxing. Like we were able to connect on a different level, I feel, than if it was with someone who I was just another number,” she said.

Helms said she is proud to be directly affecting those disparities in a positive way.

“There are studies that show that women of color, black women in particular, have better outcomes when they have culturally similar care providers,” she said.

Helms said she's thought about closing her doors a few times due to financial struggles. But with a new $100,000 equity impact grant from the County’s Office of Equity and Racial Justice and coaching from The Nonprofit Institute at the University of San Diego, she's getting ready to expand her maternal care services.

The grant program aims to support small, grassroots and minority-led organizations working towards social and racial justice.

“We're trying to, you know, reverse the disparities that exist for women of color in hospitals. And I think one of the first things that I want to do is to be able to support our group prenatal program,” Helms said.

She said mothers with similar due dates will go through the education process together.

The possibilities the grant creates stir up a mix of emotions for Helms.

“It's exciting, it's daunting, it's terrifying,” said Helms. But I have no doubt that I am exactly where I'm supposed to be.”

The child care industry has long been in crisis, and COVID-19 only made things worse. Now affordable, quality care is even more challenging to find, and staff are not paid enough to stay in the field. This series spotlights people each struggling with their own childcare issues, and the providers struggling to get by.