- Women represent 80% of homeless adults (Liveright, 2018)
- Homeless women have an increased risk of chronic illnesses, infectious diseases, substance abuse problems, mental illness, and being a victim of sexual and/or domestic violence
- Homeless women are less likely to have insurance, social support, income, and access to preventative health care
Pregnant, Homeless Statistics
- Typically younger than nonpregnant homeless women
- 4% of the homeless population, roughly 1 in every 26 women of reproductive age (Liveright, 2018)
- Strong history of family disruption likely
- Higher rates of cigarette smoking
- Lower rates of unemployment, less formal education received
- Associated with Black and Hispanic races, those who are unmarried, uninsured, and not taking vitamin supplements prior to pregnancy
- More likely to be an unplanned pregnancy
Pregnancy and Child Outcomes
- Increased risk of adverse outcomes due to poor access to health care, poor nutrition, lack of housing, substance abuse, exposure to violence, high rate of infections, and co-occurring medical conditions
- Increased risk for preterm delivery and low birth weight
- Increased rates of acute and chronic health conditions for child after birth
In the Media
This media clip sheds light on an unfortunately all too common scenario. The pregnant, homeless population tends to fall through the cracks of and be failed by the health care system. Current research supports this, however the amount of help these women are willing to accept depends largely on their past. If a pregnant, homeless woman has been failed by the system multiple times, and has had a tougher life, the less likely it is that she will accept help. It also becomes more difficult to teach and ensure this population will understand and follow-through with care. Those who become homeless after say losing a job, and who have had a formal education are more likely to accept help. (Amauri dos Santos et al., 2017).
The woman in this news clip became homeless late in her pregnancy after experiencing a job loss and running out of money. This woman was preparing to stay with family but their house was destroyed by Hurricane Harvey leaving her with no where to live. She stayed in shelters until hearing about a new program in her area called In My Shoes. This program provides a safe-place for the pregnant homeless population. The program provides therapy, education, and resources and allows the women to stay until their child in nine months old. Programs such as this have been popping up all over the country. Current research shows that emergency housing such as this improves birth outcomes and reduces unnecessary hospital visits (Clark et al., 2018).
This clip shows the story of a pregnant, homeless woman named Amanda. Amanda is pregnant with twins and is living on the streets of Philadelphia. She has lost five children through Department of Human Services (DHS) due to substance abuse issues and lack of stable housing. Amanda’s family wants nothing to do with her. She is now in a methadone program, and she lives off of food stamps, begging, and stealing when necessary. Amanda states she is getting assistance with getting into a Mommy and Me program. She is not unique in her situation, as current research shows many homeless, pregnant women have been turned away by their families. Roughly 35% of this population has a substance use disorder (Liveright, 2018). Resources are limited in terms of housing accommodations and generally no social services assessment occurs until 28 weeks of pregnancy (Fordham, 2015). Healthcare providers need to advocate for this population and assist in ensuring that basic human needs are met for this population.
Massachusetts Community Resources
Women, Infant, and Children (WIC) 1-800-942-1007 https://www.fns.usda.gov/wic/women-infants-and-children-wic
Emergency Housing Assistance Resource 1-617-573-1106 https://www.mass.gov/how-to/find-emergency-family-shelter
Local House Authority Transition Housing Program (LHATHP) 1-671-573-1100 https://blog.mass.gov/blog/living-in-massachusetts/housing-resources-for-massachusetts-homeless/
Boston Health Care for Homeless Program 1-875-654-1000 https://www.bhchp.org/
Amauri dos Santos, A., Amuzza Aylla Pereira dos, S., Ingrid Martins Leite, L., Clodis Maria, T., & Elainy Priscila Bezerra, F. (2017). The context of the pregnant woman in the situation of street and vulnerability: its look at the pre-natal. Journal of Nursing UFPE / Revista De Enfermagem UFPE, 11(10), 4103-4110. doi:10.5205/reuol.10712-95194-3-SM.1110sup201713
Clark, R. E., Weinreb, L., Flahive, J. M., & Seifert, R. W. (2018). Health care utilization and expenditures of homeless family members before and after emergency housing. American Journal of Public Health, 108(6), 808-814. doi:10.2105/AJPH.2018.304370
Cutts, D., Coleman, S., Black, M., Chilton, M., Cook, J., Cuba, S., & … Frank, D. (2015). Homelessness during pregnancy: a unique, time-dependent risk factor of birth outcomes. Maternal & Child Health Journal, 19(6), 1276-1283. doi:10.1007/s10995-014-1633-6
Fordham, M. (2015). The lived experience of homeless women: insights gained as a specialist practitioner. Community Practitioner, 88(4), 32-37.
Liveright, E. (2018). Prenatal care for homeless women. In V. Barss (Ed.), UpToDate. Retrieved August 22, 2018, from https://www.uptodate.com/contents/prenatal-care-for-homeless-women