Being Pregnant While Experiencing Homelessness
Homelessness poses a number of risks to everyone, but the stress level for homeless pregnant women can have severe consequences for both mother and child. Moreover, these women face a number of challenges to accessing prenatal programs and other critical health care. As such, prenatal issues, serious or not, can go undiagnosed. Infants born into homelessness are at risk for later complications that can increase the mother’s emotional and financial stress — which may contribute to a cycle of poverty.
Young Women Most at Risk of Homelessness During Pregnancy
Young people who experience homelessness often face increased exposure to sexual activity, which puts them at greater risk of sexually transmitted infections (STIs). Young women who become pregnant and contract a STI also risk their health and the health of the baby. Young women experiencing homelessness also have higher chances of becoming pregnant given their sexual exposure, especially if they do not have access to resources of family planning programs and pregnancy prevention education, resources critically needed across the country.
Also urgently needed are programs to help families deal with the financial stress of pregnancy. One of the driving factors behind the homelessness crisis in the United States is the increasing cost of housing. Recently, the New York Times profiled a family that became homeless as a result of pregnancy and the complications it posed to an already unstable housing situation. Those who struggle to make rent often find themselves under an increasing amount of financial strain, especially if the mother needs to stop working before and after giving birth. The experience becomes even more dismal if the mother has complications during or after the pregnancy, which can leave her with hefty medical bills and not able to work.
Cities across the country report increases in the number of pregnant women experiencing homelessness and, as a result, children under the age of six occupy an overwhelming number of shelter spaces. Some of the primary reasons women experience homelessness includes eviction, family discord and domestic violence. Pregnancy can add to the complications created by these situations. Families may fall behind on rent and other bills because of the costs associated with pregnancy and tensions begin to rise, which can lead to disagreements with partners.
Complicating Factors in Pregnancy During Homelessness
Another factor making pregnancy particularly worrisome during periods of homelessness remains the complex relationship between homelessness and substance use. Rates of substance use among pregnant women experiencing homelessness are disproportionately high in comparison to their similarly aged peers with stable housing. Drug and alcohol use can have serious repercussions for the unborn child, such as fetal alcohol spectrum disorder (FASD) and neonatal abstinence syndrome (NAS), which results when neonates withdraw from opiates they were exposed to in the womb. Even without these serious complications, substance use can lead to prematurity and low birth weight, which put the child at risk of other neonatal conditions and infections.
Programs aimed at connecting pregnant women to care throughout and after pregnancy are often underutilized, often because the women do not want to self-identify as homeless. They may fear they will lose child custody if they disclose their housing status, not to mention other stigma associated with homelessness. The corollary of the problem is the number of births by women experiencing homelessness remains drastically underreported. The challenge to addressing the intersection between homelessness and pregnancy lies in mitigating the stigma around it and ensuring that women can access services without fearing they will lose custody of their child.
Providing for Pregnant Women Experiencing Homelessness
The key service pregnant women require is prenatal care, which may be challenging for reasons such as transportation. Furthermore, pregnant women experiencing homelessness will often put housing, food and clothing before health care, so it is important to provide for these needs as well. Another issue some women face is providing for children they already have. Without childcare, these women will have difficulty scheduling appointments, especially since bringing other children along is not always feasible. Connecting pregnant women experiencing homelessness to prenatal care is not as simple as creating clinics offering these services. The solution must involve finding, engaging and educating these women, as well as meeting their other needs, including treatment for substance use, through integrated programs.
In addition to this sort of programming, researchers have also called for immediate housing solutions for women experiencing homelessness once they become pregnant. Researchers have found that any period of prenatal homelessness increases the risk of adverse events for the child. However, it is also important to consider how women will be housed once they have given birth. Not having a home other than a shelter to bring a newborn back to can cause a lot of stress during a time when new mothers should be focusing on other issues.
