Written by: Thuwaraka Mohanakumar and Aansah Imran
Edited by: Anamika Adhikari
Over a quarter of Canadians who are experiencing homeless are women (Adermann et al., 2021, p. 1). Among the population of women experiencing homelessness, those who are “fleeing gender-based violence, trapped in situations of sex trafficking, (...) doubled-up or couch surfing, or staying in unsafe and/or exploitative situations to access shelter” are often excluded from government-based health initiatives due to the lack of data collected on their struggles (Schwan et al., 2020, p. 6). This blog will discuss the barriers faced by women in obtaining prenatal care and childcare services in Canada as well as existing solutions that must be highlighted to raise more awareness and help combat this issue.
Unhoused pregnant women encounter several challenging obstacles to accessing prenatal care services and ensuring the healthy development of their baby. For instance, many homeless women dealing with substance abuse, may put the fetus at the risk of suffering from fetal alcohol syndrome, low birth weight, and neonatal abstinence syndrome (NIDA, 2023, para. 2-9). Thus, the expansion and development of a prenatal care program for homeless women such as HARP (Homeless At-Risk Prenatal) in Toronto, which provides “free prenatal vitamins, food certificates and TTC tokens for medical appointments” and “supportive accompaniment to appointments, meetings and programs” (Toronto Public Health, n.d., p. 1) is integral to safe health of the mother and the fetus. Housing is also key for the development of the child and stability of the mother’s well-being. However, women who are experiencing homelessness or are on the verge of homelessness regularly encounter the burden of having to wait extensively long periods of time to receive subsidized housing - even taking as long as 10 years (Samuels, 2022, para. 3). Oppression and ‘othering’ against the homeless pregnant population also puts them at risk of receiving inadequate prenatal health care and exacerbates their reluctance to access this form of healthcare. Thus, prenatal health care providers for homeless pregnant women must provide gendered and trauma-informed care through a harm-reduction-based lens (Milaney et al., 2020).
What options are available to assist women after they have given birth? Unfortunately, hospitals have a limited number of beds available, leading to the discharge of patients who no longer require medical support, even if it means discharging them into homelessness. Fortunately numerous community organizations are available for women to receive support from after leaving the hospital. This includes the London Pregnancy and Family Support Center, a local non-profit that offers a variety of services to new mothers, such as free parenting classes (see STEP & GRIP), abortion support, or general help with getting connected to other organizations based on their individual needs. Another example is Safe Families, an organization that provides temporary placements for children facing difficulties or danger in their immediate environments. Through Safe Families, women can opt to have their young children stay in the homes of volunteer families while they undergo postpartum recovery. Various women's shelters, such as ANOVA, provide temporary housing and are another potential option, especially for women who do not wish to separate from their children. Lastly for women looking to enter the workforce after having children, Clothing Works can be a valuable resource. They offer education on dressing professionally to impress employers and provide free clothing to help women feel confident and well-prepared for their interviews. While there are supports available to help new mothers experiencing homelessness, it is crucial to recognize these resources do not entirely eliminate the challenges many face when raising their children. Continuous effort is still highly necessary to enhance the overall experience of these women.
It goes without saying that pregnant women experiencing homelessness face many barriers throughout every stage of their pregnancy and also after giving birth. Children born into homelessness are at higher risk for certain prenatal conditions, adding an even greater burden of care onto new mothers. Postnatally, homeless women face the challenge of raising newborn children in unstable environments while often having to sacrifice the time they need to heal from the stress that pregnancy places on the female body. While it is somewhat reassuring to know that support does exist to help these women throughout their journey, understanding and acknowledging these barriers is a crucial first step to generating awareness and working towards new and improved long-term solutions.
Andermann, A., Mottt, S., Mathew, C.M., Kendall. C., Medndonca, O., Harriott, D., McLellan, A., Riddle, A., Saad, A., Iqbal, W., Magwood, O., Pottie, K. (2021). Evidence-informed interventions and best practices for supporting women experiencing or at risk of homelessness: a scoping review with gender and equity analysis. Health Promotion and Chronic Disease Prevention in Canada, 41(1). https://doi.org/10.24095/hpcdp.41.1.01.
Milaney, K., Williams, N., Lockerbie, S.L. et al. (2020). Recognizing and responding to women experiencing homelessness with gendered and trauma-informed care. BMC Public Health 20, 397. https://doi.org/10.1186/s12889-020-8353-1.
NIDA. (2023). Substance Use While Pregnant and Breastfeeding. NIDA. https://nida.nih.gov/publications/research-reports/substance-use-in-women/substance-use-while-pregnant-breastfeeding.
Samuels, J. (2022). Addressing the Effects of the Inadequacy of Prenatal and Postnatal Care Among Unhoused Women in Canada. RN Journal. https://rn-journal.com/journal-of-nursing/effects-of-inadequacy-of-prenatal-and-postnatal-care-among-unhoused-women-in-canada.
Schwan, K., Versteegh, A., Perri, M., Caplan, R., Baig, K., Dej, E., Jenkinson, J., Brais, H., Eiboff, F., & Pahlevan Chaleshtari, T. (2020). The State of Women’s Housing Need & Homelessness in Canada: Executive Summary. Hache, A., Nelson, A., Kratochvil, E., & Malenfant, J. (Eds). Toronto, ON: Canadian Observatory on Homelessness Press. https://womenshomelessness.ca/wp-content/uploads/Executive-Summary-State-of-Womens-Homelessness.pdf.
Toronto Public Health. (n.d.). TORONTO PUBLIC HEALTH: HOMELESS AT‐RISK PRENATAL. Canadian Public Health Agency. https://www.cpha.ca/sites/default/files/assets/progs/soc-detrmnts/frontline/harp-risk.pdf.