Home is Where the Health is

Pregnant women experiencing homelessness were more likely to have some adverse childbirth delivery outcomes than those with secure housing.

chart showing people experiencing homelessness also experienced worse childbirth outcomes and higher cost

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A home is more than a space that holds your material things. It is more than a place that you retire to after a long day. A home represents shelter, safety and stability.

The threat of homelessness is larger than four walls and a roof. Those threats could be even more severe for pregnant people and infants. Homelessness is associated with high rates of malnutrition, substance use, and mental illness and worsening of preexisting medical conditions. Previous studies suggest that pregnant women who experience homelessness attend fewer prenatal visits and face an increased likelihood of preterm delivery and infants with low birth weights who need neonatal intensive care. As a result, these families often experience longer hospital stays and hugely expensive health care bills.

A cross-sectional study conducted by Dr. Yamamoto and colleagues at UCLA compared the childbirth delivery outcomes and costs of health care of pregnant women experiencing homelessness with those who have secure housing. The researchers analyzed over 31,000 records from women who gave birth in Florida, Massachusetts and New York.

The graph above shows that pregnant women experiencing homelessness were more likely to experience preterm labor and placental abnormalities than women with secure housing. The study also found that pregnant women experiencing homelessness faced higher costs of care, even when delivering at the same hospital.

Women experiencing homelessness were also more likely to have been diagnosed with high blood pressure, obesity, alcohol problems or liver disease, and psychoses. Independently, each of these conditions can lead to negative outcomes for the mother and the child; together, these can be fatal.

Among the many reasons to end homelessness, we must add to the list an improvement in the health of new mothers and their children.

Yamamoto A, Gelberg L, Needleman J, et al. Comparison of Childbirth Delivery Outcomes and Costs of Care Between Women Experiencing vs Not Experiencing Homelessness. JAMA Network Open. 2021.