Pregnancy and homelessness: service responses
This research by Launch House in Victoria, originated from concerns that pregnant homeless women are not receiving the level of support warranted, given their circumstances and that of their unborn child. While individual homelessness services work with pregnant homeless women, there is currently no systemic response to this group, nor is there reliable information on how many women among the homeless population are pregnant. These gaps in the service system, and in the collection of data, contribute to lost opportunities for intervention to provide the best possible support to women and infants.
The lack of data about the incidence of pregnancy and homelessness in Australia is a significant gap in knowledge that could be used to inform social and health policy and service delivery. While homelessness can have dire consequences for both mothers and infants, pregnancy can be a turning point for homeless women, which supports the need for strong system responses to this group.
The research found that, like all homeless people, pregnant homeless women experience difficulty in accessing housing support due to the overwhelming demand for these services. Moreover, even when accessing housing support services, pregnant homeless women may not receive responses to their additional support needs, in part because some homelessness services do not take pregnancy into account as a risk factor for determining access to support until late in the pregnancy. In a housing crisis, women may be referred to rooming houses or to stay with family or friends, which is likely to be unsustainable or become unsuitable once the baby is born.
Many pregnant homeless women have experienced domestic and family violence but, due to an overburdened service system, they may not receive a family violence specialist response. Women aged 25 years and over are the least likely to receive a specialist response. Critical shortages in safe, stable and affordable housing constrain the capacity of homelessness services to support pregnant homeless women.
It was also evident that housing and homelessness service workers may not have the skills to work with pregnant homeless women. Training is needed in sensitively collecting information about pregnancy status and improving practice with this client group to produce the best possible outcomes for the woman and her child.
Service providers reported the need for specialist health support for homeless pregnant women, as well as for mainstream health services, to be well-informed of the needs and circumstances of this group of women. Service providers identified the key elements of these programs as wraparound provision of services, continuity of care and outreach. Peer support was identified as particularly important for young women and there is the potential to further develop such initiatives for pregnant homeless women of all ages. Long-term support, while often needed, was limited.
Ongoing collaboration and further integration among and between specialist health and homelessness services were seen as a means of improving responses to pregnant homeless women.