National Maternity Housing Coalition

The Issue

Each year, about 160,000 of new mothers in the U.S. were homeless at some time in their pregnancy. Babies born to women who struggled with housing insecurity during their pregnancy face an increased risk of premature birth or low birth weight, which, in turn, can lead to longer hospital stays, more intensive medical care, and more time in the NICU. Babies born early face more health complications and long-term developmental challenges. The trauma of housing insecurity can also have a long-term impact on a child’s understanding of the world and the way they process information.

The research is clear that a lack of stable housing for expecting mothers negatively impacts both women and children. However, less is known about what programs can help offset these risks. Maternity homes are an under-studied intervention that could improve outcomes for expecting mothers and their babies. These services seek to provide stable housing and comprehensive services that address both the immediate housing needs of pregnant women, as well as set the mother and child on a path towards long-term self-sufficiency.

The Intervention

Maternity homes provide pre- and post-natal housing as well as critical services for homeless pregnant women and their children. These specific housing programs offer expecting mothers an alternative to abortion. For those who do not already have a community to rely upon, a maternity home can be the social support they need in order to welcome a child into the world. 

Maternity homes offer support and resources for more than just the pregnancy. They are prepared to help women simultaneously facing other challenges, including trauma and mental health struggles, abuse and addiction.

At the core of every service offered is a desire to promote the overall health of mothers and babies. The goal is that by the time women are leaving these nurturing environments, they are stably housed and have the skills they need to lead lives unlocking their fullest potential.

Hundreds of maternity homes exist across the United States, many belonging to the National Maternity Housing Coalition (NMHC), an umbrella organization that promotes excellence among providers and articulates a collective voice. Although each individual home offers a unique style when delivering services, their care structure remains deeply personalized to each resident and their particular obstacles. 

For this project, LEO is partnering with five maternity homes across the US which are a part of the NMHC. In these five homes, residents can stay and receive services for about a year after the delivery of their baby. Housing remains available even if the child is lost during pregnancy or birth. 

Over the course of that year, the new mothers continue to receive housing, supportive services, and parenting guidance while they work towards their education and employment goals. After residents leave the home, the maternity homes maintain some degree of contact, care, and support with the residents.

Research Question

What is the effect of maternity homes on housing stability and measures of well being for the mother and child?

Intended Outcomes

• Housing stability, increased skill development as measured by education attainment, employment, and earnings among mothers.
• Improved measures of well-being at pre and post-natal care visits for children.

Research Study Design

LEO and the National Maternity Housing Coalition (MNHC) are working together to conduct a randomized controlled trial involving five NMHC’s maternity homes across the country.

Those who are interested in or referred to maternity housing reach out to one of the NMHC homes via a phone call and conversation with the staff. The staff check the interested person’s eligibility to make sure they qualify for maternity housing. Pregnant women are eligible if they are at or below 250% of the federal poverty line and do not have stable housing.

Next, interested individuals schedule an interview to see whether or not they are a good fit for the specific maternity home they are interested in. Participants must  agree to specific rules in order to live in the homes, and expectant mothers have the chance to decide beforehand  if they are willing to agree to those rules. The individualized interviews also help the providers get to know the mother at a more personal level, so they can have fuller context on her situation and how best to serve her.

At this point, if the participant consents, they are placed on a waiting list for a spot in the maternity home.  When a spot becomes available, the spot is randomly assigned to one of the top two people on the waiting list. Mothers stay on the waiting list for two weeks. Individuals who are part of the treatment group receive a maternity housing slot as well as access to services within the maternity home. These homes provide a healthy and safe environment, facilitate access to prenatal care, social support, mental health treatment, life skills and employment training, parenting classes, and general support towards achieving goals. This evaluation is only possible because there is substantially more demand for slots in maternity homes than available beds and the evaluation gives all applicants a fair chance at receiving services.

Those individuals who are randomly assigned to the control group do not have access to these same services. Instead, they are given a list of references and information about other nearby maternity homes, local shelters, food banks, Medicaid enrollment, and other assistance programs.

Through the use of surveys at multiple stages along this process and administrative data, the researchers will track the outcomes of participants in both the treatment and the control group.

In partnership with the de Nicola Center for Ethics and Culture

 

 

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