The term underhoused will be used in this discussion and is defined as ‘anyone without access to safe, secure and affordable housing’ (Shah et al., 2017). This term is preferable to homeless, as the women in question may have access to a temporary place to stay such as a shelter, refugee centre, or may be “couch-surfing” between friends’ homes, but do not have a safe and reliable place to live in. An estimated 300 babies are born per year in Toronto alone to underhoused women (Shah et al., 2017), and many are missed due to inadequate data collection methods and barriers to prenatal care. These women are at an increased risk of physical and mental health issues, and many lose custody of their babies because they cannot provide them with a safe and stable home environment (Shah et al., 2017). Many parents are also reluctant to disclose their housing status out of fear of being separated from their babies, leading to further underestimation of the issue. At St. Joseph’s Healthcare Hamilton where I work, I see many women coming in off the street to deliver babies, often without any prenatal care. In these cases, the gestational age is unknown and must be estimated. Many women in this situation report “not knowing they were pregnant” (which I feel is often a defense mechanism to avoid the guilt associated with not having prenatal care), or having a lack of resources or transportation to attend prenatal appointments. Some of these women are stable enough to be discharged with their babies to places such as a maternal care home, while most others have mental health or drug addiction issues that prevent them from safe parenting. Increased funding of social service programs is required to address this issue, such as the Young Parents No Fixed Address (YPNFA) program, which has fostered major collaborate projects supporting this population, including the creation of affording transitional housing, respite care, bereavement courses and educational events (Shah et al., 2017). There is a dire need for investments in affordable housing as rental prices in Toronto soar. A single parent working full-time at minimum wage simply cannot afford to rent an apartment in Toronto on their own anymore. Investments in shelters is like putting a bandage over the problem, as it still does not provide underhoused people with a safe and stable home to call their own. Increased access to addiction treatment services has also shown to increase the likelihood of parents regaining custody of children who have been apprehended (Shah et al., 2017). Lastly, more training is required for health care providers in order to understand and treat underhoused people. The American Pediatric Society recommends that pediatricians, nurses and social workers who work in the field should be trained in screening, assessment and referral of parents living in poverty (Shah et al., 2017). Reference: Shah, S., Bernstein, J., Moore, A. M., Thompson, G., Sohail, S., Ford-Jones, L., & Vandermorris, A. (2017). Three hundred babies born to underhoused mothers in Toronto--understanding the problem and how we can help. Paediatric Child Health, 22(5), 282-284.
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