A Room at the Inn: Homelessness During Pregnancy and Demand for Maternity Housing
Abstract
More than one in fifty women who give birth in the United States report experiencing homelessness during the prior year. Yet most homelessness services are not well-suited for pregnant women. One potential solution is maternity homes, which provide housing and wraparound services to unhoused pregnant women. We estimate there are over 350 maternity homes in the United States with capacity to serve about 4,500 women. Yet there is little systematic evidence about the population they serve or the need for homelessness services during pregnancy.In this paper, we analyze the characteristics of 1,084 women applying to nine maternity homes between 2022 and 2025. We compare these women to nationally representative samples of pregnant women and of women of childbearing age to characterize their unique needs.
We find that maternity home applicants are substantially more disadvantaged than the comparison populations. For example, applicants’ formal education is significantly lower: 38% do not have a high school diploma compared to 7% of pregnant women in the Medical Expenditure Panel Survey (MEPS); only 3% have a four-year degree compared to 50% in MEPS. In addition, applicants report much higher drug use: one in four used cocaine, methamphetamines, or opioids prior to pregnancy, versus 6% of women ages 18-49 in the National Survey of Drug Use and Health. During pregnancy, 10% report continued use. Maternity home applicants also report significantly worse mental health, with 55% experiencing depression, compared to 14% of new mothers in PRAMS. These disadvantages may be partially traced back to childhood: 46% report five or more Adverse Childhood Experiences compared to 20% of women of childbearing age in the Behavioral Risk Factor Surveillance System. These findings suggest there is a significant need for housing services during pregnancy that address barriers beyond housing, including substance use, low educational attainment, and mental health.