Pregnant and living hard life on the streets
S.F. struggles to get help to homeless moms-to-be
Sami Basu has lived outside for much of her pregnancy, first in a camp near AT&T Park, then in the parking lot of a diner on Potrero Hill.
With less than a month left before her daughter is due, the 23-year-old former UC Davis student and her fiance, Dustin Johnson, are sharing a room at the Mission Street Navigation Center with their two dogs. She has kicked heroin and crystal meth. But Basu still doesn’t know if she’ll have a place to live once the baby is born.
“At this point, it’s a waiting game,” she said, eyes widening as she clutched Johnson’s hand outside the Navigation Center one day last week. The two are on a list with 60 other families, all vying for a private-room shelter.
They’ve come to symbolize a distressing, increasingly visible face of the city’s homeless crisis: young adults who struggle to clean up their lives as they prepare to become parents. Doctors and agencies who work with these people say
more of them are showing up on the streets of San Francisco, but the city doesn’t have a way to track them or a coordinated plan to help them.
“We don’t even know how many of these women are not getting served,” said Martha Ryan, founder of the Homeless Prenatal Program, a nonprofit that offers medical and social services to homeless and low-income pregnant women. “But some are not getting served, I’m sure. We just don’t have the capacity.”
After Mayor Ed Lee formed the Department of Homelessness and Supportive Housing last year, the city doubled the number of private singleroom-occupancy units it offers to women in their last trimester of pregnancy — from four to eight. Ryan and other advocates applauded the increase, but are pushing for more. They say the rooms are always full.
The city does not keep data on how many pregnant women are on the streets. At least three live in Navigation Centers. Of the 22 HIV-positive women receiving services at UCSF Medical Center and San Francisco General Hospital, half are either homeless or in some kind of temporary living situation. The Homeless Prenatal Program offers medical care, job counseling and other services to 525 low-income and homeless pregnant women a year from throughout the Bay Area.
Social workers and others who serve these women say they should be a high priority.
“Once you get these mothers off the streets, you can start stabilizing them; you can get them invested in raising a healthy baby; you can look at the long term,” said Carrie Hamilton, a case manager at Homeless Prenatal.
She and Ryan say helping an expectant mom is the first step toward breaking a cycle of poverty that might get passed down from parents to children.
It’s also a way to help these mothers bear healthy babies.
Pregnant women who live in encampments are at high risk of contracting sexually transmitted diseases. Drug use is rampant, and basic comforts are scarce. People who live outside often don’t eat, sleep, drink water or use the bathroom on a regular schedule, which can be even more harmful during pregnancy.
Some women seek shelter and safety in the city’s jails, getting themselves arrested for petty crimes, Ryan said. Others get health care during pregnancy but struggle to find permanent housing after giving birth. If a woman shows up in the delivery room and tests positive for drugs, she risks losing custody of her children.
And then there are some women who just show up at the delivery room, sometimes with complications that could have been prevented.
It’s not that the city doesn’t offer services to help, said Deborah Borne, medical director of the Department of Public Health’s Transitions Division, which cares for homeless or marginally housed people who suffer from mental illness or substance abuse. It’s that people have to seek out those services and be willing and able to navigate the system by themselves.
The challenges only intensify once a baby is born, Ryan said.
“We want the baby to have food and housing, but we also want to invest in the mom, get her off subsidies and into the workforce. If our mission is to end the cycle of poverty, the effort has to continue for two generations.”
Officials at the Department of Homelessness say that when they find a pregnant women sleeping in a car or a tent, they make every effort to get her inside.
“If we find someone in an encampment who believes herself to be pregnant, alarm bells go off and we get her into services right away,” said Sam Dodge, the department’s deputy director.
There has been discussion within the department about opening a special shelter or Navigation Center for pregnant women, Dodge said, but so far nothing concrete has emerged.
Meanwhile, doctors and organizations who help these women face serious challenges, Borne said.
Elise Brodeur-Jacobs was one of those hard-toreach women who nearly eluded all the outreach teams that tried to help her. The freckled, disarmingly buoyant 24year-old was living in a tent on Division Street when she found out she was pregnant. She was arrested on an old theft warrant two months before giving birth to her son, Jeremy Lin-Harvell II.
Brodeur-Jacobs spent much of her last trimester in jail. Four months later, she talked about the experience.
“I just couldn’t get fresh air or eat vegetables, and I had to keep asking for extra Ensure (nutrition) drinks, because I knew I wasn’t eating enough,” she said of her time in jail, bouncing tiny Jeremy on her lap.
The two now live in Women’s Hope, a residential treatment program for low-income mothers with drug dependencies or psychiatric disorders. Brodeur-Jacobs, who grew up in the Haight and whose parents battled crack addiction, started taking opiates when she was 14 years old. She later moved on to heroin and speed.
It took months for outreach workers to coax her into services.
“People living in encampments want to be disconnected from social systems,” said Kelly Costello, a social worker at the Homeless Prenatal Program who cares for women suffering from substance abuse or mental illness.
“Many of them go by street names,” Costello said. “The mentality is, ‘If I stay under the radar, I’ll be able to keep my baby.’ ”
But pregnancy can also be an opportune time for change, Borne said.
Brodeur-Jacobs dreams of moving to an apartment on Treasure Island with her fiance, the elder Jeremy Lin-Harvell, whom she met at the Division Street camp. Getting there won’t be easy. Lin-Harvell is a former foster child with deep suspicion of any authority figures, including the city workers who tried to assist him. He now lives in a Tenderloin residential hotel.
Over at the Mission Street Navigation Center, Basu and Johnson are starting to get anxious. The two have settled into a routine, taking their dogs to the methadone clinic, intermittently napping in their room and calling their case manager, Hamilton, for word about housing.
Basu, who has lupus, said she is tired all the time.
“It’s nerve-racking,” she said. “I’m getting closer and closer.”