San Francisco Chronicle - (Sunday)
Helping families find better lives
Founder of Homeless Prenatal Project aids thousands
Chances are, many of the 7,500 homeless men and women living on San Francisco streets and in shelters began life poor. They may have been born addicted or premature — and they may have mental or physical problems as a result.
Three decades ago, Martha Ryan understood the pattern: a tragic, costly cycle affecting multiple generations and absorbing millions of taxpayer dollars. But as a shelter volunteer in
San Francisco three decades ago, Ryan had no idea of the role she would play in halting that cycle and improving the lives of thousands of people and their descendants.
The nurse practitioner planned to spend her career in the developing world. She’d already worked in far-flung regions — Ethiopia, Somalia, Sudan and Uganda — teaching, nursing and training women to be public health leaders in their villages. She wanted to keep doing it.
But in 1988, Ryan paused to earn her master’s degree in maternal and child health from UC Berkeley and to volunteer at the Hamilton Family Shelter in San Francisco’s Haight-Ashbury, where, she worked with homeless women. Many were addicts, and many were pregnant, with more immediate concerns than getting the sleep, balanced diet and medical care needed for their babies to be born in good health. This alarmed Ryan, who began knocking on the doors of public health officials and local nonprofits to tell them prenatal care was critically needed among the city’s growing homeless population.
“They would say, ‘that’s awful,’ ” Ryan said. “But no one did anything.”
So she did.
“I found the developing world right here in San Francisco, one of the richest cities in the world,” Ryan said.
She won a $52,000 grant in 1989, dubbed her new venture the Homeless Prenatal Project and, from her headquarters in
“I found the developing world right here in San Francisco, one of the richest cities in the world.”
Martha Ryan, nurse practitioner
an empty closet at the shelter, she referred 45 pregnant homeless women to prenatal programs around the city that first year.
Today, the $7.5 million Homeless Prenatal Project serves more than 3,500 families a year — not only helping with medical care, but with housing, parenting classes and a range of other services intended to break the cycle of extreme poverty.
Ryan is one of six finalists for Visionary of the Year, an annual recognition by The Chronicle of Bay Area leaders whose work improves the world.
San Francisco Mayor London Breed believes Ryan has done just that and nominated her for the honor.
“What’s inspiring about Martha and her vision is that she’s really changing lives in a way that is absolutely amazing,” Breed said. “This organization is amazing and an important part of our city, the future, and our ability to care for a very vulnerable population.”
Breed expressed particular admiration for the fact that Ryan’s “project” has grown and consistently improved over three decades with Ryan at the helm.
Rep. Nancy Pelosi, D-San Francisco, has called it a national model. A walk through the Homeless Prenatal Project’s three-story building in Potrero Hill across from San Francisco General Hospital reveals a bustling, cheery environment where children play, women get their needs met, and half of the 100 or so staff members are former clients.
Often, the best ideas come from people whose life experience tells them what’s needed, Ryan said.
“You hire people much smarter than you are,” she said. “Hire to your weakness.”
It’s not that Ryan never knew poverty while growing up — or babies.
The third eldest of 13 children, Ryan was 6 in the 1950s when her dad’s San Mateo business — distributing White Rock soda — collapsed. Family members didn’t lose their house. But they ate stale bread and wore handme-downs.
“Everyone except us knew we were the ‘poor Ryans,’ ” she recalled. Devout Catholics, her parents vowed to attend church every day if they came out of poverty. It was at church that a man offered her father a job selling auto parts in Asia. Ryan was 9 when the family moved to Hong Kong, and then to Japan, where she learned to feel comfortable in a culture different from her own. She stayed until 1967, when she returned to the Bay Area for college. “Knowing that we were poor, and knowing that people gave us clothes and people helped us when we were in need, I think that has something to do with why I do what I do,” she told the University of San Francisco in 2014 when the school gave her a medal. She graduated from USF in 1972 with a bachelor of arts in languages.
Through the Homeless Prenatal Project, Ryan learned that to improve life for children, you had to help their parents. If not, “I guarantee you that the next generation of chronically homeless is in the pipeline,” she said.
So the airy, industrialstyle building doesn’t only have bins of free clothing for children and stacks of diapers for the taking, it has private cubicles for counseling, and day care. On a recent Wednesday, a housing workshop was about to begin, offering help finding — and keeping — a home. Often, when families do find a place, they have nothing to fill it up with.
So the Homeless Prenatal Project, known as HPP, is working with a local company, McRoskey, to donate and deliver mattresses. HPP also gives families pots and pans — always new, Ryan emphasizes.
Nearly 240 families found housing through the Homeless Prenatal Project in 2018. But rents are soaring, so that’s less than in prior years. Nevertheless, “we start with a map and ask people where in the Bay Area they want to live,” said housing associate Antionette Fort.
The Homeless Prenatal Project also has an office that helps parents with the Family Treatment Court, which is the San Francisco court that tells parents who are in danger of losing custody of their children what they need to do to keep them. Often, the answer is to work with HPP’s substance abuse program,
or join its Fatherhood Support Group.
Upstairs are a UCSF family planning clinic and a high school: Five Keys, a public charter school begun by the San Francisco Sheriff ’s Department and specializing in young people transitioning from foster care to independence.
For homeless pregnant women — whose common connection is not only poverty but often childhood abuse, Ryan said — HPP tries to emulate the kind of caring, healthy and even pampering experience that other women enjoy when pregnant. So there is yoga, massage and midwives. There are parenting classes that culminate in a baby shower — a joyful party that’s expected for women of means, but not always for homeless women, who are at high risk for postpartum depression.
And then there’s “belly casting,” making a plaster cast of a mother-tobe’s pregnant belly. That can be fun — but it’s also serious stuff, Ryan said.
“These are often unwanted pregnancies. Maybe the result of rape,” she said. Belly casting can help women bond with their baby, while the parties and classes give them a community of friends.
In 2018, the Homeless Prenatal Project tracked 333 pregnant women and found that 306 babies (92 percent) were born fullterm. Of 316 babies weighed at birth, 284 (90 percent) came in at a healthy weight. And of 233 babies screened for drugs at birth, only one tested positive.
In 2012, it collected the stories of 28 graduates of its Community Health Worker training program in a book called “Facing Forward.” One graduate had had an infant with severe medical problems and had received an eviction notice. Another had dropped out of high school and become pregnant at 23; the baby’s father was in jail. A third was the daughter of a crack addict and an alcoholic and spent her early 20s in jail before having a son at 25.
Like all of the graduates, Ramona Benson, too, had a story. She was homeless, used drugs, and had a young child when she met Ryan. After going through the program, Benson graduated from San Francisco State University in 2012, and her daughter, 31, “is doing well,” she wrote in the book. Today, Benson is a director at Healthy Black Families, a Berkeley nonprofit. “Martha and HPP gave me a second chance when nobody else would.”
Nanette Asimov is a San Francisco Chronicle staff writer. Email: nasimov@ sfchronicle.com Twitter: @NanetteAsimov