Pregnant People to be Prioritized for Shelter and Housing

In San Francisco, all pregnant people should be prioritized for shelter and housing.

We are health professionals at UCSF and we recently asked you to help us guarantee this. We are pleased to report that on Friday, October 18, London Breed signed into agreement that all pregnant people who are unhoused will qualify for family status in access to shelter and housing. Previously, only pregnant people in their third trimester were eligible. This policy change has the potential to prevent poor health outcomes for pregnant people and their future children.

Pregnant people experiencing homelessness are at increased risk of preterm delivery and increased risk of delivering a newborn with low birth weight. Preterm birth and low birth weight can lead to short- and long-term consequences for infants ranging from heart and lung issues, to bleeding in the brain, to chronic medical conditions. Further, traumatic experiences during pregnancy can lead to PTSD, anxiety and depression, which can affect the bond between parent and child.

Importantly, shelter and housing are medicine. Homeless people staying on the street are at an even greater risk of these complications than those staying in shelters. In one study, shelter and housing was more predictive of poor birth outcomes than access to prenatal care.

Given this data, we want to celebrate the victory of the current policy change and recognize that there is still a need for improvement. Although all pregnant people are eligible, they are not prioritized. A clinical assessment is being developed to consider the need and risk of all family members. We must remain attentive during the implementation process in order to hold the mayor accountable. We must remain attentive to ensure a fair and equitable distribution of resources.