An NBC Bay Area investigation reveals a dramatic increase in the number of homeless pregnant women and newborns struggling to make ends meet in high-priced San Francisco, where the median rent for a one-bedroom apartment now totals $3,390 per month.
"Women tend to languish without stable housing for most of their pregnancy," said Dana Lazarovitz, a registered nurse with the San Francisco Department of Public Health. "There's nowhere affordable for them to live with their family."
When pregnant women are spotted throughout the city, Lazarovitz is generally the first to respond. The epidemic of pregnant homeless women is on the rise and Lazarovitz is trying to confine the crisis.
"More and more women are describing themselves as homeless or marginally housed," she said. "It doesn't feel like there's enough housing available to them when they need it most."
Rising Number of Homeless Pregnant Women
Her patient list of homeless pregnant women has roughly tripled in just the past five years. While San Francisco shelters boast 137 beds each night for homeless families, most pregnant women aren't prioritized until they're at least 7 months along.
“In my experience, pregnant women will spend most of their pregnancy on the streets before they're prioritized for a family shelter,” she said. "That's a really serious issue."
Lazarovitz believes the housing crisis is to blame for the rising number of pregnant homeless women.
“There are so few affordable housing units and supportive housing units for women,” she said.
The number of pregnant homeless women is difficult to track, but the crisis is clear in San Francisco: moms with children, including newborns, can be seen begging on the street.
The Homeless Prenatal Program, a San Francisco based non-profit aimed at eliminating childhood poverty, provided housing and prenatal care to at least 224 homeless pregnant women so far this year. The number of women giving birth in San Francisco who identify as homeless or live in a single-room occupancy hotel has spiked 76 percent from 2010 to 2015, according to the California Department of Public Health.
Impact of Homelessness on Pregnancy
The pressures of homelessness can affect a pregnancy, according to Lazarovitz.
“That kind of a chronic stress of not knowing where you're going to have your baby and not knowing where you can take your baby is an indicator for a negative outcome for a woman's labor and delivery," she said. "Women who have chronic stress throughout their pregnancy are more likely to deliver early and we know that pre-term birth can have lasting effects for the child."
One of Lazarovitz's patients is 24-year-old Patricia Dowell.
“When I found out I was pregnant I was just like really overwhelmed and scared,” said Dowell. “How am I going to bring this kid into this world right now? I don't have anything. I don't have anything to offer...but I don't believe in abortions. So I decided to keep my baby.”
"I Made It This Far...I Can Go Further"
At a free visit with a midwife at San Francisco General, Dowell learned she’s having a baby girl, who she decided to name "Faith."
"It's believing in things unseen," she said. “I made it this far, you know, I can go further."
To get her doctor’s appointments, Dowell embarks on an hour-long commute each way: two bus lines and a train. Her fiance, Ace has also been on the streets. He now lives at a drug rehab center and Dowell resides in a women-only shelter though Catholic Charities. Dowell also regularly attends free parenting classes at the Homeless Prenatal Program in San Francisco’s Potrero District.
"Just because you're homeless doesn't mean that you're not capable of getting what your child needs," Dowell said.
Dowell has lived nearly half her life homeless. Her mother’s drug addiction forced them onto the streets when she was only four years old. Despite her rough beginnings, Dowell held several jobs and spent a year in college.
“I had to stop going to school because it's really hard trying to focus on school if you're homeless and you don't know where you’re going to sleep at night,” she said.
At times, Dowell has slept in city parks.
"I was in survival mode," she said.
"We Are Going to Literally End Family Homelessness..."
"There is a housing crisis in San Francisco -- it's been a crisis in the making," said San Francisco Mayor Ed Lee.
Lee, speaking exclusively to the Investigative Unit, appeared optimistic over the city's newly unveiled plan to dramatically reduce the homeless population through a public-private aimed at increasing affordable housing and shelter space.
Lee pointed to a $30 million program led by Lynn and Marc Benioff, which will create rent subsidies aimed at getting homeless families into housing.
Over the next five years, the city plans to develop more permanent housing for homeless families, enough for 527 people. The subsidized housing, unlike shelters, won’t have time limits on when families would need to move out.
“We are going to literally end family homelessness as we know it, “ said Lee.
As San Francisco moves forward with it's latest proposal to house more families, children continue to be born into homelessness.
New Found Faith
On October 30, 2017, Dowell checked into San Francisco General. One week past her due date, she was in labor. “A Halloween baby,” she said. Dowell was determined to have a natural child birth. But after about 30 hours of labor, doctors discovered the baby was in distress and decided to deliver immediately by C-Section.
Faith was born at 2:02am on November 1. She stretched just over 20 inches long and weighed 5 pounds, 14.7 ounces.
“I’m exhausted and happy at the same time,” said Dowell, beaming over her baby. "She's mine."
Dowell’s temporary shelter runs out in 4 months.
"You have to just survive and do what you can," she said.
While she isn't sure where she will move to next, Dowell is sure she will be able to provide a home for her baby.
"I have no choice but to be confident and hopeful that things will get better," she said. "If I have to change around my whole life just to make sure [Faith] has a place to stay and that she doesn't have to be homeless during her childhood, I will."