Good afternoon Councilmember White, Committee Members and committee staff. Thank you for the opportunity to testify today on B25-0945, the Housing Is Maternal Health Amendment Act of 2024. My name is Mary Katherine West, and I am a Policy Analyst at DC Action and a Ward 1 resident.
DC Action uses research, data, and a racial equity lens to break down barriers that stand in the way of all kids reaching their full potential. Our collaborative advocacy initiatives bring the power of young people and all residents to raise their voices to create change. We are also the home of DC KIDS COUNT, an online resource that tracks key indicators of child and youth well-being.
Births to parents under 25 make up about 15% of births in the District, and it is essential that these young parents have the support and resources they need to set up a solid foundation for themselves and their children. In 2023, the DC Primary Care Association, Children’s National Hospital, Howard University, and DC Action, alongside other organizations that serve expectant and parenting youth, released “A Well-Being Survey of Expectant & Parenting Youth in the District of Columbia.” This survey included responses from 385 youth under 25 who identified as expectant or parenting. Of these respondents, 14% did not have a place to call home at the time of the survey, 30% had experienced homelessness within a year of survey completion, and almost 50% reported housing as a top concern for themselves and their families. The impact of housing instability on parents well-being is reflected by the fact that researchers found that each additional move a young parent made was associated with a 23% reduction in the likelihood that a young parent would self-report themselves and their families as thriving.
The impacts of homelessness and housing insecurity on pregnant people and their children have significantly detrimental health and economic implications. When coupled with the structural racism that often limits Black people’s access to opportunities, resources, and power in the District to create acute racial disparities in homelessness and housing insecurity, the result is widespread adverse perinatal outcomes for Black families.
This legislation would help reduce a barrier that may contribute to harmful impacts on birth outcomes and parent and child health. As cited in legislation’s introduction, housing insecurity contributes to chronic stress, higher rates of depression, post-traumatic stress disorder, and comorbid mental disorders that can arise during pregnancy. Chronic stress from housing instability can exacerbate or prolong maternal health risks.
Furthermore, housing insecurity and homelessness decrease access to and use of medical care, which can lead to more visits to the emergency room for parent and child, preterm births, birth complications, and chronic health conditions for parents and children. Research shows that women experiencing homelessness experienced birth complications at twice the rate of women with stable housing. Maternal morbidity rates are unacceptable in the District at twice the national average, and disproportionately impact Black mothers.
Homelessness in early childhood exposes children to toxic stress, an adverse childhood experience in itself (ACE), which disrupts early brain development. Children who experience homelessness have developmental delays at 3-4 times the rate of those that do not experience homelessness, and the impacts on are more severe the longer the duration of homelessness. Toxic stress has impacts on the child’s social and academic outcomes,
Research shows that ”the compounding stress of homelessness both before and after birth is associated with significantly worse health outcomes for children than either homelessness before birth or after birth alone.” Ensuring that parents can access housing support as early as possible will help them stabilize and exit homelessness, which is key to preventing negative health and well-being outcomes for both expectant parents and children.
Earlier this year, Georgetown University released a report, Navigating Homelessness Assistance While Pregnant: A Rapid Qualitative Research-to-Policy Collaboration in Washington, DC, that recommends “timely and meaningful access to safe and stable housing in pregnancy.” This recommendation comes directly from participants discussing the barrier the third-trimester policy created to access care and services.
A 24 year-old parent in the report said, “It was very depressing . . . when I was experiencing homelessness, I always kept a good job, so in the housing program’s eyes, [I] don’t need help. I couldn’t get housed until I was nine months pregnant . . . [the housing office said] “We can’t give you anything unless you’re seven months at least.”
Other parents who participated in the study described the experience as stressful and frustrating. They want to take care of themselves and their babies, but delayed access to shelters created a barrier in their ability to access medical care, eat nutritious meals, or save money for the baby.
Limiting access until the third trimester means that expectant parents are spending critical periods for the parent’s health and a baby’s development in instability and economic precarity. This legislation addresses this barrier by permitting access to housing during the second trimester, and I urge the Council to go further to extend access to pregnant parents at any point in their pregnancy, including first, second, and third trimester to fully eliminate any time-bound barriers parents might face.
Parents want a place to unpack their own bags and a place to fold onesies and prepare for their little ones. Trimesters measure the development of the child, not the right to housing.
Beyond the scope of this bill, but equally important for the District government to address, the Georgetown researchers uplift “care coordination for services and referrals that support physical, mental, and social well-being; and access to a living wage and affordable housing” as recommendations from community members to support the health and well-being of expectant parents experiencing homelessness.
We hope for a District where all parents, and especially Black parents and young parents, have access to secure and stable housing that will set the foundation for thriving for themselves and their children.
Thank you for your time, consideration, and commitment to reducing maternal health disparities for Black parents and families in the district. I look forward to working with you in the future to implement a holistic systems-based approach to ensure all District families have the opportunities and resources they need to thrive.
