A heartbreaking number of women become pregnant when living on the  streets. Here's how one program is helping homeless pregnant women have  healthy babies.

Each year, hundreds of Canadian women give birth while living on the streets or in shelters. In fact, about 50 percent of all young homeless women will become pregnant, often within the first year of becoming homeless. It's a staggering figure that becomes understandable only when you consider the risks these women face each day. On the streets, women are susceptible to rape and some turn to sex work for survival. Birth control can be financially out of reach, hard to obtain without identification or difficult to use for those struggling with substance abuse or mental illness, and pills may be stolen and sold as drugs. And, of course, many women choose to get pregnant.

"The reasons, unfortunately, are hard to hear," says Marisa Cicero, social worker and coordinator of St. Michael's Hospital's My Baby and Me Infant Passport Program, which helps many of the about 300 homeless pregnant women in Toronto each year. In 2005, St. Michael's created the passport, a portable health record for moms-to-be that tracks appointments and health information and helps locate local shelters and food banks. Now available as a free smartphone app, the passport allows women to take their health info to whatever hospital or walk-in clinic they visit, making for more coordinated prenatal care. But one of the most important facets of the program is how its health practitioners and social workers foster connections between the women and their unborn babies.

"It can be really soul-destroying to know that you're carrying this baby and you're not going to be able to look after it when it's born," says Cicero, explaining that many moms have to lose their children to the child welfare system, either because they don't have a safe place to live or because they're dealing with substance or mental health struggles. "I work with women and say to them, ‘This is your time to be a mom. The fact that you're growing this baby and trying to eat the best you can and reduce the risk of harm, that's you taking care of this baby.'"

For babies, this means healthier outcomes, and for women, it means a lasting memory of being mothers. Each woman in the program gets a prepaid disposable camera to take photos of her baby at birth that she can take with her back out onto the streets. "It's often the only pictures these moms have of their babies," says Cicero. "The saddest thing is seeing a mom leave the hospital without her baby, but if she can say goodbye, if she can take pictures, we can make the experience as positive as possible."

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