Emergency Maternity Housing for Pregnant Mothers in Need

Overseen By Vivian Crumlish, MEd

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: University of Notre Dame

Disqualifiers: Not pregnant, Under 18, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

Duration: Up to 1 year

1048 Participants Needed

Trial Summary

What is the purpose of this trial?

Moms will call and agencies will determine if she is eligible based on basic criteria. If she is eligible, the agency will send her an intake application link to complete, which includes a consent form. After completing the survey, if she is still eligible, she will be placed on a waitlist for services. When a bed becomes available in an individual agency, the agency will call two moms at the top of the waitlist, conduct in-person interviews to confirm eligibility and good fit. They will use a computer to randomly assign one to treatment and one to control. Agency will let moms know of their status and will allow the treatment mom to move in. Moms in treatment and control will be surveyed approximately one year post the mother's reported due date of the child.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Emergency Maternity Housing for Pregnant Mothers in Need?

Research shows that maternity group homes (MGHs) improve social support and relationships for pregnant women, especially those with poor initial support. Additionally, supervised group homes for homeless pregnant teens provide comprehensive care, leading to educational and vocational achievements. ^{1 2 3 4 5}

Is Emergency Maternity Housing safe for pregnant women?

The research does not provide specific safety data on Emergency Maternity Housing for pregnant women. ^{4 5 6 7 8}

How is the treatment 'Emergency Maternity Housing' different from other treatments for pregnant mothers in need?

Emergency Maternity Housing provides a safe place for pregnant women to stay near healthcare facilities, ensuring they can access timely medical care, which is crucial for those facing transportation or distance challenges. Unlike other treatments that might focus on medical interventions, this approach addresses social and logistical barriers to healthcare access. ^{4 5 9 10 11}

Research Team

Adrienne Sabety, PhD

Principal Investigator

University of Notre Dame

Jessica Brown, PhD

Principal Investigator

University of South Carolina

William Evans, PhD

Principal Investigator

University of Notre Dame

Eligibility Criteria

This trial is for pregnant women over 18 facing housing instability. Eligibility varies by home: some allow other children, others don't; background checks are common but not always disqualifying. Women must be low-income due to the nature of their housing situation.

Inclusion Criteria

I am a woman aged 18 or older.

Each home may have slightly different eligibility criteria such as allowing other children to come with her into the home or requiring a background check

Woman must be experiencing housing instability

Exclusion Criteria

I am not pregnant.

Some homes exclude mothers who have other children currently in their care

I am a man.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Randomization and Intake

Eligible participants are randomized into treatment or control groups and intake procedures are completed

1-2 weeks

1 visit (in-person)

Treatment

Participants in the treatment group receive a bed in the maternity home and wrap-around services

Up to 1 year

Follow-up

Participants are monitored for outcomes such as life satisfaction, employment, and housing stability

1 year after approximate due date of baby

1 survey (virtual)

Treatment Details

Interventions

• Emergency Maternity Housing

Trial Overview The trial tests the impact of providing maternity housing to homeless or insecurely housed pregnant women. Participants are randomly assigned to receive a place in maternity housing (treatment) or not (control), and surveyed about one year after their due date.

Participant Groups

Group I: Maternity Home Bed Experimental Treatment 1 Intervention

Receives a bed in the maternity home, wrap-around services, etc.

Group II: Control Active Control 1 Intervention

Referred to other services available in the community

Emergency Maternity Housing is already approved in United States for the following indications:

Approved in United States as Emergency Maternity Housing for:

• Housing for homeless pregnant women
• Support for pregnant women in crisis

Who Is Running the Clinical Trial?

University of Notre Dame

Lead Sponsor

Trials

36

Recruited

60,000+

Maggie's Place, USA

Collaborator

Trials

1

Recruited

1,000+

Bethlehem House

Collaborator

Trials

1

Recruited

1,000+

In My Shoes

Collaborator

Trials

1

Recruited

1,000+

Our Lady's Inn, USA

Collaborator

Trials

1

Recruited

1,000+

Aid for Women

Collaborator

Trials

1

Recruited

1,000+

Findings from Research

The establishment of a transitional care ward at Peterborough Maternity Unit has enhanced the overall care for mothers and their babies, ensuring that infants needing extra attention receive timely support.

This new ward also fosters a supportive environment for mothers with babies in NICU, allowing them to connect and share experiences during a challenging time, suggesting that other maternity units should consider implementing similar facilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transitional care for neonates. Simpson, D.[2004]

Maternity group homes (MGHs) significantly improve social support for pregnant women, with 54% of participants reporting better support during their stay compared to before, especially benefiting those with poor pre-MGH support.

A majority of women (77% to 82%) believe that MGH admission will enhance their current and future relationships, indicating that MGHs not only provide immediate support but also foster long-term relational benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternity homes and social support: A cross-sectional survey stratifying outcomes. Buskmiller, C., Columbus, C., Gavard, JA.[2020]

A maternity home program for homeless pregnant teens provided comprehensive care to 285 young women over six years, resulting in significant support such as prenatal care, education, and social services.

At discharge, 74% of the residents had achieved or were pursuing their educational or vocational goals, highlighting the program's effectiveness in improving outcomes for both the mothers and their newborns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The maternity home for adolescents: a concept from the past fulfilling a contemporary need. Yordan, EE., Yordan, RA.[2022]

Maternity waiting homes (MWHs) in Malawi are effectively reaching vulnerable women, particularly those with a history of spontaneous abortions and from lower wealth quintiles, suggesting they are targeting at-risk populations.

The study indicates that MWHs could be a valuable strategy for reducing maternal mortality in low-income countries, as they provide essential support to women who may face barriers to accessing healthcare.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reaching vulnerable women through maternity waiting homes in Malawi. Singh, K., Speizer, I., Kim, ET., et al.[2018]

Pregnant women who are homeless face significant risks for both maternal and fetal health outcomes, highlighting the need for targeted support.

Current social housing support for homeless pregnant women is inadequate, and improving collaboration among social and healthcare services, along with clearer definitions and legislation regarding homelessness, could enhance access to necessary resources during this critical time.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The homeless pregnant woman. Esen, UI.[2022]

Hemorrhage is the leading cause of severe maternal morbidity and preventable mortality, making it crucial to implement a national maternity patient safety bundle to address this issue.

The safety bundle consists of four key domains—Readiness, Recognition and Prevention, Response, and Reporting and System Learning—designed to standardize critical clinical practices across maternity units, with flexibility for adaptation based on individual facility resources.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

National Partnership for Maternal Safety: Consensus Bundle on Obstetric Hemorrhage. Main, EK., Goffman, D., Scavone, BM., et al.[2022]

Hemorrhage is the leading cause of severe maternal morbidity and preventable mortality, making it crucial to implement a national maternity patient safety bundle to address this issue.

The safety bundle consists of four key domains—Readiness, Recognition and Prevention, Response, and Reporting and System Learning—designed to standardize critical clinical practices across maternity units, with flexibility for adaptation based on individual facility resources.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

National Partnership for Maternal Safety: consensus bundle on obstetric hemorrhage. Main, EK., Goffman, D., Scavone, BM., et al.[2021]

Hemorrhage is the leading cause of severe maternal morbidity and preventable mortality, making it crucial to implement a national maternity patient safety bundle to address this issue.

The safety bundle consists of four key domains—Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning—designed to standardize critical clinical practices across maternity units, enhancing patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

National Partnership for Maternal Safety Consensus Bundle on Obstetric Hemorrhage. Main, EK., Goffman, D., Scavone, BM., et al.[2016]

Stakeholders in rural Zambia overwhelmingly support maternity waiting homes (MWHs) as a solution to improve access to skilled childbirth care, addressing significant distance and transportation barriers.

MWHs are viewed as a feasible and sustainable intervention that could enhance maternal outcomes by increasing the use of skilled birth attendants, but it is essential to also improve local quality of care to maximize their effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing a community driven sustainable model of maternity waiting homes for rural Zambia. Lori, JR., Munro-Kramer, ML., Mdluli, EA., et al.[2022]

Maternity waiting homes (MWHs) face significant challenges during crises, such as requiring women to be away from home and often lacking security and adequate space, which can hinder their use.

Some MWHs have successfully adapted to provide birthing and reproductive health care during conflicts, highlighting the need for flexible care systems that better meet women's needs in both stable and emergency situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternity waiting homes in times of crisis: Can current models meet women's needs? Wild, K., Kurji, J.[2021]

A study of 10 maternity waiting homes in Zambia over 12 months revealed significant variability in bed occupancy rates, ranging from 13% to 151%, indicating challenges in accurately planning the number of beds needed based on fluctuating demand.

Most sites had annual occupancy rates between 26-69%, suggesting that planners should use recent monthly birth data to better estimate capacity, especially during peak utilization periods, to ensure adequate support for pregnant women awaiting delivery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Planning for Maternity Waiting Home Bed Capacity: Lessons from Rural Zambia. Vian, T., Kaiser, JL., Ngoma, T., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Transitional care for neonates. [2004]

2. United States pubmed.ncbi.nlm.nih.gov

Maternity homes and social support: A cross-sectional survey stratifying outcomes. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

The maternity home for adolescents: a concept from the past fulfilling a contemporary need. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Reaching vulnerable women through maternity waiting homes in Malawi. [2018]

5. England pubmed.ncbi.nlm.nih.gov

The homeless pregnant woman. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

National Partnership for Maternal Safety: Consensus Bundle on Obstetric Hemorrhage. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

National Partnership for Maternal Safety: consensus bundle on obstetric hemorrhage. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

National Partnership for Maternal Safety Consensus Bundle on Obstetric Hemorrhage. [2016]

9. Scotland pubmed.ncbi.nlm.nih.gov

Developing a community driven sustainable model of maternity waiting homes for rural Zambia. [2022]

10. Netherlands pubmed.ncbi.nlm.nih.gov

Maternity waiting homes in times of crisis: Can current models meet women's needs? [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Planning for Maternity Waiting Home Bed Capacity: Lessons from Rural Zambia. [2022]