1. Morgan Chalifoux, PSW
Patricia Gladue, PSW
Marissa Nakoochee, PSW
May 2013Streetworks, Edmonton 1
H.E.R. Pregnancy Program
Streetworks
Edmonton, AB

2.  Involved in the street lifestyle
 Working in the sex trade
 Illicit drug use and addictions
 Current or past Children’s Services involvement
 Involvement or fear of the criminal justice
system
 Unaddressed past trauma
 Highly stressed, undernourished, homeless
 unhealthy relationships
 Preexisting or undiagnosed health problems
(HIV, mental health,STIs,PTSD,FASD)
May 2013Streetworks, Edmonton 2

3. May 2013Streetworks, Edmonton 3

4.  ID’s go missing
 Contact information frequently changes
 Homelessness – no place for your stuff, no
consistent bed, no safe space
 High rate of abuse and trauma – sexual, verbal,
physical, systemic, stigma, discrimination
 Difficulties navigating systems
 Previous negative experiences with service
providers
 Ability to read people
May 2013Streetworks, Edmonton 4

5.  Lack of knowledge on how and where to access
resources
 Fear of social systems/health systems
 Fear of “Authority” figures
 Fear of judgment or hesitation as a result of past
judgment
 Addictions
May 2013Streetworks, Edmonton 5

6. May 2013Streetworks, Edmonton 6

7.  Limited nutrition
 AISH and SFI limited incomes
 $627.00/month. $304.00 for essentials of
which $143.00 is for food, (housed)
 $323.00- Essentials- for women without a home
 Don’t all get a buspass
 Basic needs take priority (food vs. bus pass)
 Often need additional income-
 Cognitive issues- FASD, brain injuries,
developmental delays, mental health issues,
institutionalization
 Abstinence isn’t always realistic
May 2013Streetworks, Edmonton 7

8.  Street Language – swearing, slang
 Never alone – no privacy, lonely when living
independently
 Street friends may be unsupportive of positive
changes
 Difficulties with trusting relationships
May 2013Streetworks, Edmonton 8

9.  Fear of Children’s Services
 Extreme guilt about what they are doing
 Potentially sexual abuse survivors
 Potentially working in the sex trade
 Share their story frequently
 A proper diet with regular fresh fruits,
vegetables and milk is unattainable
 Harm Reduction - Clean needle is better than a
dirty needle, less use is big step, smoking
marijuana is better than drinking alcohol
May 2013Streetworks, Edmonton 9

10.  Previous negative experience with a health care provider
(from physicians to receptionists) and lack of
understanding by health care personnel about the realities
of street-involved lives
 Fear of judgement by mainstream service providers (race,
age, income, addictions etc.)
 Services and care focus on the fetus with limited woman
specific opportunities
 Labeled as a mother vs. a woman who is pregnant
 Lack of knowledge about pregnancy issues and the
importance of prenatal care
May 2013Streetworks, Edmonton 10

11.  Building relationships
 Outreach
 Non-Judgmental environment
 Meeting women where “they are at”
 A multidisciplinary team
 Networking and Collaboration – agencies, programs,
hospitals, Children’s Services, etc.
 Staff with similar past/shared experiences
 Informal setting
 Focus on the women
 Capable of “going with”
 Fetal heart rates for bonding and engagement
 Incentives
May 2013Streetworks, Edmonton 11

12.  Client centered
 Offering inner-city prenatal classes
 Recreational activities
 Consistent weekly drop-ins
 Social media
 Networking with other agencies
 Flexible(no appt necessary)
 Having Harm Reduction supplies handy
 Be consistent
 Use street or common language
 Make a “safe place”
May 2013Streetworks, Edmonton 12

13.  Address her concerns before addressing yours
 Focus attention on your conversation with her
(don’t do multi tasking)
 Having an open ear- willing to listen
May 2013Streetworks, Edmonton 13

14.  Long Intakes (what do you really need to know- Prioritize)
 Repeatedly asking about drug use
 Don’t let personal bias effect care
 Don’t give incorrect info about drug use + Pregnancy
 Don’t tell her “ you have to quit” when she brings up her
use
 Don’t cut her off of services if she misses an appointment
 Don’t use complex language- in person and on hand-outs.
May 2013Streetworks, Edmonton 14

15. May 2013Streetworks, Edmonton 15

16. Increasing the number of pregnant women who use drugs who
receive prenatal care requires systems-level rather than only
individual-level changes. These changes require a paradigm shift
to viewing drug use in context of the person and society and
acceptance of responsibility for unintended consequences of
public health bureaucratic procedures and messages about
effects of drug use during pregnancy.”
 Roberts, S. C. M., & Pies, C. (March 2010). Complex
Calculations: How drug use during pregnancy becomes a
barrier to prenatal care. Maternal Child Health Journal, 15,
333-341.
“Before you were born I carried you under my heart. From the moment
you arrived in this world until the moment I leave it, I will always carry
you in my heart”.
May 2013Streetworks, Edmonton 16

17. He knows I’m pregnant.
I told him last night.
He doesn’t think it’s his.
I m sure it is.
He told me to quit using.
While he sat there and lit up.
Is he going to leave me?
But he said he wouldn’t
Will he stop hitting me?
He said he would….
May 2013Streetworks, Edmonton 17

18. May 2013Streetworks, Edmonton 18

19.  Samantha Hardeman, BScN RN
 shardeman@boylestreet.org
 780-238-4632
 Brittney Willetts, RSW
 bwilletts@boylestreet.org
 780-990-7411
 Morgan Chalifoux, Pregnancy Support Worker
 mchalifoux@boylestreet.org
 780-239-2872
 Marissa Nakoochee, Pregnancy Support Worker
 mnakoochee@boylestreet.org
 780-239-5609
 Patricia (Trish) Gladue, Pregnancy Support Worker
 pgladue@boylestreet.org
 780-238-4862
May 2013Streetworks, Edmonton 19