# The Experiences of Service Providers Who Care for Homeless Pregnant or Early Parenting Women

## TL;DR

This study explores the challenges and ethical tensions faced by service providers caring for homeless pregnant or early parenting women, emphasizing the need for systemic reforms and support.

## Contribution

The study introduces a feminist pragmatist perspective to highlight the emotional and embodied labor of service providers in this context.

## Key findings

- Systemic barriers like inadequate housing and fragmented services hinder effective care for homeless women.
- Service providers find purpose in their work through relational engagement and advocacy.
- Health systems must prioritize equity and support for providers to improve outcomes for homeless women.

## Abstract

Homelessness among women and children is a growing concern, shaped by intersecting structural inequities. Service providers working with women who are homeless, particularly those who are pregnant and/or parenting young children, navigate complex responsibilities that span legal, medical, housing, child welfare, and psychosocial domains. These responsibilities are often carried out in under-resourced environments and in response to trauma rooted in systemic injustice. A feminist pragmatist perspective recognizes the relational, embodied, and context-specific nature of this work, and values the insights of direct care providers as essential to shaping equitable and responsive care.

Our study purpose is to deepen our understanding of the ethical tensions and emotional and embodied labor inherent in the work of service providers who work with pregnant and/or parenting women who are homeless, while advocating for structural reforms that support both client outcomes and provider well-being

This study is part of a larger community-based research initiative. This article draws on a subset of data from 22 semi-structured interviews and two focus groups with service providers, including social workers, nurses, nurse practitioners, psychologists, corrections staff, outreach workers, and health administrators. Data were analyzed thematically, guided by feminist pragmatist principles that center experience, reflexivity, and practical action.

Findings reveal persistent systemic barriers to care, including inadequate housing, fragmented services, and institutionalized discrimination. Despite these challenges, service providers expressed a deep sense of purpose and fulfillment in their work, rooted in relational engagement, advocacy, and bearing witness to the resilience of the women they support.

Awareness of the human condition and a commitment to relational, justice-oriented care are central to effective service delivery. Health systems must prioritize equity and justice, ensuring that nurses and service providers are empowered and supported as advocates for pregnant and/or parenting women who are homeless.