Across all interviews, we identified five global themes that describe the experiences and needs that women encounter from pregnancy to the baby’s almost first birthday: 1) experiencing cascading effects of hardships during pregnancy, 2) relying on food assistance and informal supports amid scarcity, 3) waiting for limited affordable housing: ‘life on hold’, 4) finding pathways towards stability after the baby’s birth, 5) making it work: efforts to look forward. Within themes, we identified patterns among subgroups of women if and when differences were seen.
Experiencing Cascading Effects of Hardships During Pregnancy
The circumstances surrounding the time of pregnancy varied for mothers in the study, as shown in Table 1
. However, all women described how their pregnancies were unplanned. When women became pregnant, they were living day-to-day and reported limited possibilities for saving money for their future babies. Most women described how their pregnancies accentuated job and housing instability, “pushing
’ them to need more support from their families and the safety net. Women described four main drivers of instability during pregnancy: job loss and lack of unemployment benefits, health problems, interpersonal conflicts, and/or unresponsive fathers. These stressors were often interconnected and led women to experience extremely challenging situations - both psychologically and financially. As L.L, who already had three children, explained:
“It changed so much (when she became pregnant) because the father did not take responsibility. Psychologically, emotionally, financially. Everything really changed. I also lost my job because of my diabetes. I ended up with the emotional, financial, social burden. The entire world fell on my shoulders because that’s what I got. I was practically alone here”.
These hardships were intertwined and interdependent, one often exacerbating the other. This was especially true for women that suffered from abusive relationships, for which the stress and trauma of experiencing verbal and in some cases physical abuse compounded health complications during pregnancy, and made them more vulnerable to losing their jobs. A.A. described these hardships:
“I found out I was pregnant, and things just went extremely downhill with my husband. I got really sick ‘cause I have polycystic ovarian syndrome. I was bleeding. I had to go on bed rest. I ended up missing a lot of work. In between the drama with my husband and then bedrest and all of that I had to resign.”
A.A. exemplified the cascading effects that interpersonal conflicts with the child’s father and insecure jobs created during pregnancy. In low paid and temporary jobs, having health complications related to pregnancy was often a reason for being fired or forced to quit their jobs. All but one of the women that were working did not keep their jobs after giving birth or were fired due to health-related problems. L.L also lost her job. She was fired due to complications from her diabetes. “I was working in housekeeping, but my health was not good because I had diabetes. What the agency should have done was—because I investigated later—to put me on leave and pay me, but that’s not what they did.” While unemployment benefits would have allowed her and other participants that were working to stay afloat, she did not receive them, despite being eligible as she later found out. Most participants were not eligible to receive sick leave given their unstable employment (short-term contracts, freelance, irregular work) and the few that were, struggled to access it. When L.L. found out that she should have received a paid leave, she went back to speak with her employer to claim it. However, the delay resulted in a temporal loss of income, which brought a lot of stress into her life at a time when she needed rest to focus on her new baby.
No other participants were able to access NYC family paid leave after giving birth, which is provided to people who have worked for 20 or more hours a week for at least six months. In a few cases (n = 3), women had moved to NYC from other states during their pregnancy to seek family support and had not worked in the city, making them ineligible. But even the few that knew they were entitled struggled to make the company comply with the law. R.R., who had been working full time at a food chain for 2 years before giving birth, went back to work six weeks after, explaining: “I went back to work but they (company) have not paid me yet for maternity leave, they don’t want to do the paperwork, and I am like forcing them.”
In sum, the hardships experienced during pregnancy, limited unemployment and paid leave benefits that were not designed to protect women with unstable jobs, and potentially non-compliant employers, all pushed women into extremely precarious situations, including homelessness. In these circumstances, women described seeking support from their networks, the shelter system, and public assistance programs. After A.A. resigned from her job due to health complications, she moved to NYC to seek her family’s support. Her family, however, was facing their own hardships. AA then heard that she could get support at a shelter, where she was still living at the time of the interview and trying to figure out how to move on. As she described: “I’ve never been so poor in my life. Poor. Have no money. …I didn’t think all of this would happen.” The moment participants experienced these hardships was the time when they needed to navigate public assistance programs to find a way to get back on their feet.
Relying on Food Assistance and Informal Supports amid Scarcity
All women, regardless of their living and job conditions after birth, experienced food assistance programs as essential. All participants received food assistance after giving birth and at the time of the interview, only one was not using it anymore. Participants discussed how receiving WIC helped them pay for the child’s food and formula: “WIC helps a lot, especially with baby food, like solids and stuff like that.” (H.H.)
WIC was widely received, and it was easy for participants to obtain and retain. Even when participants experienced “being cut”
from other assistance (i.e cash) as they started working more hours, they did not lose food assistance entirely as B.B. described:
“Once they (public assistance office) saw that I was working — and they didn’t care if I was making $215 a week — It was automatically no this, no that, no Medicaid for you, you won’t — you’re not getting any more cash, but you could receive food stamps. But I went from $353 to $179 in stamps a month”.
However, although SNAP and WIC helped participants to cover their food needs, these benefits were most often not enough by the end of the month, especially after experiencing reductions in monthly benefits. As P.P. described it: “Usually, by the end of the month, that’s when - before I get my food stamps, that’s when food runs out.” This was accentuated for women not working and those either not receiving cash assistance or receiving small amounts of cash such as O.O. who had three children and was living at a shelter for victims of domestic violence “It’s difficult when you get $250 every two weeks (cash assistance). I spend a good $60 on diapers. Then, when we run out of food stamps because my kids eat, I just have to buy her (daughter) snacks to keep her going”. Not having enough by the end of the months also led some women to stretch the food they bought using SNAP: “when I lost my job what I did was stretching it (SNAP). If there was no meat, we would eat eggs. I would buy one pack of corn flakes and not leave it around. I measured out what I would give them (children)” (L.L.) or buy cheaper and less nutritious food. While food assistance was critical, mothers who experienced periods of no or very low incomes (making $100 per week) described how they had to rely on their families to cover other basic household expenses, baby items, cleaning necessities, or cell phone bills. “My aunt, she pays my cell phone bill for me. At the end of the month, she’ll give me some money, and that’ll help towards all the other stuff that I need.” (J.J.)
Participants also described the role of community resources to cover such expenses. For example, D.D. was getting help from the shelter with diapers, formula and clothes, while other mothers, such as G.G., would cut down on their expenses to cover indispensable baby items. “There was one week, a few months ago, where I had enough money left over for toothpaste for myself”. The problem of covering essentials was accentuated for undocumented immigrant mothers (n = 2), who were not eligible for SNAP and thus had to use any income they had for food. One such participant, who was diabetic and did not have enough resources to buy food consistently, told us: “I am not eating well. What they (WIC) give me is not enough” (I.I.) She was making $150 per week babysitting, living with a woman from her church, and receiving only WIC. Her experience highlighted the added problems for undocumented migrants. In contrast, the few mothers that were receiving disability income and housing assistance or that at some point after giving birth managed to work (part or full-time) and obtain childcare support (either by public assistance or family) described few difficulties covering their family’s food needs and baby expenses.
Waiting for Limited Affordable Housing: ‘Life on Hold’
Having a safe place to live was the other main priority for women and their babies “I just want to have my own place for me and my child”. Nine out of twenty women were living in shelters at the time of the interview, and two more had been in a shelter at some point before the interview. Living in a shelter permeated the women’s daily lives and worries. While the shelters provided a safe place, they also created stress and a sense of ambivalence. As one mother reported, “I don’t want to stay in the shelter, but for now it feels like home” while at the same time “not having family around, not having friends. It takes a toll on you.” Participants described shelters as a temporary solution, and the quality of their experiences depended on how much support they received at the shelter. While some women received a lot of support, for example in applying for benefits and obtaining baby items, others did not “they gave you the crib, but they don’t help you. I asked my caseworker “where can I get baby food supplies?” she told me to google it. I would do four different housing specialists in a year. It was nerve-wracking.” (A.A.)”
Despite the limited availability of public rental assistance, families living in shelters are supposed to have priority to access housing assistance. Across the nine participants who lived in shelters, six got a housing voucher and four of these six were using it or moving out soon. Two participants, who had been waiting for housing assistance for years, described how ‘everything sped up’
when they entered the shelter. As J.J. described it: “I was surprised when I got the housing specialist. She helped me with the application and I kept calling every week for an interview. I was surprised I got an interview with housing soon after I got here.”
With the support within the shelter and her persistence with the housing department, she finally got a voucher and moved to a small apartment where she paid $300 a month in rent that she covered using a portion of her disability assistance, which she received due to mental health issues. However, other mothers experienced the wait for a housing voucher as long and stressful. Participants described how they needed to show proof of stable income in order to access housing assistance. That in itself delayed the process, particularly when mothers struggled to secure a stable job.
“You have to work 30 h a week for a month straight before you can qualify for a voucher (housing). But right now I am not working because my job finished. It was temporary. I was a flu program coordinator. It used to be reasonable hours but I could not get to 30 h”. (D.D.)
Participants that were receiving disability benefits explained how having an income facilitated the process of accessing housing assistance. “The guy
(housing specialist) said – they
(housing office) are like, food and shelter on the application… someone just on welfare. They don’t want that. If I didn’t have an income, I would be right back in shelter.” (J.J.)
. However, despite having an income was described as necessary to access rental assistance, one mother described how changes in income could affect her ability to retain the voucher that she much needed, which created an additional mental burden. B.B. described “They
(welfare) told me, if you go up on your days (
from part-time work to full-time), you are not entitled to your voucher, which means that the apartment you just got, you have to pay out of pocket
.” She was making $115 a week and contributing to her rent, but was worried about not being able to cover her expenses if she started to work full time. These experiences reflect how burdensome and confusing navigating the process of accessing and keeping a housing voucher was for mothers. Not being able to secure an income combined with the lack of support to apply for assistance in some shelters brought a lot of uncertainty, affecting the well-being of participants and putting their lives on hold.
“It would be much better if I was able to have Section 8 and find a place where my kids could be free. Here (the shelter) it feels like a work-release prison. All your rights are stripped from you. I think mine and her (daughter) attachment would be a little bit better (if not here)’… I wanna go back to school, and I would be willing to work. Because I have to do both. I have to get out of this. I am at a standstill right now. I am in a funk. Bein’ here, I don’t wanna do nothing, especially livin’ in this neighbourhood, is just horrible to me. I feel once I leave, everything will be different.” (J.J.)
Most mothers navigating shelters and housing assistance programs reported anxiety, exhaustion, and even symptoms of depression as a result, as A.A. described: “my pregnancy was terrible, I was really depressed. I went down a little once I had him. I was still depressed because I was in the shelter”.
When women managed to access housing assistance, a new set of issues emerged. Participants’ challenges with the voucher process highlighted critical implementation gaps. For example, two participants described how property owners often refused to take vouchers. I.I. lost her voucher after not being able to use it, and at the time of the interview she was moving to New Jersey with the hope that it would be easier: “They don’t want to accept it here. I’ve been looking for three months. They say that if I don’t have credit — income tax — they won’t rent it”. I was a victim of domestic violence, only spoke Spanish, had been in and out of shelters for two years, and could not find a stable job. Not being able to use her voucher put her in an even more vulnerable position.
Participants that managed to use their vouchers described housing options that were limited given NYC’s high rental rates, which lead to having to move into more resource-deprived areas. Feeling “lucky
” to finally get a Section 8 voucher, B.B, described how she had to take an apartment in an unsafe area:
“The vouchers are $1268. That does not even cover a studio in New York City. So finding a place that is willing to take you with a voucher is hard on itself…[When are you moving?]. My move out date is November 2nd, that is when my six months (at the shelter) is up. So for me, it was the first apartment I saw, I took it, in (name of the neighborhood). It’s in a drug-infested area, but I have no choice but to take it because I have to be out (of the shelter system).”
The experiences of these women suggest that while the system tries to provide housing assistance to the most vulnerable women that enter the NYC shelter system, larger systemic factors may impede housing assistance from working as it should. For the rest of the participants, the most common way of finding affordable housing was by living with family members. However, having insufficient income to afford an apartment for themselves and their children brought feelings of low agency and stress for numerous participants as H.H. described:
“Right now I can’t save. I am just living off what I make. I try, but when I do save I have to throw it towards a bill, not towards moving. My goal is to get a second job and move forward with my life. I want my situation to be different… I want my space, yes. Yes. It gets frustrating, and then that leads me to not checking up on my friends, not being a good friend. It just makes me not want to reach out to anyone, because I’m in this bubble of stress.”
Uncertainty about when they would have enough income to become independent made it hard to plan. While participants living with their families accepted that this was the best solution for the time being, and expressed gratitude to have their family support, they also described how having to depend on their families and share small spaces made them feel like “I don’t want to be a burden”
and caused tension in their relationships. E.E. described how, after fighting with her mother and brother, she thought about leaving. However, she could not afford a place by herself and she did not want to enter a shelter: “I am scared to live by myself, how am I gonna cover the rent when my job is not stable? When it is busy
(salon) I get all this cash and tips, but when is slow, I only may get two clients”
. The dilemma between staying with family when conflicts arise or moving into a shelter showed the complex tradeoffs that mothers faced when trying to provide necessities like housing for their new babies as S.S., who lived with her abusive mother put it:
“I just had a baby, so do I really wanna walk into a dirty shelter with a brand-new baby? No. I did not feel like that then, and I still don’t feel like that now, so it just bothered me. I was like, “Shelter’s not an option. I’m not goin’ through it.” People will be like, “Why didn’t you, you’ll get your apartment in a year,” and I’m like, “I can’t.” I just couldn’t. I can’t find it in me. It’s just the whole process of it, too. I just can’t.”
Entering the shelter system was described as a way of getting housing assistance. However, it took an emotional toll that some women tried to avoid.
Finding Pathways Towards Stability After the Baby’s Birth
For most women, except for those on disability, their priority while finding stable housing was to secure any
job, as a pathway to have a more financially stable situation, and provide for their children. Nine of the participants were working at the time of the interview (only 2 full time), and four were looking for a job. Most participants described how they had to prioritize finding a job over continuing their education despite their desire to continue their studies in order to secure a better job for themselves and a better future for their children. A.A., who was in a shelter, described “I got into nursing school, but I can’t go because I don’t have anywhere to live. Not even that, I don’t have nobody to watch him
(infant) if I need time to study, or watch him in the morning…I wish I had the supports to where I could have went to school and started my career. That way we don’t have to go through this anymore
.” As A.A. experienced, more often than not, women had to put their educational desires on hold, with no supports to pursue them and pressure to find a job to both secure an income and access housing and childcare assistance. Only three participants managed to engage in educational activities, primarily because they received support from their family or caseworkers. In contrast, R.R. did not return to college after giving birth and found a full-time job while the baby’s paternal grandmother took care of the baby. She was receiving assistance for college but she needed to work, pay for NYC public housing and be with her baby.
“I was planning to go back to school. Now I feel I don’t have, not the desire, because I do want to go, but I don’t have the time. I work Monday to Friday and then come home with the baby. I could do online for two days but I don’t know if the government would pay for student assistance for a private college. Because I can’t miss work, I haven’t been able to go and get the information. I feel my time is running down. First I have to see how the daycare is going to look like and like my schedule. I have to learn how to balance everything together and see if everything connects.”
R.R. knew where to go to obtain child care and other resources, but was uncertain of the outcome, so it was hard for her to plan how to both work and go back to school. This struggle was common for mothers that describe how they wanted to find more stable jobs or study to access well-paid jobs and yet how they did not have the time, energy and resources. However, participants recognize how that was the pathway towards both financial and emotional stability for themselves and their babies “I wanna be happy for my baby to be happy. I can easily get a makeup job somewhere (what she was doing), but I don’t want to do that. I’m trying to figure out exactly what I can do where I know I’ll be happy enough to stay and save.”(H.H.)
One aspect that compromised women’s ability to find their pathway towards financial stability was access to childcare. At the time of the interviews, when children were almost 11 months, only six out of 20 mothers had access to public benefits that covered childcare and five women who were working were relying on their families to care for their children. When women had family members that could take care of their children, they chose that option first, as it was often convenient, flexible, and they knew them already. As children got older, mothers began considering other childcare options to provide socialization opportunities to their children and have a more structured form of care. For women in shelters, or with no family members that could take care of their babies, finding subsidized childcare was the only option to be able to find a job or go back to work, to pursue more stability.
Mothers trying to access subsidized childcare before having a stable job described a range of challenges to accessing such supports, such as work requirements. Mothers saw the need to have childcare as a prerequisite for applying and getting a job, however, this was not what they experienced when applying for a childcare voucher. As M.M. described it: “I had a voucher that corresponded to my housing support, but they told me I could only use it once I was working. How was I supposed to look for jobs without daycare?” Participants reported wanting to go back to work, but such rigid conditions for receiving assistance did not facilitate the process. Similarly, G.G. was told that once she gave her information to get a childcare voucher she should have to attend a ‘back-to-work’ program within three days, but she said “I didn’t have anyone to watch the baby.” While she believed that eventually, she would get the childcare voucher, such rigid implementation made the process burdensome and complicated, adding another layer of stress to her life. Such requirements were particularly complicated for women that lacked the family support to care temporally for their children while looking for jobs.
Having fluctuating paychecks and transitioning off of cash assistance were also described as barriers to securing stable childcare assistance. B.B., who was living in a shelter due to domestic violence and had recently stopped receiving TANF, explained her struggles: “I feel like in a shelter with a baby, I should qualify for daycare. They were covering daycare, and then they stopped it because they said I work (too much), and they do not seem to understand that daycare is a lot of money.” Such issues to obtain and keep a voucher left some participants struggling to find childcare and relying on informal care options while trying to become financially stable. As E.E., pointed out: “They literally do not care if I show them the different pay stubs, they are ‘no, this is what you are making now so you can’t have it (SNAP and a childcare voucher).” E.E., who lost her benefits after travelling to her country to see her family could not obtain childcare assistance again. She had changing schedules and fluctuating income and saw her benefits reduced to match her highest monthly paycheck rather than her lived reality over months. These issues fueled worry about service discontinuities, adding an extra layer of financial burden.
In addition, most participants navigated the process of finding childcare alone and described having to deal with limited options in their neighborhoods, centers not taking their vouchers, or centers refusing to have children that showed challenging behaviors (i.e., “crying too much”
). These barriers affected participants’ capacity to find work but also increased their mental burden.
“I have to look for the baby’s daycare before I can go to work. It’s impossible. Every daycare that I’m running into is (for children) two to five (years old), they don’t wanna take him cuz he’s one year; and when I finally do find the age-appropriate one, they don’t take the voucher. So I am stuck. And I don’t know a really good person to take care of him.” (C.C.)
This conundrum was accentuated for single mothers with limited support from their families. With no references or recommendations, trusting people they did not know to care for their child was seen as an additional challenge. Mothers longed for guidance to facilitate the process of finding childcare and using childcare subsidies.
“Welfare’s willin’ to pay either the daycare or even a person, but I don’t even have a person that I trust, that I know that’s gonna be like, “This is your job.” I don’t wanna leave my baby to somebody that’s gonna do half of a good job. I don’t really know a good person…so it’s hard. I’ve literally been, still, no job, nothing, in the same spot, because it’s like, “Where to go? What to do,” and then I gotta look for all the resources.—I hope someone would tell me “Here, there is a childcare here and you can use the voucher” so that I can go back to work” (G.G.)
In contrast, four women in our sample, all of whom happened to work, described better access to childcare assistance and good experiences finding childcare centers near them, suggesting easier access for already “working mothers” and how differences across neighborhoods in childcare options (availability, quality, acceptance of vouchers) intersected with families’ ability to access and use childcare assistance.
Making It Work: Efforts to Look Forward
Despite the barriers and challenges described above, virtually all the mothers in our sample reported putting their child’s needs first and finding strength in their children. Many went to great lengths to pull together resources from community organizations, family, and public assistance programs to cover their children’s needs. When L.L became pregnant, single, and jobless with three children she mobilized all available supports
“I started looking for information. Who could help me, who couldn’t, who could I talk to. I looked for a social worker. A hospital helped me find places where I could get diapers. I started to prepare financially. Emotionally, I talked to my kids, to my friends. They supported me. They gave me support. I told them what was going on and all of those things, and I got emotional and financial support.”
All participants described how they made sure their child’s basic needs, such as food and having a safe place to live, were covered first and foremost, even if their financial situation would not allow them to buy toys or books for their child. F.F. reported: “My main thing is her food and rent. Whenever I do have $10, I’ll be: ‘Okay, she needs this.”
Beyond material goods, participants described how their priority was to be a caring mother despite all the stress they felt given their limited financial resources. As H.H. put it: “As long as she’s getting read, she’s eating, her diaper’s changed, food in her belly, clothes on her back, she’s playing, she’s a happy baby — that’s all that matters.”
The child’s well-being was top of mind constantly for all participants, as all their actions were driven by their desire to provide a better future for their children despite the challenges they faced as they tried to move out of poverty. When children’s needs came first, participants often neglected their own needs: “It’s never like: ‘Okay, I need this.’ It’s more like: ‘She needs it.” (
F.F.), sometimes to the detriment of their well-being:
“Sometimes it’s just hard for me to focus. When I become stressed, it’s just hard to focus. The main thing I do focus on is my child. I make sure she’s eating, and I make sure she’s happy. I make sure I’m doing what I’m supposed to do as a parent…I keep forgetting, like, ‘Take care of yourself too.” (H.H)
The stress they experienced - from having to navigate unstable jobs, unstable housing, and the limited short-term possibilities to change their situation – made it difficult for them to care about their well-being. Nonetheless, across the interviews, some women described how their future started to look a bit better. In paying close attention to their stories, we observed a common pattern. Mothers described individualized support that helped them navigate and coordinate all the public assistance programs and community supports that were available to them in the best possible way. One mother described how, through a social worker at a non-profit organization (not Room to Grow), she found free childcare, which gave her the flexibility that the childcare voucher, with strict work requirements, had not given her. That allowed her to have the time she needed to finally finding a stable job. Another mother described receiving job training through public assistance that helped her prepare for a more stable job in the future. She described: “I like the job specialist. I don’t have to work now because I have a disability but I feel I want to work in security. The specialist helped me take the city exam and I passed.” Such support benefited mothers’ capacity to think long term and find the right job without undue pressure. Mothers reiterated the value of such supports across other domains as well, such as finding stable housing and childcare and continuing with educational pursuits. N.N. described the pivotal role that her social worker at Room to Grow played in helping her to utilize her voucher before losing it: “They played a big part. It was really hard to look for an apartment. Had the voucher for 6 months, couldn’t find anything - and she found me an apartment that would take it!”
Similarly, the three participants that described being able to enroll in educational programs also received significant support from their close family or a social worker. D.D. entered a homeless shelter with her two children when she was unable to afford an apartment with the income from her job at a dollar store. Once in the shelter, she received support from her caseworker to apply for cash assistance, childcare, and student financial aid to finish her associate degree. Also in getting baby items such as diapers and wipes. She described: “I’ve been getting a lot of help from my case worker. I have a wonderful caseworker. I speak to her and she helps me figure it out.” D.D. not only received support to cover her material needs and apply for benefits but also support in using them: “My caseworker is the one who advised me about one daycare. I went down, saw how it was set up, how the caretakers took care of children…But it was really hard…putting your children with people you don’t know.” Despite she struggled at first, this support allowed her to take a part-time job and put a lot of effort into finishing her education. D.D.’s case demonstrates that when assistance is coordinated, comprehensive, and flexible, mothers could focus their energy on educational opportunities that could potentially lead to better jobs and greater stability in the future.
Similarly, N.N. found practical and emotional support in her social worker at Room to Grow to finish her GED while receiving cash assistance and living at the shelter. “she pushes me to go harder, she gave me all the information, to go and do (GED)…I would have never gotten my GED. I would had to go and get a full-time job. I would not had the time to do what I had to do for myself, to better myself.” Recipients of temporary cash assistance in NYC are required to engage in work and/or educational activities, yet the focus continues to be on finding a job. N.N. received all the information to enroll in a free GED program that would allow her to keep the cash assistance and childcare she needed to finish her education and plan her long-term goals to have a more stable life “Next is I wanna go pick up a trade for Certified Nursing Assistant. From there, I wanna get into this CAN-get more stable than what I am now, and I am planning on going to college.”