Baby props help to teach expectant mothers how to hold and care for their infants.

Martha Ryan began her journey to the Homeless Prenatal Program unlike many of her clients: as a volunteer in African refugee camps and teaching English in Ethiopia with the Peace Corps. There, she learned the importance of community health, and upon her return set out to study nursing, and soon, to open the Homeless Prenatal Program.

After working at San Francisco General, and noticing a rash of pregnant homeless women, Ryan realized “the third world was right here in San Francisco, right in [her] backyard.”

“Pregnancy,” she realized, “can be a chance for women to turn their lives around,” and in 1989 she formed the Homeless Prenatal Program, in hope of doing just that.

“That first year we served around 70 women,” she said. Now, 20 years later, the program serves more than 2,500 low-income families a year, and has helped with more than 1,400 pregnancies. The numbers are impressive, and for Ryan, each healthy baby is something to be thankful for. This year alone, 234 babies were born, of which 92 percent were a normal birth weight, and 99 percent drug-free.

Carrie Hamilton now works at the Homeless Prenatal Program. 50 percent of the staff were once clients.

For many of the program’s patrons the path to a drug-free birth has been laced with successes and failures—still many return each week for food, counseling, child care, and a feeling of community.

Carrie Hamilton is one of these women.

Now drug-free, she works as Wellness Coordinator for Homeless Prenatal.

When she moved to San Francisco in 1990, she was living out of her van, and had a steady habit of methamphetamines. Her addictions, however, stretch back much farther than that.

“I’d been helping my mom shoot up since I can remember,” said Hamilton, who was born in the spring of 1969—a child of free love. Her mother had been a habitual drug user, ranging from marijuana to the pharmacy grade methamphetamine, Dosoxyn, which she used intravenously.

Hamilton’s drug use followed suit, first smoking pot with her mother, then moving on to harsher drug use, and eventually “hustling” her own methamphetamines to satiate her addiction. “Back then, my high was my first priority,” she said.

Now she’s clean, but it’s taken a lifetime to get here, after three pregnancies and the help of Homeless Prenatal, now nestled into the hillside at Portero and 18th streets.

Hamilton is 40 years young, with piercing sea-green eyes, a loud laugh, and a welcoming countenance. As she walks through the burgundy and grey cement halls of the Homeless Prenatal building she greets everyone by name, rubs bellies and asks due dates.

“I love to share my story,” she says, “I know it can help other women going through the same thing.”

Hamilton knows firsthand that having children can change lives. During her pregnancies, morning sickness made drug use impossible and offered her a welcomed window into a sober lifestyle.

Beyond her pregnancies, her children reminded her of the basics: food and shelter—two necessities that kept her returning to Homeless Prenatal week after week. “I used to come for the food boxes,” she said. “I didn’t know my rights as a homeless person, so back then I was mostly trying to stay off the radar.”

More and more she looked to the program for help, slowly got clean, started substance abuse counseling and was able to find housing.

For the first time since she moved to San Francisco things were looking up for Carrie Hamilton.

Then, she fell off the wagon—once more spiraling out of control. “I was partying way too much,” she recalled, “and I kept thinking, what am I going to do with my life?” She knew she had to make a change.

Again, Homeless Prenatal was there to help.

“Nancy,” now her co-worker, “was my case manager,” she said, remembering when she was on the other side of the equation. With her counseling and support, Hamilton was encouraged to enroll in the Program’s Community Health Worker Training. This program is one of many designed by Ryan and her team to help women turn their lives around.

Beyond Health Worker Training, Homeless Prenatal offers low-income families many ways to get off the streets, or out of dangerous living situations. The majority of their programs are bilingual, and include Doula services, prenatal classes for pregnant mothers, various forms of housing help, free legal and tax services, day care, acupuncture, yoga, mental health services, and the list continues.

Every Thursday mothers gather for their weekly prenatal class. Husbands and boyfriends are sparse, many of them working, or out of the picture.

At a recent meeting entitled “Get to Know Your Baby,” Beth Helton and Nancy Frappier, both wellness coordinators, schooled expecting mothers on what babies look like, how long they sleep, and how to care for the newest member of their family. Questions ranged from “What does the umbilical cord look like?” to “How does your baby tell you that it’s hungry?” Glowing mothers answered with a mixture of confidence and questioning trepidation.

Emily Braken is expecting a healthy baby boy, after years of drug abuse.

At the end of each class Hamilton runs a raffle—one where patient husbands draw names from a Dixie cup, and expecting mothers win prizes ranging from homemade quilts to baby books, food vouchers and toys.

Emily Braken is one of these mothers, and on that Thursday she’d prepared homemade certificates for Hamilton, and the entire Homeless Prenatal Program. Written in different colors of pink—for breast cancer awareness month, she explained—Braken read aloud a poem dedicated to the program that had helped her so much.

Underneath your exterior,

Underneath your clothes,

Underneath your words,

A special person grows.

The students clapped, nodding along, and teachers teared up.

Braken’s story is similar to Hamilton’s. Both grew up around drugs, and both have children they might never see again—drugs had gotten in the way.

Before moving to San Francisco last year, Braken, now 27 years old, lived on the streets of Salem, Ore. “Back then I did mostly crystal, crack cocaine, and drank a lot,” she said matter of factly. Her first months in the city were spent on the streets at 16th and Portreto streets. “I’d been used to sleeping under bridges,” she said.

Sometime in March, Braken met a man and became pregnant. “He is so different from anyone I’ve been with,” she said, sitting in the waiting room of the Homeless Prenatal. “I mean, the man had never even smoked a cigarette!”  With his support, and the conviction to have a healthy child, Braken quit “cold turkey,” and began attending prenatal courses. Since then her life has turned around, and she’s expecting a drug-free baby boy.

“There is so much they have to offer,” she said, looking up from her belly. “Sometimes it’s just nice to have someone to talk to.”

And, according to Ryan, these services aren’t going anywhere. Although many of the city’s human services have seen large cuts to their budget, Prenatal continues to receive 50 percent of their finances from the county level—a number that has remained fairly steady the last three years. The rest of their $4.7 million budget comes from a combination of grants, private donors, foundations, and a small amount from space they rent to other nonprofits.  “We’ve built a reputation on hard work,” she said. “The city knows we are solid and solvent.”

Hamilton his thankful Prenatal is here to stay. “I plan on being there for the rest of my life,” she said.

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