Pregnancy Pathways helps homeless pregnant women build a better future

A daring idea in action

May 29, 2017

Contributed by: John T. Lilley, MD, FRCPC, DABA & Ameeta E. Singh, BMBS(UK), MSc, FRCPC

On average, each year in Edmonton approximately 100 pregnant and parenting homeless women live on the streets and struggle to survive. That’s a sad, sobering statistic and situation.

Without homes and roofs over their heads, these women face myriad challenges, including limited access to prenatal care, addiction, poor nutrition and violence. Once their delivery dates arrive, the infants often wind up in the social services system, and the new mothers return to the streets and lives of struggle.

That reality prompted Dr. John Lilley, a retired anesthesiologist, to join forces with others who were equally concerned about expectant mothers with few resources and even less hope. The result is Pregnancy Pathways, a many-partner coalition whose goal is to secure a 10 to 12 unit apartment building as a residence for pregnant and infant-parenting homeless women.

“I was seeing all these homeless, pregnant women in labor in the case room,” says Dr. Lilley, “and I knew something had to be done.”

Dr. Lilley, chair of the Edmonton YMCA’s Welcome Village campaign in 2012, began approaching his contacts at the time and found them receptive to the idea of creating more resources for expectant, homeless women.

No small feat: 25 partners

Since then, more than 25 community organizations and agencies – including Alberta Health Services, the Royal Alexandra Hospital (RAH), RAH Foundation, Dr. Ameeta E. SinghBoyle McCauley Health Centre, Bent Arrow, Edmonton Community Foundation, Homeward Trust, Capital Region Housing, the City of Edmonton, Catholic Social Services, the YMCA and many others – have partnered to procure a multi-suite apartment complex that will provide a safe place for these women to call home.

Dr. Ameeta Singh has worked closely with Dr. Lilley from the start. A clinical professor with the University of Alberta Division of Infectious Diseases, Dr. Singh first became aware of the struggles of pregnant, homeless women while working as the medical director of the Edmonton Sexually Transmitted Infections Clinic. During a large syphilis out-break in the mid-2000s, they began seeing a lot of babies born with congenital syphilis.

“It raised the question of ‘why is this happening?’ because we have been screening for syphilis for years. What we realized is that many of these babies were being born to homeless women who hadn’t received prenatal care.”

Down in the valley

Dr. John T. LilleyAn outreach team was formed. “I would go out with the team,” says Dr. Singh, “And although I don’t live in a bubble, I was utterly horrified to see how these women are living. We’d go into the river valley, under the High Level Bridge and find pregnant women living in tents … just a few meters from these beautiful homes on Saskatchewan Drive. It was just completely unacceptable to me and I knew something had to change.”

Pregnancy Pathways’ housing-first approach is based on a similar program in Vancouver that has been highly successful. In addition to offering safe housing for stays of 12 to 18 months, Pregnancy Pathways will also link women to other services and provide 24-hour on-site support, with the goal of graduating women to their own stable housing. “We’re hoping to have the three-year pilot in place by next spring,” explains Dr. Singh.

An annual operating budget of approximately $500,000 is anticipated for the project. To date, the project partners have already received funding commitments from Merck for Mothers and individual physicians. They remain hopeful that other funders will come on board.

Coming together to make a difference

“We’ve really been pleasantly overwhelmed by the response this project received from the various community partners, who all recognize the importance
of this work,” says Dr. Lilley.

“It’s a combination of acute health care providers and community agencies,” he continues, “which is a unique partnership, as these groups often work in silos. It
seems that everyone who hears about it is interested  in becoming involved.”

As he looks forward to continuing to work with all the partners to develop the project to fruition, Dr. Lilley adds, “Although there’s still a lot of work to be done, the response from our partners gives us hope for what we can accomplish and the difference we can make to pregnant women who feel they are alone.”

For more information on Pregnancy Pathways or to make a donation: RAH Foundation ( or email Dr. Singh at

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