Kay Trattles became executive director of Mary’s Shelter Gulf Coast, a maternity home in Elberta, Ala., when the board of directors realized the organization was “not meeting our mission because we were turning away the people who needed us most,” she told attendees of her workshop at the 2024 Heartbeat International Annual Conference.
“I was hired to transition Mary’s Shelter from being intake-restrictive to intake-open,” she said.
To illustrate the difference, she used the intake criteria of three randomly chosen sample maternity homes to “screen” 10 real, anonymized cases. The applicants self-reported issues including drug addiction, mental illness, already-born children, domestic violence or trafficking, and criminal records.
Of the 10 cases, all of which were admitted to Mary’s Shelter, only one or two would have been served by the three sample homes due to their intake restrictions.
“What does this mean?” Trattles asked. “It means 83% of pregnant homeless women would still be pregnant and homeless, or no longer pregnant.”
“We have to realize we are not in competition with other maternity homes,” she said. “We’re in competition with Planned Parenthood. And they have no criteria.”
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In the virtual version of Trattles’ workshop, Shannon Bohan, program director at Mary’s Shelter, shared 2022-2023 statistics on their residents. She said 54% had substance abuse problems; 39% had mental health diagnoses; 49% had criminal records; 28% already had children; and 37% were victims of either domestic violence or human trafficking.
“This is our demographic,” Bohan said. “These are the women we serve. These are the women who find themselves in need of a homeless shelter for pregnant women.”
“The reason we exclude is, plain and simple, fear,” Trattles said.
“Toolbox” for overcoming fear
Their list of common fears included dangerous behavior, heavier case management loads, conflict among residents, shortage of resources, and having to report poor success rates to boards and donors. Together, Trattles and Bohan shared the tools Mary’s Shelter has used to deal with each kind of fear.
First, Trattles said maternity homes need to re-examine how they define success. If a home reports an 80% success rate but only admitted 10% of the needy women who reached out for help, that translates into an 8% rate of success.
“What is your success rate if you don’t try?” she said.
Bohan stressed the importance of staffing the home 24/7 to detect problems as they arise. In addition, she said, an effective maternity home program will have a plan in place, develop and using protocols, and utilize community resources, “because we can’t do any of this by ourselves,” she said.
Both presenters emphasized substance abuse as the main issue to address first.
“Addiction is the most likely [problem] to crop up in their lives and keep contributing to failure,” Bohan said.
For that reason, Mary’s Shelter offers women services ranging from admission to an in-patient rehab facility (while still being considered a resident of the home), Intensive Outpatient programming off-site, and/or Narcotic Anonymous meetings, depending on their level of need.
Within the home, residents agree to undergo regular drug testing and monitoring. If a woman repeatedly fails drug tests and/or does not follow her case plan, she can be dismissed from the program. The staff is also trained to recognize signs of dangerous withdrawal, which must be supervised by a medical professional.
All residents undergo mental health assessments within their first 30 days. Trattles and Bohan recommended cultivating relationships with judges and lawyers in case a need arises for voluntary or involuntary commitment to a mental health facility.
Mary’s Shelter residents are required to follow all prescribed mental health regimens during their stay. The home shows zero tolerance for violent actions, language, or threats.
Women with criminal records whom the courts have remanded to Mary’s Shelter “tend to be our better-behaved residents,” Bohan said, because disobeying house rules could send them to jail.
For these women, making court dates, paying fines, and obeying probation conditions are critical to ultimately achieving a self-sufficient life after the home. Staff attend all court dates and advocate for residents. Trattles added that court dates provide opportunities to build greater awareness of the home’s services.
“We’re in the business of addressing whatever issues our residents are facing that are going to continue to be the cause of failure when they’re trying to live independently,” Bohan said.
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For women with children already born, Mary’s Shelter has two family/dormitory style bedrooms in their eleven-bedroom, eleven-and-a-half-bath house. Their care includes “mini” case plans for the children to make sure doctor visits happen, shots and medical records are brought up to date, and schooling takes place.
“This is an opportunity to mentor residents in parenting, child discipline, and conflict resolution,” Bohan said.
She added that her maternity home cooperates with social workers as needed to help moms navigate Child Protection Services requirements.
To serve victims of domestic violence or human trafficking, Mary’s Shelter has developed relationships with law enforcement, attorneys, and others who can assist in keeping residents safe.
“Associates of the women do cause problems,” Bohan said. “And they are a toxic influence in the women’s lives.”
Mary’s Shelter keeps its doors locked around the clock, sets door alarms at night, and has “advanced security systems with the ability for different levels of security,” Trattles said. “If a male visitor arrives, we call 911 and ask questions later.” Lockdown drills occur regularly.
Other general policies include residents may not have cell phones in their possession; working a full-time job is expected within two weeks of setting up a case plan; and no overnight passes are issued.
The cell phone policy work policy, and overnight passes policy are not punishments, Bohan said, rather they spare residents the temptation to fall into unhealthy habits.
“Our residents are here to create huge changes in their lives, to develop structure, develop schedules, work, and save money. The last thing they need is to be sitting around on their phones all day,” she said. “Our job is to work for the best interest of our residents.”
Editor's note: Heartbeat International manages Pregnancy Help News.
