In a sterile hospital room, around 3 p.m. on Nov. 28, 2020, Toronto’s homeless population increased by one. A six-pound, 12-ounce infant with a shock of dark hair came into the world without a fixed address.
The baby was delivered by C-section after medication to induce labour dropped the infant’s heart rate. Though the medical system bore the weight of a pandemic, the infant’s mother said she felt safe in the hospital. Her partner was able to stay with her for a day, though no longer.
Born with a cleft lip and palate, the baby would have to stay in hospital for a few days, with surgeries to come in the months ahead. But there was no nursery sitting empty at home.
The baby’s mother — whom the Star is identifying only as Morgan — and 13-year-old sister have spent the past few months bouncing between temporary accommodations, from a homeless shelter to the single room where they’re now crashing with a friend.
Squeezing into one room is homelessness all the same, Morgan said. It’s a stopgap — a setup that’ll tide them over for now.
The baby girl born that November day is one of hundreds of infants birthed each year in Toronto by homeless and underhoused mothers. While an estimate of how many babies were born without fixed addresses in 2020 isn’t yet available, shelter use data alone indicates a shift in recent months. The number of children living in city shelters — a count that had grown from 483 in 2016 to more than 1,000 this year — has slowly come down during COVID-19, but the percentage of infants in the system has only grown. And that data doesn’t include children like Morgan’s, who are living through homelessness in informal setups outside of city facilities.
In January 2020, babies no older than a year made up 6.1 per cent of all the kids in Toronto’s shelter system. By early December, that age group represented 8.7 per cent — and the city’s Shelter, Support and Housing Administration said it has no “firm insight” on why.
It’s a trend the city said it’s actively monitoring. In an email, a spokesperson speculated that the change could be connected to fewer refugee families — “who perhaps are more likely to have older children” — entering shelters since the pandemic started.
Toronto midwife Shezeen Suleman floated another “very likely” factor. In her role co-leading a perinatal program in South Riverdale, she and her team saw a surge of clients during COVID-19 who were homeless or underhoused. “We also saw a commensurate rise in rates of domestic violence, and the two are really closely connected,” Suleman said.
Conditions of the pandemic — from economic turmoil to isolation — can intensify an unsafe living situation or relationship, Suleman said. And she noted that pregnancy or a newborn’s arrival can be the final straw that leads a woman to flee a toxic home.
“They might say that if it’s just them in the picture, they can tough it out, but as they’re considering the birth of this baby and what kind of environment they want the baby to be in, they don’t want to make those same choices,” she said.
On top of young families with babies living in Toronto’s shelter system, cases like Morgan’s are “incredibly” common, said Dr. Ashley Vandermorris, who works with adolescent mothers and their babies at Toronto’s Hospital for Sick Children — cases where families move between temporary living situations, and pack into single rooms to stay housed.
“There are a number of timepoints along the course of pregnancy and into parenting in which people often have to sort of rethink their living arrangements,” she said. “I would say it’s atypical for that to end up, in my experience, with a sort of permanent home. It’s often these sorts of makeshift arrangements.”
To her, their stories are illustrative of a city crying out for more affordable housing. “It’s not exactly tenable to have two parents and a baby in one room.”
* * *
For several years, Morgan said, she and her daughter lived on their own in a two-bedroom apartment. Those were the years of ice-cream dates on Sunday afternoons, she recalled, of space for her daughter to play freely and a kitchen of her own to make them their meals.
But financial difficulties crept up on Morgan as she struggled to find full-time work, after finishing her schooling as a nurse. Eventually, they moved back in with Morgan’s parents.
The move gnawed at her self-esteem.
Existing tensions between family members were strained further by the news that Morgan was expecting a second child this fall. Moving in with her partner wasn’t an option, as his one-bedroom apartment wouldn’t be enough for a family of four. Searching for a place together, they were rejected repeatedly, which Morgan believes is due to bad credit amassed before she secured a role in long-term care.
Eventually, the frustration between family members reached a tipping point. In August, with nowhere else to go, Morgan phoned the city’s central intake number.
Was she ready and willing to get to a shelter within a few hours?
“I wasn’t prepared for that at all,” she said.
But she started to get things ready, packing what she could in the two suitcases the shelter would let them bring. She didn’t tell her partner what she had planned. A few days later, she asked her daughter if they could go for a walk, and explained to her that they’d be leaving — and soon.
From there, the process moved quickly.
Anything they couldn’t squeeze into their bags had to be thrown out. That meant food, to her immense discomfort, and their mattresses.
Soon, mother and daughter were being led to a single room in a shelter, with two single beds and an adjacent washroom.
Having their own space made Morgan feel safe.
As they adjusted to their new surroundings, Morgan was grateful that a day camp her daughter had planned to attend hadn’t been derailed by the pandemic. It offered the 13-year-old a routine each day; something steady in a time of turmoil and upheaval.
The staff were supportive and kind, she said, and the shelter itself was generally clean.
But starting from scratch was still painful. They were given an allowance for food over the first few days, but replacing all the ingredients needed for a meal was still expensive.
The kitchen on their floor was open during set hours, and after work, she’d scramble for a spot to cook before it shut for the night.
As she neared her due date, Morgan struggled to sleep through the nightly chorus of a congregate setting: babies crying out, footsteps down the hallways, a door slammed shut again and again.
And October brought more hard news. An ultrasound revealed the baby’s cleft lip and palate, which devastated Morgan, and became a point of tension between her and her partner as she questioned how it happened.
“I kept asking God why, what did I ever do? Why do I have to go through this on top of everything else?” she said.
While she said both had since processed the situation, the realization that their baby would need to spend time in hospital meant re-thinking their housing all over again.
Crashing with a friend instead of staying in the shelter meant leaving her older daughter with someone she trusted when she was at appointments or in the hospital with the baby. It was closer to work for her, and a single bus ride away from school for the 13-year-old.
And, crucially, it meant a kitchen she could use at any hour in the early days of having a newborn to care for. While she believes the setup is better than the shelter, it’s a reminder that her family has no place of their own.
“I know what it felt like to have my home,” she said in October. “Anything you want was yours, all yours at any time without having to label things or put it in one corner of the fridge. My daughter was free to roam and play with all her toys. She had her own space at that age, and I took that away.”
* * *
Toronto’s estimate of babies born into homelessness and under-housing each year — 318, as of 2019 — is acknowledged by officials as likely undercounted. It relies on community agencies reporting the initials and birthdates of infants who they know aren’t living in permanent homes, and goes beyond the data the city keeps about children in certain age groups using its shelters.
Vandermorris, the Sick Kids physician, noted that the initiative was started by a network known as Young Parents No Fixed Address with a doctor at Toronto Public Health, and called the network an “unusual” example of a collaborative approach to one population’s needs.
But the effort to count Toronto babies born into homelessness and under-housing is vulnerable to staffing, funding and logistical challenges. It was halted entirely from 2015 to 2018 when one group wasn’t able to collect its usual data, and public health officials feared skewed results.
And in records from Ontario’s Better Outcomes Registry and Network (BORN), there’s nothing to distinguish babies born into homelessness from those born to incarcerated mothers, with both listed as babies with no fixed address. Data for 2018-19 shows 833 live and stillbirths with no fixed address in Toronto, which a senior BORN analyst said was “definitely an under-capture.”
“It’s hit and miss, really, what we’re trying to do,” said Barbara Chyzzy, a Ryerson assistant nursing professor who is researching homelessness among pregnant and postpartum women. “How do you count people who are homeless? That’s always been a type of structural issue.”
While Toronto Public Health says intermittent data can still offer a snapshot of the issue if continual surveillance isn’t possible, some are pushing for the problem to be monitored closer — to allow for a more targeted response. An article published in 2017 by authors from Toronto Public Health, the University of Toronto and Sick Kids said data systems typically failed to capture underhoused babies’ existence, leading to them being left out of policy discussions.
“I think the government really doesn’t want to see it, because they’ll have to deal with it,” said Gillian Cullen, founder of a doula service that operates in Toronto called Birth Mark.
To effectively monitor the problem, the authors of the 2017 report called for help from Ontario’s ministry of health or other “established” surveillance programs, noting that community-based networks can be affected by changes in individual agencies’ policies, management and staffing levels.
Asked this fall if anything had changed since 2017, Toronto Public Health said in an email that data collection efforts continue, but that its attention was needed on the pandemic. The Ministry of Health deferred questions about infant homelessness to the Ministry of Municipal Affairs and Housing, which said it plans to introduce more real-time data collection across Ontario’s broader homelessness sector in 2021, but that details weren’t yet available.
Suleman worries that under-captured data could lead to a warped public perception of what homelessness looks like in Toronto — an idea that under-housing in the city only looks like the kind of older person the public might see panhandling outside. Not babies, not newborns.
“They’ve been here for a long time,” she said. “This should not be surprising to anybody.”
* * *
In some cases, knowing at birth that an infant is homeless or precariously housed relies on a parent being willing to disclose their housing status to health workers. Several in the field say making that choice can trigger fears about child protective agencies entering their life.
A significant portion of Vandermorris’s patients with babies — many of whom struggle with housing — had experience in the protective care system. It was “potentially unrealistic,” she said, to ask them to trust their kids to institutions they went through themselves.
Heather, another new mom living in Toronto’s shelters who spoke with the Star this fall, said she’d spent her own childhood in and out of foster homes and group homes. She entered the city’s shelter system for the first time roughly two years ago, slightly before she turned 18.
In October, she said it had been about a year since she applied for a Toronto social housing unit, joining a waitlist that can take upwards of a decade. Before finding out she was pregnant, she and her partner lived in a couple’s shelter — both had lived in youth shelters originally.
They were moved to a hotel shelter together for a while after confirming her pregnancy. But eventually, in her eighth month, Heather was moved to a family shelter without her partner.
Their daughter, like Morgan’s, was homeless from the day she was born.
Being in the shelter as a new mom meant having staff and other women to lean on, Heather said. Emotional support was critical to her, knowing that she couldn’t push the housing waitlist to move any faster.
She was conscious that the strain of being apart from her partner due to the shelter’s rules may have affected their parenting. Caring for the baby essentially on her own was taking a toll, Heather said, especially as she faced waves of postpartum emotions.
When she spoke to the Star, Heather was waiting on the baby’s birth certificate — and hoping it would increase their chances at social housing once it arrived, while she and her partner continue their search for a place they can afford in the private housing market.
During her two years of shuffling through Toronto’s shelter system, Heather said she’s seen many other women in similar circumstances — either pregnant or having recently given birth to a baby, while struggling to find permanent and stable housing. “It’s like a blindspot,” she said.
* * *
Pregnancy, Chyzzy pointed out, can be a disruptive experience.
If a woman is working, but can’t access maternity leave, a pregnancy can jeopardize her income. Without a regular paycheque, covering essentials like rent and food might become a squeeze. Then there’s the question of childcare, which can add another significant expense.
“We tend to think of childbirth or pregnancy as being a time of joy,” Chyzzy said. “But it is also a huge time of stress.”
Since her baby girl arrived, Morgan said sleeping in one room with three people has been a challenge. For now, they’re making it work. When the baby cries in the night, Morgan scoops her up and carries her into the living room, to let the 13-year-old sleep until morning.
She’s frustrated with the advice a counsellor gave her, which revolved around her moving outside of the city to somewhere more affordable like Ajax. She’d consider it down the line, but for now, the prospect of leaving Toronto is daunting.
She doesn’t have a driver’s licence, or access to a car. Her job is in the city, once she goes back to work. The baby’s medical situation means they’ll have to be at Sick Kids repeatedly in the months ahead. And Morgan fears uprooting the 13-year-old from her school, after so much displacement, would be unfair.
“I have no support out there,” she said. “How does someone move to a new city with my situation?”
Sick Kids’ Vandermorris also expressed concern about new mothers in Toronto who have to weigh their need for housing against the prospect of losing their local support systems.
“I’ve seen any number of scenarios where, because of a lack of housing, a young woman has ended up being more isolated from the supports that she did have,” she said. “That has potential implications for both her and her baby.”
Two weeks after her baby was born, Morgan thought about one of her earliest nights in the family shelter, when she lay awake in the unfamiliar room. There were sounds coming from above, which she later learned was a new mom and her baby, stirring in the quiet hours.
She thought about the bleary-eyed hours that a new parent keeps — waking in the nighttime with a baby that won’t settle — and how much harder the experience would be in a shelter, a place that wasn’t your own home.
She thinks, now, about the number of mothers across Toronto facing the same challenges as her, trying to keep a roof over their children’s heads. She stressed that her story wasn’t a one-off.
“People need to know,” she said. “It’s not easy at all.”
Victoria Gibson, Local Journalism Initiative Reporter, Toronto Star