By Crystal Charley, Policy Manager, Fair Share Housing Center

As a birth worker, I have spent years supporting families through pregnancy, birth, and the postpartum period. As a housing advocate, I have spent years fighting for policies that expand access to safe, stable, and affordable homes.

What I have learned from both worlds is simple:

A pregnant person should not have to worry about where they will sleep while preparing to bring a child into the world.

Yet for far too many families, that is exactly the reality.

Across New Jersey, expectant mothers are navigating rising rents, eviction threats, overcrowded living conditions, housing discrimination, and the constant fear that one unexpected expense could destabilize their family’s future. These challenges are often treated as housing issues. They are. But they are also maternal health issues.

In fact, I would argue something even stronger:

Stable housing is maternal health infrastructure.

What I Learned From Birth Work

People often think maternal health begins in a doctor’s office, a hospital, or a birthing center.

But long before labor begins, families are making decisions shaped by the conditions around them.

Can they afford healthy food?

Can they get to prenatal appointments?

Can they safely rest during pregnancy?

Can they store breast milk after birth?

Will they have a stable place to recover postpartum?

Can they safely bring a newborn home?

These questions are rarely discussed as housing policy questions, yet housing influences every one of them.

As birth workers, we often talk about creating the conditions for healthy pregnancies and healthy births. Housing is one of those conditions.

No amount of prenatal advice can eliminate the stress of wondering whether an eviction notice is around the corner.

No childbirth class can solve the challenges created by unstable housing.

No hospital discharge plan can replace the security of knowing a family has a safe place to return home.

Housing Stress Shows Up in the Delivery Room

The connection between housing and maternal health is not theoretical.

New Jersey researchers examining more than one million birth records found that women living in areas with greater affordable housing availability experienced lower rates of severe maternal morbidity, the life-threatening complications that can occur during labor and delivery. Researchers concluded that affordable housing investments have the potential to improve maternal health outcomes and reduce disparities among economically vulnerable mothers.

The broader housing data tell a similar story. Nationally, nearly half of renter households are housing cost burdened, meaning they spend more than 30 percent of their income on housing. For Black renter households, that figure exceeds 56 percent. Nearly one-third of Black renters are severely cost burdened, spending more than half of their income simply to keep a roof over their heads.

When housing consumes such a large share of a family’s income, difficult tradeoffs follow. Families often have less money available for food, transportation, child care, medications, and health care. For expectant mothers, those tradeoffs can have profound consequences for both maternal and infant health.

Numbers help us understand the scope of the problem. Birth work helps us understand the human cost. Behind every statistic is a family trying to prepare for a child while navigating uncertainty about where they will live.

The reality is that chronic housing insecurity follows families everywhere. It follows them to prenatal appointments.

It follows them to ultrasound visits.

It follows them into labor and delivery rooms.

And it often follows them home after birth.

When policymakers talk about maternal mortality, infant health, or birth outcomes, housing must be part of the conversation because families do not experience these issues in isolation.

A family’s ZIP code, housing conditions, and economic stability can shape health outcomes just as surely as access to medical care.

Why This Is a Racial Justice Issue

As a Black maternal health advocate, I cannot talk about maternal health without talking about race.

Black women continue to face disproportionately high rates of maternal mortality and severe maternal morbidity.

At the same time, Black families continue to experience the ongoing consequences of discriminatory housing policies that have shaped neighborhoods, wealth accumulation, and access to opportunity for generations.
These realities are connected.

Redlining may have been outlawed decades ago, but its impacts remain visible in housing patterns, community investment, environmental conditions, and health outcomes today.

The same communities that were denied mortgages, denied investment, and denied opportunities to build generational wealth are often the communities where mothers and babies continue to face the greatest risks today.

When we discuss Black maternal health disparities, we must also discuss the systems that create chronic instability in people’s lives.

Housing is one of those systems.

Housing Policy Is Birth Justice Policy

Too often, housing policy and maternal health policy operate in separate silos. One conversation happens at housing committee hearings.

The other happens at health committee hearings.

Families do not experience their lives that way.

Families experience housing, health care, transportation, employment, child care, and economic security as interconnected realities.

That is why affordable housing development, tenant protections, eviction prevention programs, anti-discrimination enforcement, and community investment should be viewed not only as housing solutions, but also as public health interventions.

When we stabilize housing, we create conditions that allow families to thrive.

When we protect families from displacement, we reduce stress and disruption during one of the most important periods of their lives.

When we expand access to affordable homes, we are investing in healthier pregnancies, healthier births, and healthier communities.

In that sense, housing policy is not separate from birth justice.

Housing policy is birth justice policy.

The Future We Should Be Building

Every family deserves the opportunity to welcome a child into a safe and stable home. Every newborn deserves a healthy start.

And every parent deserves the dignity of focusing on their growing family rather than fearing housing instability.

As New Jersey continues to address both its housing affordability crisis and its maternal health challenges, we must recognize that these issues are deeply connected.

The foundation for healthy families is not built in a delivery room alone.

It is built in homes.

And that is why stable housing is not simply a housing issue.

It is maternal health infrastructure.

Fair Share Housing Center works to ensure that every New Jersey community provides its fair share of affordable housing opportunities. Expanding access to safe, stable, and affordable homes is essential not only for economic security, but also for the health and well-being of families across our state.