it takes all of us: reflections from the national women's shelter network conference
By Dominique Alex, Mary’s Place CEO
Last week I joined shelter providers, clinicians, advocates, and policymakers from across the country in Arizona for the National Women's Shelter Network conference. The energy in every room was focused and generous. People came ready to share what's working, name what isn't, and learn from each other. I left with new connections, new ideas, and a clear reminder: this work takes all of us.
Collaboration means a shared table, not separate lanes
I spoke on panels about how clinicians, policymakers, community leaders, and families can work together to improve outcomes for mothers and babies. Families experiencing homelessness are pregnant and parenting too. Their needs don't pause because they lack stable housing, and our systems can't treat maternal health and housing as separate problems.
At Mary’s Place, 54% of the heads of household we serve are single moms. We know that homelessness often means delayed or missed prenatal care. Coming inside to shelter can be the turning point: a chance to connect families with culturally responsive care through partners like Ayan Maternity Healthcare Support, OB-GYNs, prenatal care, pediatricians, and the safe, consistent support every parent and baby deserves.
The disparities are stark: in 2024, Black mothers in the U.S. died from maternal causes at more than three times the rate of white mothers, and hypertensive disorders during pregnancy, including preeclampsia, were most common among Black and American Indian/Alaska Native women. Washington's decision to add doula coverage to Medicaid shows what collaboration can produce. Clinicians documented disparities in maternal outcomes, providers and advocates made the policy case, and lawmakers acted on the evidence. The data backs up what families and birth workers have long known: one national study of Medicaid births found that doula-supported pregnancies had a 47% lower risk of cesarean delivery, a 29% lower risk of preterm birth, and a 46% higher likelihood of a postpartum checkup. The next step is making sure private insurers follow, so a family's access to a doula doesn't depend on which insurance they have.
Community partners are critical. Our partnership with Ayan Maternity brings culturally responsive care built by and for the communities it serves. That trust is often what determines whether a family engages with care at all.
Care should follow the family
Too many families experience pregnancy, birth, and the postpartum year as a series of disconnected handoffs. Continuity works when care follows the family instead of asking the family to follow the care. Locally, we see this in programs like SUPP (Substance-Using Pregnant People) at Swedish Medical Center Ballard, which provides addiction treatment for pregnant people experiencing homelessness; Seattle King County public health visiting nurses who support families at home after birth; and Early Head Start, which helps parents alongside a trusted partner track their child's development so gaps are caught early.
My key takeaways
Real progress requires clinicians, elected leaders, community members, and organizations acting together, guided by data and bold leadership. It requires listening to and building with the people we serve, whose lived expertise leads to better solutions. And it requires creativity and innovation in challenging times, from funding to program design.
What's at stake right now
HUD is seeking feedback on major changes, and Head Start performance standards are at risk. These aren't just policies and rules. They are babies, moms, and families who deserve housing, health, safety, and dignity. They are kids who deserve high-quality early learning, stable schooling where they can be curious and learn, and the chance to graduate on time. They are communities that deserve systems where everyone can access what they need to thrive.
I came home more committed than ever to raising our collective voice. No child should sleep outside, and together, we can make sure they don't.