REDDING, Calif. \u2014 Five days after giving birth, Melissa Crespo was already back on the streets, recovering in a damp, litter-strewn water tunnel, when she got the call from the hospital.<\/p>\n

Her baby, Kyle, who had been born three months prematurely, was in respiratory failure in the neonatal intensive care unit and fighting for his life.<\/p>\n

The odds had been against Kyle long before he was born last summer. Crespo, who was abused as a child, was addicted to fentanyl and meth \u2014 a daily habit she found impossible to kick while living homeless.<\/p>\n

Crespo got a ride to the hospital and cradled her baby in her arms as he died.<\/p>\n

\u201cI know this happened because of my addiction,\u201d Crespo said recently, just after a nurse injected her on the streets of downtown Redding with a powerful antipsychotic medication. \u201cI\u2019m trying to get clean, but this is an illness, and it\u2019s so hard while you\u2019re out here.\u201d<\/p>\n

Crespo, 39, is among a growing number of homeless pregnant women in California whose lives have been overrun by hard drug use, a deadly coping mechanism many use to endure trauma and mental illness. They are a largely unseen population who, in battling addiction, have lost children \u2014 whether to death or local child welfare authorities.<\/p>\n

She and other women are now receiving care from specialized street medicine teams fanning across California to treat homeless people wherever they are \u2014 whether in squalid encampments, makeshift shantytowns clustered along rivers, or vehicles they stealthily maneuver from one neighborhood to another in search of a safe place to park.<\/p>\n

\u201cThis is a really impoverished community and the big thing right now is maternity care and prenatal care,\u201d said Kyle Patton, a family doctor who leads the street medicine team for the Shasta Community Health Center<\/a> in Redding, about 160 miles north of Sacramento in a largely rural and conservative part of the state.<\/p>\n

Patton, who dons his hiking boots and jeans to make his rounds, has managed about 20 pregnancies on the streets since early 2022, and even totes a portable ultrasound in his backpack to find out how far along women are. He\u2019s also helping homeless mothers who have lost custody of their children try to get sober so they can reunite with them.<\/p>\n

\u201cI didn\u2019t expect this to be a huge part of my practice when I got into street medicine,\u201d Patton said on a hot June day as he packed his medical van with birth control implants, tests to diagnose syphilis and HIV, antibiotics, and other supplies.<\/p>\n

\u201cThe system is broken and people lack access to health care and housing, so managing pregnancies and providing prenatal care has become a really big part of my job.\u201d<\/p>\n

Street medicine isn\u2019t new, but it\u2019s getting a jolt in California, which is leading the charge nationally to deliver full-service medical care and behavioral health treatment to homeless people wherever they are.<\/p>\n

The practice is exploding under Democratic Gov. Gavin Newsom, whose administration has plowed tens of billions<\/a> of dollars into health and social services for homeless people. It has also standardized payment for street medicine providers through the state\u2019s Medicaid program, called Medi-Cal, allowing them to be paid more consistently. The federal government expanded reimbursement<\/a> for street medicine this month, making it easier for doctors and nurses around the country to get paid for delivering care to homeless patients outside of hospitals and clinics.<\/p>\n

State health officials and advocates of street medicine argue it fills a critical gap in health care \u2014 and could even help solve homelessness. Not only are homeless people receiving specialized treatment for addiction, mental illness, chronic diseases, and pregnancy; they\u2019re also getting help enrolling in Medi-Cal and food assistance, and applying for state ID cards and federal disability payments.<\/p>\n