Where do you fit in changing this?
After moving through this much history, it would be reasonable to feel overwhelmed. We've covered... a lot.
How do we change a system that was built through the combined choices of lawmakers, doctors, nurses, teachers, insurers, researchers, funders, journalists, organizers, families, and many others? By intentionally and consciously promoting change through the combined choices of lawmakers, doctors, nurses, teachers, insurers, researchers, funders, journalists, organizers, families, and many others.
People act from different positions, with different tools, and the connections between those efforts make the work stronger.
The baobab tree offers us a beautiful way to picture this. Its roots reach wide beneath the ground. Its trunk holds enormous weight. Its branches stretch outward and create space for new life. The roots do not need to become branches, and the branches do not need to do the work of the trunk. The tree survives because each part does its own work while remaining connected to the whole.
Exhibit · Interactive
The roots that sustain the work
Open any root for the work it holds and the people doing it.
No single root sustains the tree. Select one to see what holds it up.
The six roots, and what each one can do
Direct care
Midwives · Nurses · Physicians · Lactation
This week
- Notice where a patient's pain or concern gets logged as “exaggerated” or “difficult” — and sit with the pattern.
- Gather the details of a few BIPOC-led midwives, doulas, or clinics
This season
- Raise a race-disaggregated outcome question at a team or department
- Build a warm, two-way referral relationship with a local BIPOC-led
Ongoing
- Believe reported pain and symptoms first — and document that you
- Make room for, and mentor, BIPOC trainees on your team.
Direct care leans on Funding to keep sliding-scale slots open, and on Storytelling to prove the patterns you see in the room are real.
Non-medical support
Doulas · Educators · CHWs
This week
- Consider whether a sliding-scale or funded slot is possible in your
- Notice the questions clients don’t know to ask their provider —
This season
- Cultivate a two-way referral relationship with a clinical provider
- Assemble a short list of local BIPOC-led orgs to share with clients.
Ongoing
- Advocate inside appointments and at birth — not just support from
- Keep whatever access commitment you make steady, rather than
Support bridges families to Direct care, and feeds Storytelling the on-the-ground reality that data alone misses.
Storytelling & documentation
Journalists · Researchers · Analysts · Historians
This week
- Note an outcome or story in your reach that’s worth documenting,
- Reach for a BIPOC scholar or practitioner where you’d default to a
This season
- Shape a documented pattern into something a community or policymaker
- Share findings back with the community they describe, in plain
Ongoing
- Name patterns as patterns, so harm can't be waved off as anecdotal.
- Credit and pay BIPOC voices for their expertise.
Storytelling gives Policy something to legislate and Funding a case to invest in — it turns what everyone in care sees into evidence.
Policy & accountability
Legislators · Advocates · Administrators
This week
- Find out when your local maternal-health or hospital board next
- Look at whether your institution reports outcomes by race, or has a
This season
- Weigh in at a budget or policy hearing, in person or in writing.
- Advocate for one accountability measure — outcome reporting by
Ongoing
- Support specific maternal-health-equity legislation, session after
- Hold your own institution to the standard you'd ask of others.
Policy sets the rules the whole ecosystem runs on — funding streams, reporting requirements, and the room Direct care and Support have to work.
Funding & philanthropy
Funders · Donors · Businesses
This week
- Look into a recurring gift to a BIPOC-led maternal-health org.
- Consider whether an existing gift could move from restricted to
This season
- Explore turning a one-off gift into a multi-year commitment.
- Compare what you pay vendors and contractors of color against
Ongoing
- Fund BIPOC-led organizations directly — and trust them with the
- Pay equitable rates for historically undervalued work.
Funding is what lets every other root keep going — the sliding-scale slot, the community fund, the organizer’s time.
Community & mutual aid
Organizers · Neighbors · Faith & community groups
This week
- Look for an existing mutual-aid network nearby to join, rather than
- Ask a neighbor or group what they actually need, before offering
This season
- Help route a resource drive or fund toward the greatest local need.
- Bring people who don’t usually talk into one room around a shared
Ongoing
- Sustain the local relationships that carry people between systems.
- Redistribute toward the greatest need, steadily.
Community organizing holds people between the systems the others work inside — and often surfaces the needs Policy and Funding should be meeting.
Source · The six roots, the work listed under each, and the ties between them are the exhibition’s own. The baobab is a figure of speech, not a citation.
The network of perinatal health has its own roots, trunks, and branches. Clinicians provide medical care. Doulas and community birthworkers offer preparation, continuity, advocacy, and trust. Researchers document patterns and test ideas. Educators help families and professionals understand what the research means. Storytellers make experiences visible. Organizers build power. Advocates change policy. Funders allocate resources.
None of these roles is enough by itself. A doula cannot reopen a hospital birth unit. A legislator cannot make a patient feel heard during a rushed bedside conversation. A physician cannot personally repair the housing, transportation, or insurance systems affecting every patient. But each can understand where their own role begins and who they need to be connected to beyond it.
Instead of asking, ’Who is responsible for fixing maternal health?’ we can ask, ’What position do I already hold, and what can I strengthen from where I am?’
For a clinician, that may mean learning the local community organizations patients can be referred to before a crisis. For a hospital leader, it may mean changing who is included when programs are designed, and budgets are set. For a researcher, it may mean asking communities which questions are most urgent before a study begins. For a funder, it may mean supporting the staff, rent, transportation, technology, and other basic infrastructure that allow community organizations to stay open — not only the newest short-term project.
There is nuance in what meaningful partnership looks like, too. A hospital and a community organization are not truly partnering if one side has all the money, makes all the decisions, and asks the other to provide trust on demand. A stronger partnership makes room for shared planning, honest disagreement, fair payment, long-term commitment, and the possibility that the institution may need to change — not only the community.
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Sources 2 entries
The image and the roles
- The baobab is used here as a figure of speech, not as a citation. It is a tree of the African savanna whose wide root system, heavy trunk and spreading canopy carry the point about interdependent work.
- The six roots, the work listed under each, and the ties drawn between them are the exhibition’s own, written from the roles that appear across the organizations named in Chapter 17.