Where do you fit in changing this?
The most common response to everything in this exhibition is a kind of paralysis. The problem is generational, structural, and national. A single practitioner is none of those things.
So this chapter narrows the question. Not what would fix this, but what is yours.
The baobab is a useful shape for it. It grows over an enormous span of time, and it functions as an ecosystem — root system, trunk, canopy, the animals and plants that depend on it. No single part performs the whole job, and no part functions well detached from the others.
Change in reproductive health works the same way. Direct care, non-medical support, storytelling and documentation, policy and accountability, funding, and community mutual aid are six distinct positions. Each one does something the others cannot. When they operate in isolation, gaps stay open. When they are connected and resourced, they start behaving like a system.
This framework clarifies something that matters for sustainability. No single role is responsible for carrying the whole weight. The expectation that any one group — particularly the people most affected by the inequity — will repair the system alone is neither fair nor effective.
Exhibit — Interactive
Find the position closest to the work you already do. Each one comes with concrete moves for this week, this season, and the long term.
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.
The goal is not for each part to do more. It is for each part to be positioned, supported, and connected so the whole system can work differently.
Which means the most useful question after this chapter is usually not about your own role. It is about the roles adjacent to yours, and whether you know the people occupying them.
A doula who knows the policy advocates in her state is more effective than one who does not. A funder who knows which community organizations are already doing the work makes better decisions than one working from a proposal alone. The connection is the mechanism.
The baobab does not grow overnight. It is shaped over time, by conditions that let it take root and expand.
This is what it means to shift from response to structure.