The Power of (Not) Listening

“Black women are 243 percent more likely to die from pregnancy- or childbirth-related causes.”—Nothing Protects Black Women from Dying in Pregnancy and Childbirth: Not education. Not income. Not even being an expert on racial disparities in health care. (ProPublica and NPR News, December 2017)

“Black infants in America are now more than twice as likely to die as white infants.”—Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis (The New York Times Magazine, April 2018)


As a consultant for a social impact firm, specifically focused on health disparities and closing gaps in care, I’ve become accustomed and even desensitized to headlines and statistics like the ones above.

But as a young Black woman looking to start a family of my own, these headlines and stats are much more personal, alarming, and terrifying.

I remember the moment that my mindset switched from, “Oh another crisis disproportionately affecting my people” to “Oh no. This affects ME. Right now!” An old colleague from CDC shared the Pro Publica/NPR article about Shalon Irvin. The title of the article, “Nothing Protects Black Women from Dying in Pregnancy and Childbirth” – and my friend’s words about her colleague – compelled me to read the full 3,000+ word piece. Less than half-way through the article, a steady stream of tears started rolling down my face.

Shalon was educated and motivated. I’m educated and motivated. Shalon was economically stable. I’m economically stable. Shalon even worked to understand and prevent health disparities, just like I do. By the time I got to the part of the article with the hard data — that in New York City, where I live, Black mothers are 12 times more likely to die than white mothers — I had to take a break to pull myself together.

The message was clear to me. Shalon did everything “right.” She understood her risks and advocated for herself with her doctors. But it still wasn’t enough. In fact, the thread that permeates not only Shalon’s story, but the countless other stories like hers (including tennis superstar Serena Williams) is the complete disregard for the urgency of listening. Taking women seriously, hearing their voices, and paying attention to what they say (and don’t say). These women tried to advocate for themselves. They knew something was wrong. But their doctors didn’t listen.

Steeped in a history of unethical mistreatment of Black women for the sake of “medicine,” healthcare providers often believe the myth that Black women have higher pain tolerance, are difficult, uneducated, complain too much, etc. These myths, whether conscious or unconscious, have led to a systemic pattern of ignoring the voices of Black women which has in turn seriously compromised our health and endangered our lives.

It’s a theme I’ve seen time and time again over the last 10 years in my work addressing the HIV epidemic: Black and Brown people feel unheard, undervalued, and invisible. As a result, they’re suffering and dying at disproportionate rates.

I’m lucky enough to work for a company that values listening to the people and communities that we work in. Deep community and stakeholder engagement are pillars of the programs we run, particularly in my work addressing HIV/AIDS issues. Still I can’t help but ask myself what more I — and we — can be doing professionally to continue shining a light on the issues around Black women and maternal health and advocating for systemic change. I’m not sure. But politicians, coalitions, and organizations have taken notice of the recent media attention around the issue and seem committed to making change happen.

Senator Kamala Harris (along with 13 of her Democratic colleagues) recently introduced the Maternal Care Access and Reducing Emergencies (CARE) Act to directly address persistent implicit bias that affects Black women before, during, and after childbirth. The State of New York has responded by establishing a task force on maternal mortality and disparate racial outcomes. The task force is meant to lead a state-sponsored initiative that will include efforts to review and better address maternal death and morbidity, with a focus on racial disparities,. The task force will also work to expand community outreach and take new actions to increase access to prenatal and perinatal care, including establishing a pilot expansion of Medicaid coverage for doulas.

A wealth of research shows that engaging a Doula and midwife significantly improves health outcomes for moms and babies. Yet Doulas and midwives are a luxury that a lot of families – especially Black and Brown families – aren’t aware of or can’t afford. Ancient Song Doula Services in my home city of Brooklyn, NY, is working to combat that. The Family Health and Birth Center in Washington, DC, offers a model of prenatal care and education that significantly improves the health and wellness of Black women and children. These types of local models keep community and the voices of women at the center of their work. Leaders of these organizations should be at the decision-making table to help scale the larger state and city-wide responses.  

While this issue is decades in the making, the sudden urgency around it speaks to the power of the media as a conduit of change. As I reflected on my own experiences and the experiences of the women in my family, it dawned on me that my own mother and one of my sisters also had traumatic and near-fatal experiences during and after childbirth. It was only after this recent media frenzy that I felt the true weight of those experiences and connected them to the crisis. It took articles like Shalon’s story and the Lost Mothers series on NPR to adequately amplify the voices of these women. As a communication professional, this is a reminder to me how important it is to not only listen, but to be active and outspoken, and to amplify.

I believe that we’re at a tipping point in this crisis. Mass media attention means more awareness, and that’s the first step in trying to solve any epidemic or social problem. I have hope that through the power of listening, my colleagues in public health, racial justice, and social impact can work together toward a change over time. Initiatives like the California Maternal Quality Care Collaborative have worked toward changing maternal mortality rates for the last 10 years, and they have slowly but surely achieved rates that are 30% lower than the national average. Until change like that happens nationwide, and benefits all women, I will remain committed to intentionally listening in my work. And on a personal level, I will remember the lessons from these women’s stories and never stop fighting to be heard.

The First Year of a New Presidency Moves Philanthropy to Action

The speculation for most of us began on Wednesday morning, November 9, 2016.

Regardless of political affiliation, the election win by a presidential candidate who promised dramatic changes in governing style and policies from the prior administration meant that grantmakers might have to rethink their current strategies and, quite possibly, fundamental priorities. As the new administration’s policy agenda rolled out over its first year in office, the interest areas of more and more funders were touched by the shifting political landscape. Continue reading

Three Ways Foundations Can Navigate Changing Political Tides

Is it on? Is it off? Is it on? Is it off? Our heads are spinning with the series of attempts to repeal the Affordable Care Act (ACA), and the numerous ways in which both the federal government and state level actors are strategizing to alter and/or erode health policy. In today’s turbulent climate, when shifting political winds and policy changes go hand-in-hand with ever-expanding health care needs across the country, how can health funders be strategically effective?

TCC’s Melinda Fine Ed.D. and Jessica Mowles share three strategic learning processes that will engage foundations and funders during complex times.

Read “Three Ways Foundations Can Navigate Changing Political Tides” on >

Responding to the Call: How to Pursue Legal Advocacy

Without legal advocacy, many norms and rights that people rely on, may have never been established. School desegregation (argued through Brown v. Board of Education), gay marriage (argued through many cases, but before the Supreme Court as Obergefell v. Hodges), clean water and air (argued at both state and federal levels as a myriad of lawsuits) – all were established as part of a legal advocacy strategy. Continue reading

Three Common Questions about Funding Advocacy

Since the 2016 election, my colleagues and I have noticed one of two things: more funders considering a first-time investment in advocacy, or funders strengthening their existing commitment to fund advocacy work. In response to this surge of activity, we’ve had the opportunity to share our findings regarding effective strategies to support advocacy campaigns  – with different groups of funders. These engaging and deliberate conversations generated additional questions – from which we’ll highlight three: Continue reading

6 Ways Family Foundations Can Make A Difference in Immigrant and Refugee Lives

With all the changes in the political climate over the past year, I’ve been especially concerned for immigrants and refugees. Many families in my city and community have been affected by the new executive orders and administrative actions, and I’ve read stories about many others across the country that are at risk. This can feel overwhelming when I think about the impact on people I know. The issues we’re dealing with are daunting and complex; it makes me wonder how I can be most helpful.  

You may believe that it would take massive investment to have even a minor impact in this climate. But the truth is, we can all make a difference. Family foundations are no exception.

TCC’s Naomi Polin shares the six essentials for family foundations to have when supporting immigrant and refugee communities. 

Read “6 Ways Family Foundations Can Make A Difference in Immigrant and Refugee Lives” on>


What Surprises Me about Human Rights Grantmaking

When your job centers on helping funders assess needs, devise strategies, and manage and evaluate their grantmaking, you wish that every field would have a resource like Advancing Human Rights: Update on Global Foundation Grantmaking. Since IHRFG and Foundation Center launched this series four years ago—and added an interactive website three years ago—I have made regular use of these tools to understand levels of foundation engagement within and at the intersection of issues ranging from women’s rights in the Global South to environmental justice in the United States. This research has also been invaluable in helping the foundations I work with to see just how many peers and practitioners have aligned interests and could become partners in realizing their goals.

That is why I was surprised when I sat down to read the 2017 Edition of the Advancing Human Rights report. I realized that in using these resources to answer my very specific, client-focused questions, I had been missing some findings and trends that are beginning to reshape my thinking about foundation support for human rights. Continue reading

Grow Stronger & Achieve Greater Impact

Earlier this month, Grantmakers for Effective Organizations (GEO) held its National Conference in Minneapolis – bringing together nearly 900 foundation professionals, executives of nonprofit organizations, consultants, and other stakeholders for a stimulating and inspiring two days. The organization promoted the conference as “an event that offers participants the opportunity to explore the most relevant topics in the philanthropic field and hear new ideas for smarter grantmaking practices that enable nonprofits to grow stronger and achieve better results.” Note the emphasis on “grow stronger and achieve better results.”

I had the privilege of attending along with four of my TCC colleagues, two of whom were leading sessions that reinforced the focus on achieving greater impact. Continue reading

Our 9 Types of Evaluation Work – Which are Useful to You?

On a cold, rainy day in February, all seven members of TCC Group’s evaluation team came together for a retreat. With our team spread across the country, this retreat was a unique opportunity for in-person team building and reflection. Most interestingly, we completed an exercise to classify the types of work we are talking about when we say “evaluation.”

The end result? Clarity around the nine types of evaluation work we do. Continue reading

CASE STUDY: Supporting Organizational Effectiveness Within Movements

Wikimedia's Organizational Effectiveness ToolFunders supporting movements face a unique set of challenges when trying to support
organizations working for the same cause. In their efforts to increase organizational effectiveness, foundations invariably face questions of credibility and control, and sometimes encounter diverging understandings of success. This case study profiles how TCC Group – with its partner, the Wikimedia Foundation – developed an innovative, participatory approach to these challenges, resulting in increased organizational effectiveness in the Wikimedia movement.

Read the entire case study >