Between Two Hands: From Conversation to Commitment
Philanthropy New York member, Tiffany Smith of Ideas in Philanthropy, reflects on a Clips & Conversations program on Black Maternal Health in NYC and outlines concrete action steps that funders can take to change the trajectory of the Black maternal health crisis.
“Show up. All you need is heart.”
This line from Chanel Porchia-Albert, Founder and CEO of Ancient Song Doula Services, lingered with me long after the program ended. It sounds simple, almost obvious, but for many funders, it remains a complicated ask. There is a persistent tension in philanthropy, particularly within social justice spaces: a desire to lead with humanity, care, and connection, while institutions remain constrained by perceived risk.
Between Two Hands: Birth, Power, and Philanthropy’s Role in Black Maternal Health in NYC was a gut-wrenching program and a moment of reflection. Ayanna Gill’s in-progress documentary, Between Two Hands, features the real stories of two mothers who lived through challenges of navigating pregnancy and childbirth in the maternal health deserts of Central and East Brooklyn. More than five years ago, after attending a similar Philanthropy New York event, I wrote about the maternal mortality crisis. I was struck by the data, the stories, and how closely they mirrored my own life — 4 pregnancies, 3 babies in 4 years.
Returning to this conversation on April 16 brought a different feeling: Disappointment. Disappointment that my story is still not unique. That the crisis remains just that — a crisis. That a room addressing an issue that disproportionately impacts Black women was still mostly filled with Black attendees, when broader solidarity, particularly from white allies, is urgently needed.
And yet, the call from panelists was clear: unpack the fear, challenge the instinct to retreat, and resist institutional inertia. The weight carried by the communities most impacted, which include women like Sharilyn and Michelle, featured in the documentary, and me, is far greater than the risks that philanthropy hesitates to take.
At the recent Philanthropy New York Annual Learning Meeting - Embracing Risk to Lead With Courage, I heard funders wrestle with what “risk” really means. Again and again, the conversation returned to institutional constraints, most notably tax status. While that is not trivial, we have to be honest about the tradeoffs. When the risk is regulatory discomfort on one side and preventable loss of life on the other, the calculus should shift. If that feels extreme, it reflects the reality.
So, what does it look like for funders to move past that fear in this particular setting?
We already know there are interventions that can change the trajectory of the Black maternal health crisis. The evidence exists. The practitioners are trained and ready. There is growing community demand. And yet, when those interventions take the form of midwifery and doula care, the response is often hesitant. These models face chronic underinvestment, driven by gaps in awareness, limited infrastructure, and a longstanding lack of respect for birth workers, particularly Black birth workers.
This is where philanthropy has both an opportunity and a responsibility to act.
There are models to build from. The Birth Fund demonstrates what is possible through a community-based funding approach that mobilizes resources quickly to expand access to care. Organizations like Ancient Song and Mama Glow Foundation are training and sustaining a culturally competent doula workforce. These efforts could be scaled to meet demand.
There is also a clear need for infrastructure. As we learned in the program, New York City, one of the wealthiest cities in the world, has just one freestanding birth center. Expanding access to birth centers is not radical. It is necessary.
And policy matters. Birth workers must be paid equitably and sustainably. Philanthropy can help fund advocacy to ensure doula and midwifery services are fully covered through Medicaid and other insurance systems, moving these models into standard care.
None of this is theoretical. The solutions are here. The question is whether philanthropy is willing to meet them with urgency, trust, and resources.
If all you need is heart, then the call to action is simple, but not easy. Fund boldly. Fund what is proven, even when it challenges traditional norms. Fund Black-led organizations and practitioners who have been doing this work for generations. Fund infrastructure, not just programs. Fund advocacy so these solutions can endure beyond philanthropy.
Most importantly, show up. Not just in the room, but in the decisions that follow. Because for Black mothers, families, and communities, the stakes are not abstract. And the time to act is now.
Tiffany Smith is the Partnerships and Community Engagement Lead at Ideas in Philanthropy.
Related Event: Funders for Birth Justice & Equity is hosting The Birth Justice Capital Summit October 20-22, 2026, in Detroit, MI. The Summit brings philanthropic partners and community leaders together to align funding around three core durability priorities. Learn more about their Summit and their work here.