Community-Led Care Requires Integrated Capital
By Tenesha Duncan, Founder and CEO of Orchid Capital Collective
Our support for midwives and community-led care must reflect their value in dollars and cents—and beyond.
For this episode of Make Shift Happen, I had the honor of speaking with Kiki Jordan, Founder and Executive Director of Birthland Midwifery, about what becomes possible when we value all forms of capital—social, knowledge, and financial, to name a few—and invest in community-owned and -rooted care systems that are changing outcomes and trajectories for families and communities.
As we shared our stories, Kiki said something that anchored us both in the room:
“There’s no separation between us and the statistics of the Black maternal health crisis.”
This was an inflection point in our conversation. The kind of moment where we breathed into an all-too-present reminder of our journeys and proximity to the work, and what it means to hold our missions as we live them.
My story spans a career of supporting access to care in hostile environments, my own negative reproductive health care experiences, and a life-changing appointment with a midwife that reshaped my belief in myself and the kind of care I and others deserve.
Kiki’s empowered birth, in contrast to the dominant narrative that birth for Black and brown people is inevitably traumatic, led her to become a midwife, the founder of Birthland in Oakland, and a fierce leader and advocate for expanding access in every community.
We have different entry points, but landed on the same question:
Why is a community-rooted model of care, a solution that works, and is efficient and evidence-backed, neglected in favor of an extractive system that produces some of the worst outcomes?
One clear reason: our dominant economic system doesn’t value non-financial capital, which midwives and other community-based providers so clearly steward and share:
Clinical capital — strong outcomes, lower intervention rates, and better experiences.
Relational capital — trust built with patients and across the care ecosystem through time and continuity.
Cultural capital — practices rooted in tradition and community wisdom.
Regenerative capital — the ripple effects of a positive pregnancy and birth experience, which is often the entry point for an entire family to experience care differently.
A positive birth or care experience can shape mental health, bonding, confidence, and how someone understands their own body and power. For Black birthing people in particular, positive experiences interrupt generations of medical trauma. They shift narratives about what is possible.
Communities have always built and known the value of localized, collective care. Midwives and community-based providers anchored care in eras of segregation and exclusion. At the height of COVID-19, out-of-hospital midwives like Kiki became the safety net. Despite systemic underresourcing, providers like her stay and build as gentrification displaces, hospitals shutter, and care deserts grow.
Those who manage financial capital study these community-based models and laud the data, praise their outcomes, then demand scale while failing to fund the infrastructure that enables it.
This is why Orchid Capital Collective exists: to provide the integrated capital that matches the full spectrum of value that midwives and providers contribute to communities.
We mobilize flexible and integrated capital, which includes grants, low-interest loans, recoverable grants, and tailored capacity support for leaders building community-led reproductive care systems. Integrated capital specifically centers their autonomy and capacity to build lasting care infrastructure in parallel to existing systems. That infrastructure includes:
Midwives reclaiming land for birth and wellness centers.
Worker-owned collectives collaborating for sustainability and training the next generation of community care providers.
Social entrepreneurs supplementing care delivery and building community-accountable mechanisms that enable ownership and community wealth.
Fully funding these essential care systems includes:
Grants for legal protection and policy advocacy to close reimbursement gaps and drive policy implementation.
Working capital to bridge slow insurance reimbursement cycles and pay equitable wages.
Patient capital for land, facilities, workforce development, and operational infrastructure.
Multi-year commitments that reflect trust and belief in the long-term vision.
There is a persistent pattern in philanthropy: we see the data and then question at length, especially when leaders are people of color. Especially when the innovation operates differently from our current systems or how we were taught to build.
So what happens if we move and value capital differently in this work?
We get healthier families.
We get providers who can stay in practice and who will remain when institutions leave.
We get communities that experience care as a site of stability and power.
We redefine what and who we believe is valuable.
If we are committed to a better future, we must ask ourselves and honor whose hands will welcome us into it. Will you join us?
Birthland Midwifery serves the Oakland, CA birthing community, offering pre- and post-natal services and supporting families in all birth settings. Currently, Birthland is expanding with the Birthland Wellness Center—an inclusive, freestanding birth center offering comprehensive midwifery care and wrap-around perinatal services. Learn more about Birthland and consider supporting their important work here.
Orchid Capital Collective invests in ecosystems where reproductive care, economy, and community meet. They're stewarding the remainder grantmaking dollars in our birth equity portfolio and carry forward our legacy of funding with integrated capital. As a Tara Health Portfolio Lead, Tenesha was instrumental in evolving our focus to include an intersectional analysis of gender and race.
Subscribe to our channel to watch the series →
Subscribe to our newsletter for updates when new videos release →
