Reflections
Hope is a Discipline and a Strategy: Reimagining Maternal Care
The stories we encounter in public health are often heavy: systems failing communities, people navigating institutions that were never designed with them in mind, and preventable harms repeating themselves generation after generation.
Yet working within the Health Equity Action Lab, designing health equity programs and working alongside communities has also given me the privilege of witnessing something else: pockets of hope. Hope that shows up in the daily work of community organizers, healthcare workers, and changemakers who are refusing to accept inequity as inevitable. These are people who are not waiting for systems to transform themselves. They are building alternatives.
My own work has long been rooted in addressing racism in healthcare, particularly anti-Black racism and how it shapes access, delivery, and patient experiences. Over the years, I鈥檝e seen a growing number of initiatives pushing for change through community leadership, cultural safety, and new models of care. One of those initiatives is led by Althea Jones, founder of .
A few years ago, organizer Mariame Kaba wrote that 鈥溾��. It鈥檚 a phrase I鈥檝e been sitting with a lot lately. If hope is a discipline, then perhaps one way we practice it is by paying attention to the people already doing the work. The people building something different.
This is one of those stories.
I first met Althea a few years ago through one of RADIUS鈥� Health Equity Lab programs (currently known as Health Equity Action Lab), where her passion for addressing the maternal health inequities experienced by Black mothers immediately stood out to me. There was a clear vision, care, and determination in the work she wanted to build. Since then, I鈥檝e had the privilege of following her journey as she has grown and scaled Ancestral Hands Midwives into an initiative making a meaningful impact in the community. We recently reconnected to reflect on that journey, the lessons along the way, and the vision that continues to guide her work today.
I invite you to sip your favorite drink, care for yourself and keep an open heart as you read through Althea鈥檚 journey, her initiative and the impact it has made.
Meet Althea Jones
Althea Jones has been a registered midwife since 2013, providing primary maternity and newborn care. But the path that led her into midwifery didn鈥檛 begin in a hospital or clinic. It began on a soccer field.
Before entering midwifery, Althea completed a biology degree at the University of Arizona on a soccer scholarship, competing as an NCAA Division 1 athlete. Athletics, she says, fundamentally shaped how she moves through the world.
The discipline, endurance, teamwork, and leadership required in high-performance sport translated naturally into birth work. Midwifery requires presence in intense moments, like supporting people through experiences that are physically demanding, emotionally vulnerable, and sometimes unpredictable.
鈥淪taying grounded under pressure, advocating strategically, and supporting people through intense moments,鈥� she tells me, 鈥渢hose are skills that translate directly from athletics into birth work.鈥�
Her commitment to supporting women in sport continues today. For Althea, athletics builds confidence and leadership in women and girls in ways that extend far beyond the field.
But her journey toward midwifery was also shaped by something else: witnessing the realities of inequity within healthcare. After completing her Bachelor of Health Science in Midwifery at Toronto Metropolitan University, Althea began to see patterns emerging in the care experiences of Black families.
She was seeing gaps in real time: Black families navigating systems that did not reflect them, did not listen to them, and too often did not protect them.
鈥淚 always knew I wanted to work in healthcare,鈥� she explains. 鈥淔or a long time I thought I would become a pediatrician. But ultimately I found midwifery, where I could practice in a way that aligned with how I believe healthcare should be delivered.鈥�
Midwifery offered something unique: a model of care built around relationships. Unlike many areas of medicine that primarily engage with illness, midwifery works with people who are largely healthy but moving through one of the most significant transitions of their lives.
鈥淚t鈥檚 a special relationship that midwives get to have with their clients,鈥� she says.
But alongside that relationship, Althea also saw the harms embedded within the broader healthcare system.
鈥淚 could see the harm in the healthcare system,鈥� she tells me. 鈥淎nd I knew we could utilize midwifery care to do better.鈥�
Eventually, those observations turned into a call to action.
The Birth of Ancestral Hands Midwives
The realization that change was needed did not come from a single moment. Althea shares that it wasn鈥檛 one moment, rather, it was a pattern.
Story after story of traumatic birth experiences. Preventable complications. Women being told their pain tolerance was 鈥渉igh.鈥� Young mothers navigating systems that treated them with suspicion rather than care. And when race-based data was available, it consistently revealed disproportionate risks for Black birthing people.
At some point, the pattern became undeniable. These were not isolated incidents. They were systemic.
鈥淎nd since the system wasn鈥檛 going to transform itself,鈥� Althea explains, 鈥渨e would have to build parallel models that demonstrate what respectful, affirming care actually looks like.鈥�
And this is when her initiative was born. Althea founded Ancestral Hands Midwives, a not-for-profit organization focused on improving the outcomes and experiences of Black people during the perinatal period.
The organization was created to address a gap that had long been overlooked: the absence of Black-led, racially concordant midwifery care in Ontario. Clients who come to Ancestral Hands are often seeking something that is surprisingly difficult to find within mainstream healthcare: culturally safe care delivered by providers who understand their experiences.
The difference is both clinical and relational.
Many Black mothers whom Althea and her team encountered in mainstream care described feeling unheard during appointments. Their concerns were minimized. Symptoms were doubted. Appointments were rushed, leaving little room for meaningful conversations or informed decision-making.
For some, the experience of navigating pregnancy care was fragmented and isolating. Others were excluded from midwifery services altogether due to high-risk classifications, leaving them to navigate complex hospital systems without consistent advocacy or support.
Underlying many of these experiences was a deeper issue: a profound lack of racially concordant care.
Many had never seen a provider who looked like them or understood the cultural context shaping their health, family dynamics, and fears.
鈥淲hat people wanted was actually very simple: to be believed. To be respected. To be informed,鈥� Althea shared.
Ancestral Hands was built to respond directly to that need.
The clinic鈥檚 model centers several core principles: racially concordant care, extended appointments that allow time for trust-building, trauma-informed approaches, and advocacy coaching so clients can navigate hospital and specialist systems with confidence.
The environment, both physical and relational, communicates something that is too often missing in healthcare spaces:
You matter here.
Althea describes the organization鈥檚 theory of change clearly: culturally safe, Black-led care can improve agency, safety, and outcomes and ultimately shift healthcare systems themselves when properly supported.
The Road to Impact
While Ancestral Hands began as a model of care, its impact has quickly extended beyond service delivery. Althea is intentional about building not only a clinic, but an ecosystem.
That includes mentorship for BIPOC midwifery students, advocacy within professional institutions, and contributions to broader policy conversations around maternal health equity.
She currently serves as President of the Board of Directors at the Association of Ontario Midwives, where she works to strengthen the profession itself and expand opportunities for Black midwives entering the field.
鈥淚 want to see a profession that mirrors the diversity of Ontario,鈥� she says. 鈥淏ut just as importantly, one that retains Black midwives once they enter the field.鈥�
The work also includes shifting public narratives around Black maternal health. Through storytelling, media engagement, and educational programs like Birthing While Black, Ancestral Hands is helping reshape how maternal care and racial equity are discussed in Canada.
The organization鈥檚 long-term vision is ambitious: the creation of a Black-owned multidisciplinary health hub that provides comprehensive care and wraparound services.
Althea also participated in RADIUS鈥� Health Equity Action Lab鈥檚 Trampoline Program, an incubator designed to support early-stage health equity initiatives. For her, the program provided something rare.
鈥淚t鈥檚 very difficult to find support as an equity-focused non-profit,鈥� she explains.
The Health Equity Action Lab鈥檚 Trampoline program offered a space to refine the organization鈥檚 theory of change, test key assumptions about the care model, and strengthen the strategic framework guiding its growth. Rather than pushing ventures toward rapid scaling, the program centers community needs, cultural safety, and long-term systemic impact.
For Ancestral Hands Midwives, that alignment mattered.
It allowed her to move from operating purely from passion and urgency toward building a care model that is both community-rooted and strategically-sustainable. And it led to another question on what needs to change to better enable this kind of community-centered work.
What this looks like in practice, from Althea鈥檚 experience is:
Sustainable, flexible funding, not short-term, project-based grants, but long-term investment that supports core operations and growth. As we say in our work: you cannot transform what you refuse to resource.
Policy alignment: regulations, hospital partnerships, and funding frameworks need to support continuity of care and culturally safe models, not create barriers to them.
Workforce development and retention: we need to actively support Black practitioners entering and staying in fields like midwifery. Representation is not incidental; it鈥檚 essential to care quality.
Shifting power: community-led organizations need to be decision-makers, not just service providers or advisors.
The Discipline of Hope
When I asked Althea what keeps her grounded in the work, even when systems move slowly, her answer was simple.
Community.
The midwives who show up every day. The families who place their trust in the clinic. The growing network of Black providers across the province working toward the same vision.
One story she shared captures the impact of that work.
A client came to Ancestral Hands after a traumatic first birth. She arrived guarded, carrying fear and unresolved questions about what had happened during her previous pregnancy.
Through the clinic鈥檚 care, she was able to access her records, understand her previous experience, and prepare for her current pregnancy with information and support.
When it came time to give birth again, she felt something that had been missing before.
Agency.
鈥淪he was able to advocate for herself,鈥� Althea shares.
Today, she is one of the clinic鈥檚 strongest supporters.
Althea is quick to point out that no healthcare provider can control every medical variable. But what can be controlled is whether people are centered, heard, and respected in their care. And that, she believes, can change everything.
鈥淚f we are serious about maternal health equity, we must resource Black-led solutions, not as pilot projects, but as pillars of the healthcare system.鈥� - Althea
Her hope is that one day the model built at Ancestral Hands will no longer be considered innovative. It will simply be standard care.
Until then, the work continues. And in that work, in the steady building of something better, we practice the discipline of hope.
This story was supported by Social Innovation Canada through the . As part of the SII Initiative, SI Canada aims to illuminate how social innovators across Canada are putting the principles of collaboration, equity, and systems thinking into practice.
