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Birthday Blog– reflecting on what it means to be a woman leader


Today is my 44th birthday, and birthdays always get me to reflect. It’s also a few days before a workshop that I have organized in Oxford, England alongside the Skoll World Forum with a dear colleague of mine at Acumen, with support from some of my favorite corporations. The focus of the workshop is on how large corporations and social enterprises are partnering to create opportunities for women around the world. To thrive, to contribute, to lead.

I organize events on corporate/social enterprise collaboration twice a year and have for about the past five years. They’re designed to inspire people, to help us all work smarter, and to spark new partnerships. It’s always humbling to see it all come together because of the passion and commitment of the people who come and tell their stories and share their challenges, with a stark honesty about the social change work they do, whether they come from a huge corporation or a scrappy start-up.

I feel especially emotional about this workshop because the theme is women. This is a conversation about “us”, women, who are not only a group facing the challenges of poverty, violence, bias, and injustice, but also the group that is most likely to solve those challenges.

This is a conversation, at a time when we are seeing the power of women’s voices – linked in solidarity, undeniable, growing stronger every day – about all the ways that women can lead: women as entrepreneurs, pioneering new kinds of enterprises that embed values in their core; women as investors, using their capital to create value and build new businesses models; women as employees, that drive productivity and in turn support their families and communities; and women as customers, making considered choices for themselves and their families that can influence entire markets.

In each of these capacities, women have an opportunity to lead, to drive change, not only by showing up and participating, but by doing it in a new way. In a male dominated society, playing by the rules only gets you so far. To lead as a woman means reinventing the rules of the game. The thought of being in a room, in just a few days’ time, with so many women and our male allies who are shaking things up in so many different ways is thrilling and daunting. Because it’s forcing me to ask myself about what it means to lead.

One of my role models, a leading advocate for women’s issues, a public figure who has led and built organizations I deeply respect, recently confided in me that she sometimes wondered about whether she was having an impact. I was stunned and slightly disheartened. If she felt that way, after decades of vocally championing the cause of justice for women, and helping to lift up the stories and voices of hundreds of women, then why on earth did I think I could make a difference?

I found myself reminding her during our conversation that she was one of the biggest reasons why I started on this journey, to make gender inclusion a core facet of my work and a strength for my organization. She had always spoken up. She had challenged people to do more. She had broken through in a male dominated industry and had committed to helping others do the same. And yet she still wondered about what impact she was having. At that moment I realized that what it means to lead as a woman, as a human in fact, is to ask that question again and again. How can I lead, how can I create change, how can I have a greater impact?

So… on my birthday I again embrace that question, but also embrace my own leadership. It was November of last year when I stood in front of a circle of women organized by Suzanne Biegel (another extraordinary leader and role model) at Wharton Business School at the University of Pennsylvania and was asked to share a commitment. That day I said out loud, “the next meeting I organize will focus on women.” Five months later, and the meeting is three days away. 44 years into my own life story, I am learning the power of choosing. As women, we may doubt ourselves a bit more than we need to, and that’s OK. But as women leaders, we choose to lead, despite the broken systems we operate within, despite a history of inequality and oppression, and despite the occasional moments of doubt.

We have never lived in a world where women’s leadership was the norm, and have never existed in a time where women shaped society on equal footing with men, so we can’t imagine what the future holds. But I feel more excited about the future than ever, because more women are choosing to lead than ever – in politics, in business, in finance, in civil society and in media. It’s a privilege to be a part of it. And a wonderful birthday gift to be in such extraordinary company. My second birthday wish: tell me how you choose to lead.


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And the Best Picture Goes To…

Chris Rock

Chris Rock, the host of this year’s Oscars, while making a point about the lack of black actors nominated for awards, pointed out that perhaps it was because there was no category for black actors. Sounds odd that there would need to be such a category, but it was also strange in this day and age, he pointed out, to have acting awards distinguished by gender. Acting is not an area where men and women needed to be evaluated separately in order to be evaluated fairly, the way, for example, some athletic activities are.

But if there was no “best female in a leading role” category we would undoubtedly see the same pattern we see so often, that primarily male producers would hire primarily male directors  and make films written by primarily male writers, with primarily male leading roles. So that, without a category for women, the Oscars would be not only mostly white, but also mostly male. At some point, I can only hope  that the reality that more women watch movies than men would lead the industry towards more movies relevant to women, more great roles for women, more great scripts by women, and perhaps the need for a separate category for female actors would go away. Until then, let’s keep the category, because I find it depressing to see women consistently overlooked in other categories that are not gender dis-aggregated, like directing. (Hello? Debra Granik not even nominated for Winter’s Bone??!! But I digress.)

The problems in Hollywood around gender are just a symptom of a deeper issue, which is a lack of recognition of the value and influence of women. And this is truer in many developing economies than anywhere else. About 10 years ago, the phrase “women and girls” started to pop up more and more. The Girl Effect, an in initiative and awareness raising campaign led by Nike, helped people begin to see the catalytic impact that investing in women and girls could have on society. Most shocking to many was learning how systematically women and girls were undervalued, and the huge cost that had not just for them, but for whole communities.

I sometimes worry that in a zero sum world of competing causes and funding, there is a risk is that “women and girls” are looked at as an issue, rather than a way to describe 49.6% of the global population.  If we simply behave as if half of the people in the world matter, and that economic growth, good governance and basic human rights, are impossible if they are not accessible to half the people living on the planet, then the interesting question becomes not whether we should focus on women and girls, but rather, how do we behave as if women matter.

The Girl Effect, Half the Sky, and Girl Rising are three campaigns of the last decade that have done much to elevate the issues facing women and girls to a global stage, leading to huge strides in making education, healthcare, economic opportunity and human rights accessible to women and girls. And in part because of these efforts, the issue of parity for women in pay, political access and leadership roles is moving to the center of major discussions from the Sustainable Development Goals to our own national election.

What started as a cause is becoming a way of looking at the world with a clearer view of what IS.

Today I celebrate my first International Women’s Day since I helped Acumen publish its report on the role of women in social enterprise with the International Center for Research on Women. I’m now committed to looking at my own work with a gender lens, both at Acumen – which finds and scales business that can improve the lives of poor people, and as a board member at The White Ribbon Alliance, which partners with women leaders across the developing world to advocate for improved maternal health. I don’t yet know where this new perspective will lead, but I do know that a gender lens is not a destination or a set of goals that one can aspire to. It is a way of seeing the world, with eyes wide open to what is actually there. It is being able to see when women are missing from a picture and considering what they could add if they were present. It’s seeing women as consumers, employees, leaders and investors, and behaving accordingly.

To go back to the Hollywood industry metaphor, it’s being able to stand in a packed movie theatre and see the women that are already there, and then, being able to imagine a new story playing out on the screen: one where women are fully represented as part of the complete story, not left in the background or entirely invisible. And it’s a story that is not just created for women, or about women, but also by women. Because whether we are men or women, the story people really want to hear is the one that’s based on a true story. And a story, or a government, or a business model, that excludes women, is one that is truly missing the big picture.



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Living the Questions with High School Students in Denver

mqdefaultLast week I had a chance to present at the Aspen Challenge in Denver to a group of high school students that had been selected for a unique opportunity. As teams, they would be challenged to have an impact in their schools and their communities on critical issues, and through the course of a two day conference, they would received the encouragement, skills and inspiration that would set them on their way. I was there for added inspiration, and there is almost nothing I have done that I found more intimidating than trying to inspire a room full of hungry high school students, since my talk was scheduled right before lunch and just after three hours of presentations by some of the most inspiring speakers I’ve ever seen.


So I had no trouble imagining how some of these high school students might feel, being asked to generate something great and not knowing exactly where to begin. So I talked about how I began, and I focused on where I had found that being confused, angry, or afraid had often helped me find my way to do something that mattered to me, and that helped me figure out who I was. It was so meta, as I was in the middle of doing something that I was asking them all to do. And it worked – if not for them, then for me.


As a result of participating in the Aspen Challenge, I was reminded that every potentially great moment starts with a little moment of fear and uncertainty. I feel renewed in my desire to push myself into uncomfortable places, places of uncertainty, and to recognize, as Rilke said, that first we must live the questions, experience everything, and the answers come much later, almost as if by accident. In practical terms, this is a great way to stat the year in a new role, focused 100% on developing creative new partnerships for Acumen. Feel free to watch the talk – it covers my story, Acumen’s work, and our leaderships philosophy, and an exhortation to keep challenging ourselves to do a little more than we think we can, and to find that community that makes it safe to take a risk.

I will have a chance to see what these students do next, what challenges they take on, and which ones successfully pitch their ideas and get to present them at the Aspen Ideas Fest. I have no doubt they will continue to inspire me, in large part by reminding me that it is never too soon (or apparently too late) to take a chance and try to change the world.

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A New Type of Corporate Partnership

If you are sitting in a traffic jam, you can blame the car in front of you, and all the cars in front of you, for creating the traffic jam, or you can take responsibility for joining them, alone in your car at rush hour, and say, ‘I am the traffic jam.’

Emmanuel Faber, COO Danone

At Acumen, we think of ourselves as a “global” organization, but I was reminded this past Friday that the word has many meanings. I spoke at a conference at Indiana University called “Framing the Global,” designed to advance the conversation within the sphere of global studies. The academics who attended were all involved in exploring the social, political, economic and cultural consequences of transnational flows of people, products and ideas. I was invited as a practitioner to talk about Acumen’s work, our model for the kind of leadership needed in an increasingly interconnected world, and to share my own experiences forging new kinds of partnerships with the corporate sector. I was there to share some concrete examples of what could be done when you assumed the world was interconnected.  This is a core element of Acumen’s guiding principles, and I believed our work would intersect directly with the issues raised at a conference on the question of what is “global.”

The Q&A session after my talk started out with a question about corruption, and moved on to challenge Acumen’s willingness to partner with corporations in light of the troubling history of multi-nationals in many of the markets where we work. Many of the questions held a real skepticism about whether corporations could help build a more equitable world, and they gave me pause.

The experience challenged me to consider very carefully how Acumen could help transform the history of exploitive corporate practices. I realized the importance of the work we are doing to forge a whole new kind of corporate partnership. It is not enough to say that our work brings real benefits to social enterprises and the people they serve. Our goal is to change the systems that have, in so many cases, led to the inequality and lack of options that we see. So, to be successful, we need to partner with corporations that are also interested in changing systems.

I was lucky enough to hear Emmanuel Faber, the COO of Danone, speak recently at a Wealth & Giving Forum event in New York focused on social impact. He openly challenged the notion that there are systems that exist beyond our control, and shared Danone’s work to partner with Grameen to innovate around product development, manufacturing and corporate investment. We see more and more companies willing to go outside their comfort zone and partner in creative ways in order to achieve breakthroughs (including through our partnership with Dow, which I wrote about here). We are now working with multiple global corporations based in both the US and the countries where we invest to provide financial and in-kind support to social enterprises that seek to scale. These companies are looking beyond traditional CSR to find new potential allies in the development of more inclusive and sustainable business models. But these are the early days of exploring the potential for collaboration between corporations and social enterprises.

We know there are systems, and drivers, and institutions that make the kind of radical change we want to see happen much harder, but my time at Indiana University served as a great reminder that if we want to create change, we can neither dismiss what is broken as “the way things are” nor can we blame it as though we are powerless to change it.

I am excited that Acumen is choosing to engage in the debate about the role of corporations in helping to build a more inclusive model of business and more dignified and equitable model. I believe we will discover a whole new set of solutions by engaging in this discussion from a position of openness and respect, even as we hold ourselves accountable to the people, and not the systems, with which we stand.

(originally posted in Acumen blog at


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The TA Initiative Summit

This past May, Acumen and Dow Chemical partnered to hold the first summit of corporations and Acumen social enterprises in Nairobi, Kenya. This short video shares the highlights and some of the key lessons learned about how corporations can work with social enterprises to better serve low-income markets and identify new business opportunities.

This event was groundbreaking for Acumen, and I was proud to be able to spearhead it with my counterparts at Dow. I look forward to seeing the lasting impact of the technical assistance support that will come out of this, and to expanding on this initiative with additional corporate partners.

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August 27, 2013 · 2:42 pm

How to Optimize Your Impact

This is a talk I gave at my 10-year Stanford GSB Reunion today.

I’ve been thinking a lot lately about what a privilege it is to have gone to Stanford, and all the gifts that being an alum of the Graduate School of Business continues to give us. And also about what we are all doing to honor that gift.

I want to talk to you about what we’re all doing here. And I don’t mean just sitting here, in this room. I mean, here we are, we went to Stanford 10 years ago, and now, we’re together and we’re having a conversation about Changing Lives, Changing Organizations, Changing the World, the Stanford GSB tagline. That showed up after we had all graduated, but when I first heard that phrase, it really inspired me and resonated with what I experienced at Stanford.

If you were at Stanford in 2003, you couldn’t escape the endless ways to do something positive for the world. Maybe you graduated with a PMP certificate in hand, or with fond memories of your SMIF or Board Fellows experience. Maybe you raised money for a great cause, or volunteered, or came up with the idea for a new kind of business that would improve the lives of the poor, like Matt Scott did with Ignite. I look around, and I see Colleen James, who is helping to make Knoll furniture more sustainable, and Carl Palmer and Robert Keith who are using innovative financing models to protect and restore wild areas with Beartooth Capital. I see friends who went into corporate social responsibility, global health or international development, school reform, or social enterprise. We’ve given in ways visible and invisible, when we were asked and when there was a need that we couldn’t ignore.  

Whatever our experience here or where it led us, we always knew that our development as leaders and professionals would be inextricably linked to how we contributed to the world around us.

But now it’s ten years since we graduated. We’re all somewhere on that journey, but are we doing enough? Have we just met the standard for giving back, or have we gone further to find our own unique capacity to make a difference in the world in ways that might be difficult, or impossible to achieve for someone else? Are we working on what we think is most urgent, or on what is most convenient?

How can you know if you’re doing enough, since everyone’s path is different? And we are, now, men and women of a certain age, building lives outside of our careers, juggling the demands of work, relationships, sometimes young children, and for those of us lucky enough to be part of the sandwich generation, aging parents. Is this really the right time to be worrying about whether we’re doing enough for the rest of the world?

Maybe this is an uncomfortable conversation. Wouldn’t it be better if we could all just pat ourselves on the back for everything we’ve already done? But I believe that even though we are at a moment in our lives when things aren’t nearly as simple and straightforward as they were ten years ago, that these questions are as important now as they were ten years ago. And what I want to ask each of you to do, since someone was foolish enough to give me this platform, is just to ask yourself the tough questions about how you are impacting the world around you, how you are, as Carl and Robert say on their quite awesome website, leaving the world better than you found it.

As Rilke said, “Live the questions now. Perhaps then, someday far in the future, you will gradually, without even noticing it, live your way into the answer.” Everyone’s journey is their own, and there is no one way to have an impact. But here we are, and I see who is in this room, and think about what the world needs, and I think it is a powerful combination. I don’t have the answer for how to optimize your impact, because it depends on who you are and what you are best able to contribute, but I think the answer for each of us has two parts. The first comes from asking ourselves these tough questions, and the second I’ll get to in a moment.

2 years ago I learned something that sort of blew my mind. I’ve worked for no fewer than 5 Stanford MBAs – I guess it’s like a rule I have, you can’t supervise me if you didn’t get an MBA from this place. But two years ago I learned that the three most important of these were actually in the same class. The class of 1991. Jacqueline Novogratz, who I work for now, started Acumen to change how the world tackles poverty and has actually succeeded in changing the face of philanthropy; Derek Brown, the former Senior Vice President of Ashoka is now the Executive Director of Peace Appeal, which develops peace processes in some of the most violent and conflict ridden parts of the world. And Charles McGlashan.

Charles took a big bet on me when I was just a few years out of college, putting me on a plane to Mexico two weeks after he hired me with a binder and a pep talk, all set to train the managers of an auto plant outside Mexico City on environmental management systems. He taught me about waste management economics and about holding my head high when we were mocked by plant managers in Detroit for believing in a greener world.

Charles personally advocated for me when I applied for my dream jobs at Ashoka and Acumen, and what I didn’t know was that he was reaching out to two classmates, encouraging them to take the same big bet that he had. Charles changed my life a few times over, and changed the world around him in profound ways. A bicycle path in Marin County was just named for Charles, who raised $2 million to improve it and served on the board of supervisors there for six years as a champion for sustainable transportation.

They also named this path for Charles because he recently passed away. Charles died of a heart attack two years ago at the age of 49. It was a tremendous loss for his friends and family, and for the world. But Charles gave everything he had and helped others, like me, on their own path. His life was far, far too short, but his legacy of impact is undeniable.

I think of him, Derek and Jacqueline. One class. And I think about what we will do. Class of 2003. Maybe asking these hard questions is daunting when we think that we’re in this alone. But this is the second piece of how we will optimize we’re impact. By realizing that we are not alone. We’ve had each other’s backs from the beginning, giving each other advice, encouragement, and just the knowledge that what we’re doing, and why we’re doing it, is bigger than ourselves. Let’s not be afraid to ask if we can do more, but imagine if this question was not just about we each do, but about the legacy we create, together, by supporting each other on this journey. And let’s never underestimate the impact we have on those that come after us, who are just starting to ask themselves those same hard questions, and who look to us. Whatever Changing Lives, Changing Organizations, Changing the World means to each of you, I’m just so proud that these are questions that we can come together, as a class, to ask ourselves. 


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Blog rescues woman stumbling through challenging year

Everyone keeps saying how tough 2012 was, and my thought is always, c’mon, it wasn’t that bad. But truth be told, it was that bad, and for many, destructive and tragic and violent. And if it wasn’t that bad for me, it’s because I am ridiculously fortunate. For many reasons, but among them, because of the support and love with which I am blessed. And in some small way, because when I look back on this year, I can see not only the horrors that took place around the world, but also the victories – the lives saved, the discoveries, the commitments made to make things even better, for everyone. And personally, I can see not only where I fell short, but also where I grew. Where I learned, who I learned from, and where I shared my own voice on issues close to my heart. This blog is a testament to that part of 2012, so before closing out the year, I thought I’d look back on my year of blogging and thank all of you for being a part of it.

On January 3rd of this year, I made a commitment on this blog to helping to celebrate the creative choices that people make to live a “whole life”, and over the course of the year had a chance to write about 3 amazing women who inspire me. There are seven more on their way.

Later, I pledged to honor my brother and all that he has taught me by loving more freely and building a “legacy of love.” That, I’m afraid, is still very much a work in progress.

I had my fist piece in the Huffington Post on the power of choice in childbirth, and the need to go beyond just survival in how we think about health among the poor. Shortly after that, I shared lessons here from the Op-Ed project, where I was given serious encouragement in my efforts to refine and share my voice and ideas with others, and I had a chance to put those lessons into effect when I did my first TEDx talk in San Francisco on the same themes as my Huffington Post blog.

I have written here about partnerships, about sustainable coffee, and about cause marketing, and I have imagined dozens of posts that I never wrote, but wanted to, and perhaps will.

So much is missing – the stories of other “whole-lifers” who inspire me and who will find their way here eventually. The story of Hurricane Sandy, and the amazing woman who took me and my children in when our apartment became unlivable.  The stories of my children and my endless revelations about how amazing these tiny developing human beings are, and yet how easily they get ill and how frequently I am standing directly in front of them when they throw up. Stories of individuals who showed me what is possible in times of crisis, and times of change, and times when good enough simply won’t do. Everything I learned throughout this incredible year of work, living, meeting up, and falling down.

This blog has been an outlet for me, and each time I’ve had the time (and more importantly, courage) to post, you have been my inspiration and my reward. Because let’s be honest, writing is not a solo endeavor, and when I write, I do it because I hope that something I have to say will occur to someone else as useful. You have made me feel that. You have made me feel that even if I am just starting on a journey of writing, that someone is listening, and that you are willing to include me in whatever journey you are on by considering my words, and sometime, even sharing them.

It makes the falling down so much easier, and the general feeling of “am I doing this right?” much less of a burden. Thank you for joining me here, and for sharing your stories with me. And with all wishes for a 2013 with just as much learning and reaching, and fewer moments of confusion, loss and self-doubt, Happy New Year!

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TEDxSF – 7 Billion Well – Yasmina Zaidman

I’ve been invited to speak on the topic of global health twice in the past month, and both times I’ve said to myself, I don’t know anything about global health. That’s what comes from being exposed, in some degree, to the insane complexity of global health. I’ve seen health experts, health investors, and health corporations struggle mightily with the challenges of addressing the large-scale health issues faced by the poor. As a society, we’ve made incredible progress with some major issues like Polio and AIDS/HIV, and seen remarkable progress on issues like maternal healthcare and diarrheal disease, but there is so much further to go.

I won’t share all the numbers, but they evoke a feeling of profound shame that we still can’t resolve these imminently solvable problems. And that millions of people, mostly children, die as a result. I believe it is the shame of our age. But I’ve surrendered to the fact that I, and even my organization, do not have the answers to these big challenges.

But we know people who do.

I’m not talking about the brilliant scientists inventing the cures, or philanthropists who take generosity to a new level to make that possible. I’m not even talking about the heroic leaders who fight diseases like AIDS and cholera in the trenches, battling bureaucracies and apathy to provide healthcare in places that the world has abandoned. I am talking about the searchers, the entrepreneurs who are looking for ways to outsmart the most challenging and persistent problems that still hold us back on issues of healthcare – the tough questions of cold chain-distribution for vaccines and life-saving drugs, or the challenges of marketing to end-users who feel a fundamental mistrust of many institutions. The issues of pricing in the face of extreme poverty, and of building a business model accessible to all.

I am talking about entrepreneurs who want to bring their creativity and relentless drive to deliver value for customers to the issues of healthcare, focused on meeting the needs of the poor. And that’s what I talk about in this short TEDx talk for the TEDxSF event, 7 Billion Well. Not because I think entrepreneurs are the answer to an issue like maternal health, but because I think they are a critical part of the solution on a whole range of issues where we need a new approach to listening to and empowering the patients themselves. And we are just at the beginning.

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November 26, 2012 · 12:11 am

What’s in a Cause?

I had the chance today to join a Huffington Post Live discussion on the impact (or lack thereof) of causes promoted by for-profit companies. Having spent the past several years developing strategic partnerships with a range of major corporations from Dow Chemical to Ferragamo, I have a point of view on what it means for companies to take on the work of making the world a better place. The discussion had a great mix, from Jeffrey Robinson of the Center for Urban Entrepreneurship & Economic Development at Rutgers University to social entrepreneur Kesang Yudron,  Founder of Padhma Creation, and outspoken blogger Ruzan Sarwar, among others. A great group, an animated discussion, and some great insights for me on what makes people skeptical of these partnerships as well as what makes people hopeful about the impact they can have. 

During the live chat, I summed up my view on what makes for a good marriage between a corporation marketing a product and a good cause as follows. The partnership should be:

1. Strategic – Meaning, aligned with the brand and strategy of the company so that it grows with the company and doesn’t fade away as trends shift. Great examples are P&G’s Children’s Safe Drinking Water program and the Tory Burch Foundation, both driven by the strengths and values of the companies behind them, and as a result, built to last.

2. Impactful – today we debated what the standard should be for impact, but I admire partnerships that support and highlight the work of existing organizations doing great work. I’m a big fan of FEED, which has focused on issues where small individual gifts really do add up to change. FEED generates those gifts through purchases of bags that essentially sell at cost+charity. With a lean operation and powerful brand ambassador in the form of Lauren Bush Lauren, they have delivered millions of meals through 13 respected non-profit partners including the World Food Program and UNICEF.

3. Generous – again, though there is no perfect standard for what is generous, charitable giving should be considered an investment in the legacy of a company and in the creation of a more sustainable future for all. This is a far cry from viewing it as one small slice of a marketing budget. Companies may start small, but great partnerships increase their generosity as they grow, rather than cashing in on short-term marketing benefits. 

With each of these, the choice rests with the consumer. Which cause-related product will you buy and wear, what statement will you make? And more importantly, how will these choices lead to bigger changes, larger acts of generosity, and a deeper understanding of the ways in which the world is interconnected. It may seem like a tall order, but I am a believer that the tools of business and the informed decisions of consumers, combined in the right ways are ONE important tool in our fight to end poverty, injustice and environmental degradation. Please do check out the discussion

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Beyond survival — Could Access to Maternal Care Transform a Woman’s Life?

This first appeared on Huffington Post

Childbirth was the moment in my life when I felt the most vulnerable. Physically, emotionally and mentally pushed to my absolute limits. Feeling like everything was at stake, and that despite the support of loved ones and medical professionals, I was alone. It was up to me to stay focused, stay strong, and do what was needed. And what was needed meant pain, blood, and hours of hard work.

It was also the moment of my life that I felt the most powerful. I was joining the ranks of the mothers of the world, about to meet my child for the first time, and I was doing it exactly how I wanted to. I chose the doctor, the hospital, the approach, and who would be by my side. I wasn’t able to decide how long it would take, or what position my baby would be in as he emerged. But I knew that I was the driver of this process, and it gave me strength and a sense of calm. And afterwards, as I recovered and reflected on what had happened, I felt tremendous satisfaction. That was a feeling I know is a great privilege. I was lucky, I know, that everything came together for a safe and simple birth.

Here in the developed world, lack of information or a patient-centric medical system can limit women’s choices around childbirth. Our litigious society often dictates what doctors advise, as they face the risk of lawsuits and tremendous malpractice insurance costs. It’s not uncommon for women to go through birth without feeling a sense of agency. Among my women friends, I’ve seen frustration arise not from what happened during birth — vaginal or c-section, fast or slow, painkillers or no painkillers — but rather from those experiences where they feel that they were treated dismissively or excluded from key decisions. My friends who have positive birth experiences are those that had their wishes respected, whether that wish was for minimal medical intervention or for an epidural, stat!

Of course, all of this is typically overshadowed by the joy of having a new child, and knowing that at the end of the day, everyone involved was working towards a common goal of having a healthy baby delivered.

In the developing world, the option for poor women to have medical assistance of any kind is often absent and this leads to the death of 800 women each day from pregnancy and childbirth. In India, two thirds of women give birth at home, not because it’s their choice, but because hospital births are not available, or because the public hospitals that are available have such abhorrent conditions that they don’t really feel like an option.

So instead of feeling powerful, women feel powerless. About 78,000 women die in childbirth every year in India alone, which is an unacceptable tragedy. Millions more women survive birth, but I think of what it means for so many of these women to go through this experience with no choices around how they gave birth, and often, no support. Many face long term health issues as a result of inadequate maternal care. And beyond the physical aftermath, how might their experience of birth be impacting their lives in more subtle ways?

I believe, as do my colleagues at Acumen Fund, that choice and dignity are inextricably linked. But this became real to me when I gave birth. How can you feel dignified when you are physically reduced to a sweating, trembling aching mess? How can you feel empowered when you are vulnerable to infection, blood loss, and I hate to say it, incontinence? Becoming a mother can be a rite of passage, a moment where you discover something about yourself and about your new capacity to love and care for another human being that you didn’t know. The sense of responsibility that comes with motherhood can be frightening, but can also bestow a deep sense of purpose. Choice in birth often boils down to women being able to do the right thing for their child, even in the hours and moments before the child is born. During my two births, I learned that you can feel dignity even in this moment of uncertainty and vulnerability when you know that you have some control.

It’s why I can’t stop talking about LifeSpring hospitals, a company Acumen Fund invested in in 2007. Because LifeSpring believes that no matter what your income level or what neighborhood you are from, that as a woman, you must have the option to give birth in a safe environment. Not only one where medical attention is provided, but where each hospital is designed to create a sense of comfort and security, with pink walls and smiling personnel. With loved ones who can visit and stay with the mother during her recovery.

LifeSpring is a chain of maternity hospitals in Andhra Pradesh that provides affordable high quality maternal care to low-income women, and they have seen over 200,000 women patients and delivered over 11,000 babies since Acumen Fund invested in them.

I think of the women they’ve served, and wonder if they had a similar sense of being powerful from experiencing childbirth with a sense of control, and a sense of choice.

Who knows how that experience could alter the course of a women’s life? But I can imagine that for a woman, perhaps in her early 20s or late teens, giving birth in a place that lets her know that she matters, that her body and her life and her feelings matter, could make all the difference. It certainly changed my life. Could an empowering or at least secure experience of childbirth transform the lives of women experiencing it for the first time? A woman has a right to survive childbirth, but so should she have the opportunity to go through this experience, with all its vulnerability, and emerge confident, aware of all the power she has to make choices that will lead to a healthy and prosperous future, both for herself and for her new child.

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