On Thursday, February 26, 2026, Black birth workers and organizers gathered at The Reading Room to honor the history and impact of their work and address Harris County's  Black maternal health crisis in light of a recent study naming Houston as the deadliest major U.S. city for Black people to give birth.

The event was hosted by Avow Texas, a pro-abortion organization dedicated to advancing abortion access and reproductive justice in Texas through education, community organizing, and local, pro-abortion governance. It was held in partnership with Scalawag Magazine, If/When/How, Full Circle Family Services, upEND Movement, WeGotUs, and Sankofa Mama.

This news about the Black maternal crisis has long been known. But recently, Harris County, which is home to nearly five million residents, one-fifth of them Black, has reported rising maternal and infant mortality and maternal morbidity rates that exceed both Texas and national averages. A study by local public health officials published in the Harris County Public Health 2024 Maternal & Infant Health Report found that from 2016 to 2020, Black women in Harris County experienced the highest pregnancy-related death rate in the nation, with 83.4 per 100,000 live births. In 2020, the national rate for Black women was 55.3 per 100,000 births, compared to 19.1 per 100,000 births for white women.

The infant death rate for Black children in Harris County from 2016 to 2020 was 11.66 per 1,000 births, more than double the national average reported in 2020. 

As Avow is a pro-abortion organization, the panel emphasized that birth and abortion are not separate issues. When discussing Black maternal health, it must include those seeking abortions, especially since the passing of Texas Senate Bill 8 banning abortions after six weeks, which is usually the earliest a person realizes they are pregnant.

raven e. freeborn, a doula and executive director at Avow Texas, told Scalawag that they hope folks get more comfortable with the reality that we won't return to a time before SB 8, as there are still "trap laws, judicial bypass, insurance providers increasing liability insurance for abortion providers and abortion clinics, pricing them out of their own profession."

"We actually have to throw down in the streets, get in the mud, and create the conditions for a future that has no trap laws, a future that does not allow for judicial bypass, a future that affirms trans folks and gender affirming care. It's not just about putting abortion back on the books, but rather, creating an infrastructure that's resistant to our rights being taken away and criminalization being thrown against us," freeborn said. 

The panelists also discussed the long tradition of birth being a communal act in Black communities. Sierra Sankofa, a doula and founder of WeGotUs and Sankofa Mama Birth Services, said she's continuously reaching into the past to bring that legacy with her into her space, carving out a collaborative care system. 

"As the doula, I have to know who to call, I'm a bridge to the time when we did know who to call… I make it my business to build relationships and build community. The people who come to me need the right people. It's a matter of life or death."

Sankofa also said that, as doulas and careworkers, they must meet people where they are and be an advocate for those in hospitals, meet them in their own houses, and initiate communal education that doesn't start and end with pregnancy.

"There is a history of white supremacy that has created branches of oppression that you can't track, but are actually moving in our bodies, and they change our health outcomes. So, yes, we need a doula by our side. We need a lactation consultant within the first 12 hours of our birth," said freeborn during the panel. "Black people did not create this problem. Who gets to define the problem and who gets to create the solution? My hope is that it's always us."

While the panel acknowledged that language won't ultimately save anyone, the popularization of the term "Black maternal health crisis" doesn't clearly define who is responsible for the crisis, who is impacted, and who should be centered. Because these systems of violence are designed to produce violence and exacerbate issues like poverty that feed the Black maternal health crisis, they are also designed to produce the "solution."

"It's a crisis for insurance, it's a crisis for providers, it's a crisis for hospital systems. These institutions are part of manufacturing the crisis and the lives of Black people,"  freeborn told Scalawag. "Black people and Black birthing people don't arrive at a hospital seeking care, expecting to come out labeled a victim of a crisis. That is not the agreement we're engaging with when we enter medical systems."

freeborn also stressed that Black maternal health policy is responsible for considering the conditions that support maternal health before conception, gestation, and postpartum. They emphasized how Black people are forced to live in environments structured with violence—from more climate disaster-prone neighborhoods to cancer clusters to policing and mass incarceration. 

"[These environments] change the condition or the state of the reproductive health system to be able to gestate and carry a pregnancy with health. [Black maternal health policy] is not just about what is occurring during the gestation or particularly what's happening at the site of a crisis like in a hospital system. If we make our policy solutions only about hospitals and hospital systems, then we forget about the Black people who are living and surviving the conditions of this crisis."

In hopes of creating something new, something rooted in community rather than the state, freeborn pushed attendees to consider their capacity to become ungovernable, while also acknowledging that mutual aid will never be a proportionate solution to the size of the problem that the state has created. 

"We need the state to account for its history, for the way that it is busting up midwifery care, particularly culturally congruent midwifery care that is Indigenous, that is Black, that is moving through its own cultural systems," said freeborn. "[The state] disrupted [midwifery care] and discouraged it. The state created a stigma that was placed on midwifery care and created a hospital system that then brought death—when we had a system that was about encouraging life and rebirth and transformation."

Panelists emphasized the need to decrease our dependency on carceral systems and solutions like the family policing system, which is also destroying the ability for Black people and Black birthgivers to live lives free of surveillance—which has been masked as a way to achieve "safety"—and violence, as it is rooted in white supremacy and racism. 

Reproductive control has long been a tool to destroy Black communities, as their ability to have children—and parent or take care of them—has always been regulated. During slavery, children of Black parents were considered the chattel property of their enslavers. Therefore, parents had no right to custody or to raise their children how they wanted. In other words, they had no autonomy. Similarly, with roots in slavery, forced sterilization has also been used to torture Black people and control their ability to reproduce.

In the post-Civil War era, judges would order Black children to be returned to their former enslavers, citing parental "neglect," leaving the futures of these children out of their caregivers' hands. This problem intensified after Clinton-era welfare reform reduced direct aid to poor families, and national studies estimate that 53 percent of Black children will have contact with Child Protective Services through a maltreatment investigation by age 18, compared to 28 percent for white children. Locally, in Harris County, Black children make up a disproportionate percentage of CPS removals and investigations and are taken by CPS 3.5 times more than white children. 

All this history led to the current child-policing system, and there is no way to reform a system that is working in the way that it was designed to work. Still today, Black families are separated because of "neglect"—a stand-in term for poverty—which often looks like struggling for food and/or housing, lack of mental health support, drug testing, and the general criminalization of pregnant people, explained Josie Pickens, the director at upEND Movement and longtime educator and organizer. 

"For example, parents who use substances are often automatically stigmatized and criminalized, although a parent using a substance is not a parenting test. That doesn't mean that they automatically are abusive or neglectful to their children. Many times, what those parents need is support in a number of ways and not stigma and shame and creating deeper harm, because they're being separated from their family structures."

The only way forward is to destroy these current conditions, this current world, and rebuild a new one, rooted in community and autonomy. 

"The nightmares of our imaginations are our realities for our neighbors, even if privilege keeps us from experiencing that level of violence at this time. If it happens there, it will happen anywhere else," said freeborn. "So let us be real about the conditions that we're living in and also be real about the hope we have for the future."

Aarohi Sheth is an abolitionist, essayist, storyteller, editor, and poet from Houston. They currently serve as Scalawag’s fact checker and Hurricane Season editor. Aarohi writes about grief in all its forms, bayou communities, humidity, radical (re)imagination, the family as a horror, and more.