raven e. freeborn on birth work amid the fifth anniversary of the Texas Abortion Ban

The following interview took place before Amplify Legal Tuesday filed a lawsuit against Texas Attorney General Ken Paxton, Texas Medical Board ED Stephen Brint Carlton, Bexar County District Attorney Joe Gonzales, the University of Texas Science Center at San Antonio, and three doctors for their contributions to the preventable death of Tierra Walker—a San Antonio mother who was unable to receive lifesaving abortion care after suffering from preeclampsia and died due to Texas' abortion ban in 2024. 

This lawsuit comes amid a recent announcement that the Texas Maternal Mortality and Morbidity Review Committee (MMMRC) will withhold its report on maternal deaths—and omit data from the first two years since Roe's fall—until after the Midterm Election in November, in which Ken Paxton is a candidate for U.S. Senate. 

"Tierra Walker's death is a direct result of Texas' abortion ban. Walker died after being ignored by over 90 doctors who refused to intervene and save her life amid a state-manufactured public health and Black maternal health crisis caused by Texas' abortion bans," said Avow Texas CEO raven e. freeborn in a statement. "We must take action for Texas mothers and birthing people—and right now, we have an opportunity to do so by demanding that the Texas Maternal Mortality and Morbidity Review Committee release its delayed report on maternal deaths in Texas and show the full picture of Texas' maternal health crisis by including every year of vital data since Roe's fall. Our movement will build power for a Texas where justice governs at the center."

September 1, 2026, marked the fifth anniversary of Texas Senate Bill 8 (SB 8), also known as the Texas Heartbeat Act, effectively banning abortions after six weeks of pregnancy. Since SB 8 went into effect in 2021, maternal deaths in Texas have increased by 56 percent, sepsis rates have risen by 50 percent, and infant mortality has gone up by 13 percent. 

Houston-based doula and Scalawag editor Aarohi Sheth and Avow Texas CEO raven e. freeborn discuss the effects of SB 8 as well as the future of reproductive justice in the South as a whole.

Aarohi Sheth (AS): Hi raven, it's good to speak with you again. Would you mind starting us off by sharing how you got into birth work and became a doula?

raven e. freeborn (RF): My entry into birth work began with organizing. I was organizing around ending capital punishment and against the family police system, but particularly, my organizing has to do with the way that states and governments create crises that the people have to balance on their backs. I started as an abortion doula in 2016 when I lived in D.C., and this was my first action after learning that Erica Garner died. Erica Garner was the daughter of Eric Garner, who was murdered publicly by the New York Police Department, and Erica Garner died of preventable pregnancy complications. I was, at the time, already a doula, and came to know that I wanted to be a part of birth work that was more intersectional and look at all the ways that people's health is compromised by way of identity or imbalances in power. So that's a roundabout answer to how I got where I am.

AS: No, that was great; I appreciate you sharing. But before we talk more about your work around capital punishment and some of these intersections between the systems you mentioned, can you talk a little bit about why y'all at Avow identify as an "abortion-forward org"? What exactly does that mean, and why is it important for y'all to identify that way?

RF: Absolutely, that's a great question. So, one, we understand that, particularly at this time, abortion is one of the more volatile social issues. That it's often used as a political bargaining chip, and that ultimately, in Texas, the interests of the people are much more pro-abortion than the bans we're living under. So at Avow, we're making some strategic pivots. One of the things that we knew was necessary was to maintain a focus on abortion access as a critical point of accessible, free, safe healthcare that Texans need and deserve. In order to secure and protect abortion access for all Texans, we have to be really committed to what Texans need to thrive, which is what reproductive justice lays out for us. We know that reproductive justice is the right to have a child, to not have a child, and to parent any children you have in safe and sustainable communities, and so we know that we'll get to a pro-abortion future by standing up for reproductive justice.

AS: Yeah, I really love that last point. When I was first doing my doula training, maybe like four years ago, I recognized how the way we talk about reproductive health is really limited by the medical-industrial complex, and then the way we talk about reproductive rights is limited by the Constitution, the government, the state. We're intentionally not taught to talk about all the things that reproductive justice encompasses and how it goes beyond the womb. Can you further define what reproductive justice is to you? What does it involve in Texas and beyond?

RF: Yeah, that's a great question. I'll first start with the idea that reproductive justice itself is a human rights framework. It's based on a kind of shared understanding across the globe that reproductive rights, which include abortion access, is in itself a human right, so it just should happen, right? It's a fundamental block of the way that we organize our society, and so that is one of the first major things for us is understanding that we're not asking for extraordinary measures. We're saying that what humans basically need in order for them to survive—the government not only should not interfere with that, but should be responsible for organizing itself in a way that ensures people are able to access their rights. 

The other thing for Avow is that we also think about reproductive justice as individuals demonstrating their own empowerment, so that people have the access that they need to support their own bodily autonomy, that they can make decisions that foster joyful living with others. We recognize that when reproductive justice is happening in the world, individuals demonstrate their empowerment by contributing to structures that protect and preserve everyone's safety and dignity. So whether that's the ballot box as a place where you can cast a vote to protect and preserve people's safety and dignity, or it's your local tenant rights meeting, or a mutual aid network, or your local daycare and preschool, right? We know that abortion clinics are also a piece of that structure that they're protecting and preserving both safety and dignity. So we hold those two things together. We say that ultimately reproductive justice is like a constellation, and abortion access is one of the stars in the greater constellation of justice.

AS: Beautiful, I appreciated you naming all the possibilities. I also want to go back to something you mentioned earlier. Obviously, the family policing system plays an enormous role in the lack of reproductive justice in Texas and elsewhere. And I know you mentioned your entry point to this work was around capital punishment. Can you speak a little bit on the growing intersections between pregnancy, the family policing system, and incarceration in Texas specifically?

RF: Well, you know, as we're thinking about the fifth anniversary of SB 8, an important piece of our conversation is about the criminalization of care. So we know that care is being denied across the state, and that Texans are suffering, and we know a couple of ways that's showing up, right? That it's both a reflection on who gets to survive the ban and who doesn't survive the ban—and also the ways that the deep harm of abortion bans is showing up in people's lives. 

We know that sepsis rates are soaring across Texas, particularly those folks who are gestating or pregnant. We know that Black pregnant Texans are two times more likely to die from pregnancy complications, and that ultimately, state structures like the Texas Maternal Mortality Morbidity Review Committee are refusing to investigate the deaths that are caused by its own laws. When we're thinking about the criminalization of pregnancy care, it is the fear and the stigma that's created by an abortion ban, but it's also the way that these bans and the misinformation that comes from them create stigma and shame and make it so that seeking abortion care is morally criminalized in society. 

We want to hear folks share their abortion stories and support folks through both the joy and the reality of terminating a pregnancy, and so when I think about the beginnings of my organizing career, thinking about capital punishment and the way that these structures and laws across the state do not allow people to thrive or to live in a dignified way, those two things have an intersection there. Houston, at this time, is one of the most dangerous places for Black pregnant people to give birth, and so that intersection is not only about what is happening, but who it is happening to. And ultimately, though abortion bans affect all of us, the likelihood of who's being criminalized, who's being surveilled, and where stigma and shame live is at those points of intersection, those race, class, and gender intersections.

AS: Five years ago, SB 8 went into effect. There are still trap laws and the criminalization of Black families, the family policing system, but is there anything that has changed in these five years since SB 8 for patients, providers, orgs?

RF: We are more clear about the dire circumstances. Now, we don't have to speak about [the maternal health crisis] in such speculative ways, since we have the information. We know that Black and brown women, Black and brown birthing people, are carrying the burden of the crisis in their communities, whether it be by not having trusted providers who can give you the full and whole bit of information that you need to manage your pregnancy and all of your realities. We're also seeing people who are leaving the state and who are no longer providing care in Texas. That's at least one thing that we can say, either with neutrality or positivity, that we can clearly see what is in front of us. The other side of that is the way that the six-week abortion ban was ultimately a domino that set the stage for anti-abortion and anti-democracy policies to take hold across the country. When we talk about Texas, we know that what was manufactured here has been exported across the country. 

Although Roe has fallen, anti-abortion centers continue to be popularized around Texas and all around the country, and we even see the White House is pushing pregnant people to seek care at fake clinics. All of that messaging, that agenda that was started here, the ways in which anti-abortion proponents have been elevated to positions of federal power—including the Texas Attorney General Ken Paxton, who's running to take his anti-abortion crusade to the federal stage—it is clearer now than ever that what we have been living through as Texans is becoming the blueprint for the country. And so, not only is it important for us to organize together, but for the rest of the country to take seriously that Texas has been surviving these conditions for a long time.

AS: I love how you mentioned Roe v. Wade because that required a lot of re-education on my part, since it literally set the viability standard. Like you said, the system worsens a problem and then produces a solution that's not really a solution at all, like the fake pregnancy clinics we see popping up across the U.S.

RF: Right. 

AS: Are there any other consequences of the abortion bans beyond abortion access that you believe don't receive as much attention?

RF: One of the places where we need to have a more considered interest is in the economic impact of an abortion ban across the state. First of all, we know that accessing abortion during the days of Roe was not equitable for all people. That, particularly in the state of Texas, depending on both your age and your wage, the time that it took to secure your abortion, and the time that it takes to receive that abortion, ultimately could have a real dollar impact on your day-to-day living. Though abortion care is still necessary in the everyday—and we're thankful to a broader network that ensures that Texans can receive abortion care in protected states—the conversation that we want to begin to have is what happens to an economy that bans health care, and that particularly is banning gendered healthcare at a time when it costs more for us to get our groceries, our gas, and you know, all of the expenses of our daily living? Not having access to essential care in a way that is safe for you, that is affirming for your life, and is equitable based on a history of legal decisions that marginalize people, that has a real cost factor, and we have to begin to name that for Texans. Not only are we losing access to fundamental human rights and basic healthcare; there's also dollar cost to the individual, to the family, and to the state at large.

AS:   Earlier you mentioned Houston being one of the most dangerous places for Black people to give birth, and I think another consequence of these abortion bans was the "Black maternal health crisis—both the growing use of the term and how the crisis got commodified, essentially. I know something that you've talked a lot about is how this term was not actually coined by Black people and doesn't actually name who is responsible for this crisis, especially in Texas, especially in Houston. Can you expand on this point?

RF: Absolutely. The black maternal health crisis itself, it does not name what's at the root of this. It does not name the actors in it, like the insurance companies, our own public health administration—federally and within the state. It really is exposing Black people, Black birthing people, as victims to a larger and sometimes invisible agent, right? Not being able to name the root of something stops us from pointing toward structural and institutional racism, and so that is a key feature of abortion bans, particularly abortion bans in the South, because Houston is the largest city in the country with an abortion ban and the most dangerous place for Black people to be pregnant.

The language of the Black maternal health crisis doesn't name [those responsible for creating the crisis] and burdens Black people and Black birthing people with a label of being under crisis. Without the interruption of white supremacy and heteropatriarchy, Black birthing people have traditions, customs, and rites of passage for pregnancy and birth that allow us to maintain safety and dignity and ensure that we're exchanging care among each other. But the label of Black maternal health crisis does not illuminate that. It just says that there's something happening to a victim without pointing at the agent. That same thing is happening with abortion bans. We're saying we've got abortion bans, but we're not being critical of the agents. 

AS: I appreciate always bringing it back to the systems. There's a lack of collective responsibility and naming the institutions that are the actual problem and create crises. What I'm hearing is a need for people to decrease our dependency on these sorts of systems and institutions that rely on white supremacy and the family policing system. I hate when people ask this question, and so you don't have to answer it—make it whatever you want—but how do we stay engaged in this fight? Where do the solutions lie?

RF: That's so funny. One of my least favorite questions is: what would you do if you were in my shoes? I'm like, I don't know, I'm not there. So this question always makes me laugh. But I think there are a couple of things that we can point to, right? One of the first ones is that we are not going to individually grant abortion access to Texans one person at a time, right? It will be when we secure abortion rights and other fundamental reproductive rights for Texans. We will do that collectively, and so we have to remember that if the win is collective, then so is the work.

We all need to identify where our collective power is. Is there an organization that you are training with or educating yourself under? Are you committed to our electoral structure? Do you have a voting plan? The other place that we can start really soon is with educating ourselves on what's on the ballot this year, and understanding each person that you're casting a vote for: how is that person representing the interests of your fundamental rights—and that includes all of the things related to bodily autonomy and gender-based care, but also what are the rights of the children that you're caring for? What are the rights of our elders? 

The last thing that I'll say here is just to have a trusted network that you can go to, and how are you a part of a trusted network? Because of abortion bans, there's so much misinformation, disinformation, and stigma about what it means to access abortion in this time. We learn that most people have a misunderstanding of the abortion bans. People may believe that in Texas they can access abortion care by one of the common exceptions, which is rape, incest, or life of the mother, and that's not necessarily true. How do you have trusted information? Where are you getting that from? Who are you sharing that with? And of course, rock with Avow, right? Come organize with us, come out to our events, all the things like that.

AS: Definitely rock with Avow. Thank you so much for your time today, raven. Anything else you want to share?

RF: As we're closing this discussion on what it means to live under five years of SB, one of the things Avow is doing differently—I love that question on why we still are pro-abortion—is that we continue to think about an abortion-forward future. The other thing that we've done differently is say that we're pro-abortion, but we are specifically looking at what it means to govern and what it means to create both a new logic and a new culture for our governance. How do we replace the existing logic that assumes that abortion bans are right, fair, and good for all Texans? We want to replace that logic, and we want to replace the culture that elects those types of people. That is squarely what Avow is doing as we move forward; it is championing pro-abortion through a governance lens, so we know that we deserve to thrive, and we believe that we can do the work to get those resources back on our side.