Yesterday, March 17th, marked one year since the arrest of Maria Margarita Rojas, a licensed midwife in Houston, Texas. It was the first criminal charge filed under the state’s near-total abortion ban. Avow Texas strategically chose this date for our conversation in order to bring awareness to Rojas’ case and what it means for accessing care and why this midwife was targeted. The conversation that unfolded was one worth putting down in full. We covered the history of Black midwifery, the maternal mortality data coming out of Texas, Avow’s current digital campaign pressuring the Texas Maternal Mortality and Morbidity Review Committee, and the Maria Rojas case.
Who raven is and what Avow does
raven Freeborn came to this work through lineage. They are the child of teachers and educators from Texas and Louisiana, raised in Houston, and trained as a licensed clinical social worker, a full spectrum abortion doula, and an organizer rooted in healing justice. They describe their feminism as informed by Blackness and shaped in relationship to the feminism of people of color and queer and trans folks of color.
Avow Texas is actively striving and working towards a Texas where everyone is trusted to live the life that they want and to be able to thrive. raven frames reproductive justice not as a single-issue cause but as a fundamental tenet of governance. “You can connect it to the Oscars. You can connect it to the WNBA.” It covers how we structure our lives and the care surrounding them.
Avow’s organizational values include boldness and communal care, two that Freeborn spent time unpacking. Boldness means saying the word abortion plainly, affirming people who have had abortions, and being unambiguous about the fact that abortion is both popular and necessary. Communal care reflects the infrastructure reality: getting an abortion in Texas right now requires transportation, funds, housing, someone who can help navigate a system that requires leaving the state entirely or safely managing pills at home. That kind of care, raven said, takes all of us.
“Receiving abortion, providing abortion care, or sharing information about abortion is communal care in itself.” -raven
The history underneath this moment
Before obstetrics was formalized as a specialty, Black midwives were primary care providers in their communities. They attended births, provided prenatal and postpartum care, and were present at deaths. raven noted the old phrase that some Black families carry: I can bring you in this world and I can take you out. The point was not the parenting style. The point was that Black midwives were there at your beginning and your end.
During enslavement, Black midwives were often the people on a plantation with the most freedom of movement, called from place to place to provide care for enslaved people, free people, and enslavers alike. When the obstetric movement began to push midwives out in the early 20th century, the campaign called them dirty, unhygienic, and ignorant of the body. raven was direct about what that was: a perversion of the truth, and a targeted erasure of a cultural practice.
By 1910, Black midwives attended 75 percent of births in the rural South. Maternal and infant mortality rose after they were removed from practice. Today, only about 5 percent of certified midwives in the US are Black. raven described what persists despite all of that as the strength of cultural memory. We are going to continue to see Black birth workers and Indigenous birth workers and parteras continuing their lineage practices, raven said. We don’t need a bill or a certification to show up and reclaim what belongs to us.
“Despite how hostile or extreme or violent a system is, our cultural memory is always the undercurrent of care.”
What the data shows and what it misses
A 2024 study from the Gender Equity Policy Institute found that Texas’s maternal mortality rate increased by 56 percent between 2019 and 2022, the period spanning the abortion ban’s implementation. The national increase over the same period was 11 percent. That disparity is not distributed evenly. Black Texans bear a disproportionate share of those deaths.
raven urged the audience not to look only at mortality. Between life-affirming care and mortality, there is morbidity- the short and long-term adverse physical and mental outcomes of pregnancy. That includes postpartum mood and anxiety disorders. It includes pregnancy-related cardiomyopathy. The data on morbidity post-ban has not yet been fully captured.
raven also placed maternal outcomes inside the broader framework of social and structural determinants of health: housing stock, air quality, food access, freedom from violence, insurance coverage. Before a person becomes pregnant, raven said, the likelihood of a poor outcome may already be elevated. The abortion ban sits on top of all of that, and it stifles access to life-affirming and life-saving care at every point in the gestational journey.
Avow’s digital campaign: pressuring the committee to do its job
The Texas Maternal Mortality and Morbidity Review Committee exists, in raven’s framing, to help administer health in the state and to inform how we do so in the future. Most states have a committee like this. The way we record a death, raven said, is part of how we inform the future.
The committee has not reviewed deaths connected to delayed abortion care in the years since SB8 took effect. Avow’s campaign is both a public education effort and a pressure campaign. It aims to help Texans understand that this committee exists and what its mandate is, and to press the committee to do the full scope of that work.
“If we are not properly documenting the truth of what is happening and what that means for what we do next, we are missing a big part of the puzzle.”
raven was clear about what the committee’s inaction signals: a political interest in ignoring the consequences of a total abortion ban. Without honest reporting from this body, trends at the zip code and county level go unrecorded. Evidence that could inform future policy, grant programs, and public health infrastructure goes unmade. Avow is asking the committee to look at all of the years and to report honestly about what is in front of them.
Maria Rojas: one year later
On March 17, 2025, Houston midwife Maria Margarita Rojas was arrested. It was the first criminal charge filed under Texas’s near-total abortion ban. She was charged with allegedly providing abortion care. Her three Houston-area clinics, which served primarily low-income, uninsured, Spanish-speaking patients, were shut by court order. Her midwifery license was suspended. She served 10 days in jail before posting a 1.4 million dollar bond, paid with the help of bail funds. Felony charges carry a possible sentence of up to 99 years in prison. As of today, she has not been formally indicted. She is in legal limbo, unable to practice or earn income. The Center for Reproductive Rights is defending her - read the case details here
raven grew up in Houston. When they spoke about this case, the weight of that was present. Houston is a city of deep cultural roots, raven said, and the way care is organized across it differs by where you come from. “Maria Rojas was a part of the solution of care for her people. The disruption of that is both extreme and a warning.”
raven drew the distinction carefully: midwives do not have abortion within their scope of care. What the state of Texas is alleging is that Rojas acted outside that scope, and that aiding and abetting an abortion is itself a crime. The case is on appeal.
But raven was direct about what this case represents at a deeper level. The state is not targeting a hospital system or an organization with teams of lobbyists and legal counsel. It is targeting a community. It is targeting the place where care is provided, where information is trusted, and where people connect regardless of what they are facing.
“They’re targeting communities. Communities are the place where care is provided, where information is trusted, and where people can connect regardless of what they’re facing.”
raven named what is underneath that strategy: state violence used to silence already vulnerable communities, specifically communities of immigrants who are being monitored and surveilled in Texas right now. Criminalizing a community-based midwife, requiring a 1.4 million dollar bond for a provider whose clinic served people with no other options, is not about public safety. It is, raven said, an act of violence.
There is also what gets lost in the meantime. Maria Rojas has not been able to practice for a year. The clinics are closed. The patients she served, most of them uninsured and Spanish-speaking, have nowhere else to go that provides the same language access, cultural affirmation, and community trust. raven put it plainly: if your dentist closed, could you just walk down the street and get the same care? This level of provision is community-centered. You cannot replace it by pointing someone somewhere else.
What birth workers need to understand right now
Freeborn closed this section of the conversation by invoking bell hooks: the personal is political. Your personal practice, raven told birth workers, is now both a political tool for freedom and a political pawn for continued criminalization, monitoring, and surveillance. The risk is higher.
The answer, raven said, is not to throw more midwives and doulas and community health workers into a broken structure. It is to address the system. Birth workers need to get organized, understand how communities are under threat, and understand how their practice both protects those communities and exposes them. You are not just a midwife or a doula anymore. You are a part of this political process.
We started this conversation talking about birth workers who were always here, doing the work before any institution recognized it, continuing after those institutions tried to erase them. Maria Rojas is in that lineage. The communities Avow works with are in that lineage.
raven closed with this: it is difficult right now. There is a collapsing of power that demands our attention. But history tells us we can change the direction of society if we organize together. Skill up, squad up, and do not pre-comply.
Keep your eye on Texas.
Avow’s Resources
People who want to act can visit avowtexas.org to learn how to volunteer, donate, or get trained. Also, their advocacy toolkit and resource list is an invaluable resource - please check them out!
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