Federal Health Data Pauses and Staff Cuts Will Harm American Mothers and Babies 

The health and well-being of all Americans — but especially women and babies — relies on timely and accurate data. Pregnancy and early childhood are particularly vulnerable periods that require careful monitoring, support, and response. The more up-to-date information we have, the better chance we have of preventing unnecessary deaths, building healthy families, and setting children up for success. Yet, US Department of Health and Human Services Secretary Robert F. Kennedy’s changes to the agency eliminated the Centers for Disease Control and Prevention’s Division of Reproductive Health, among other divisions, almost entirely.  

These changes have disrupted the division’s longstanding programs and efforts that directly impact maternal and child health. Among them, the division’s data collection for the Pregnancy Risk Assessment Monitoring System (PRAMS), CDC’s premier data source on experiences around the time of pregnancy, has been halted. Little is known about the reasons for the pause, and updates on the PRAMS website suggest there have also been delays for participating sites (states, localities, and territories) in receiving expected data releases. 

These data not only helped researchers and public health officials learn whether prevention efforts were working, but they were also used to strategically allocate resources to the populations in most need. This loss of public health staff and data will keep clinicians and policymakers from being able to improve maternal and infant health and will inevitably lead to increases in maternal and infant deaths, teen pregnancies, postpartum depression, and infertility.  

Lifesaving Pregnancy Data are at Risk  

Since 1987, CDC’s PRAMS team has provided financial and technical support to state health departments to collect standardized data to learn about many factors impacting the health of moms and babies shortly before, during, and after pregnancy. States share their data with CDC, where they are compiled and can be used by researchers and policymakers to understand nationwide trends in maternal and infant health. Before PRAMS, data on national pregnancy-related trends were limited to just a few sources such as vital statistics, claims data, and hospital discharge data, which include little information about demographic characteristics and immediate pregnancy complications and no information on health behaviors or outcomes before or after the place of birth.  

PRAMS revolutionized clinicians’ and researchers’ ability to understand the factors that influence maternal and newborn health. It has allowed researchers to understand women’s experiences across a wide range of topics including prenatal vitamin use, pregnancy intention, access to care, life stressors, and prenatal care attendance, and explore how these experiences might influence health outcomes for mothers and/or their babies. In 2024, PRAMS surveillance covered just over 80% of all U.S. births.  

PRAMS data are useful for understanding national trends. Some examples include safe infant sleep practices, postpartum depression, and breastfeeding. These data also enable us to drill into state-specific concerns. In South Carolina, PRAMS data showed that WIC recipients were less likely to initiate breastfeeding than non-WIC recipients. In Hawaii, it revealed that too few pregnant women engage in disaster preparedness efforts. And PRAMS data from Georgia were used to identify trends in reasons why pregnant women declined flu vaccination. As part of Tennessee’s efforts to address racial health disparities among pregnant women, flu vaccination outreach was directed toward clinicians after PRAMS data showed that pregnant women were more likely to receive the vaccine when their care teams recommended it. Due to the large number of respondents, PRAMS data can be reliably used to identify concerns for women living in rural areas in any state, including lower insurance coverage rates and heightened concerns regarding intimate partner violence.  

Not only have PRAMS data provided a peek into the complex world of conception, pregnancy, and newborn care, but they have also been used to evaluate the impact of various policy changes on maternal and newborn health, including the role Family Paid Leave law had on breastfeeding initiation among Black mothers in New York and contraception usage in West Virginia. 

Without PRAMS and CDC’s Division of Reproductive Health, policymakers and public health and medical professionals will struggle to improve Americans’ life expectancy or effectively prevent childhood health issues—both priorities of the Make America Healthy Commission.  

Putting the Brakes on Maternal and Newborn Health Will Cost Lives 

US mothers are more likely to die during and within one year of their pregnancies compared to mothers living in all other high-income countries. Poor maternal health can also affect infant health, with underweight and preterm babies more prone to chronic conditions later in life, including diabetes, heart disease, depression, and more.  Tracking the pregnancy and birthing experiences of women is key to improving the health for all Americans, especially those most vulnerable. Some groups, especially racial and ethnic minority groups, are at a much greater risk of experiencing these events compared to non-Hispanic whites.    

Without PRAMS’ public health-related data collection, responsibilities would ultimately fall upon individual states, subject to available funds, which are always more limited in resource-constrained environments where disparities are the greatest. Furthermore, important linkages and the ability to compare state outcomes get lost without intentional national coordination, resulting in poorer data on which to base public health decisions, evaluate programs, and allocate resources. We will not know where our health gaps are, what is causing them, or whether we have been successful in addressing them. This will almost certainly lead to wasteful spending and declines in health. 

As a laboratory scientist recently said: “Public health is the mom of science. She does everything and no one notices until she stops doing it.” We are on the brink of finding out just how much we took her for granted. Let’s rally together to protect public health so we can get back to protecting our moms and babies. State legislators and maternal and child health professionals living in the 46 states where PRAMS had been in place can reach out to their state health departments to learn how their data collection has been impacted by the recent changes. Those who have used PRAMS data to inform programs and policies can share these stories with the media to highlight this invaluable resource.  

State policymakers have a number of levers to ensure ongoing support for PRAMS and other data essential to maternal and child health.  

1. Have the conversation: Ask maternal and child data programs in your state health department whether they have access to the most recent national data, whether they have the staff and funding to continue data collection in your state, and whether additional barriers exist to ongoing data publication and integration with other data sources for a clearer picture of maternal health needs.  
2. Contact federal delegations so that they are aware of state needs: CDC offices are now unavailable to support maternal and child health efforts, so federal delegations need to understand what is at risk. 
3. Determine if additional state support is needed and available: States are being tasked with hard decisions as funding cuts mount from federal sources. As many PRAMS programs are supported with federal funds, understanding what funding is at risk and determining if states have resources internally or with private partners to fund it will be important for maternal health advocates. 

Finally, we all have our own stories to tell, and far too many of us have stories of challenges that we or a loved one have faced around the time of pregnancy. Sharing these stories with federal representatives and with media and highlighting the need for continued data collection from new mothers are essential to protect the health and well-being of the most vulnerable among us.