The Quiet Dismantling · Week 2 · PRAMS · Foundation Document
The Boondoggle in the Basement
The Pregnancy Risk Assessment Monitoring System is being killed without being killed. The CDC team has been on administrative leave for thirteen months. The 2023 dataset was finished and never released. The OMB paperwork moves forward while no one operates the program.
Dr. Yamicia D. Connor·The Quiet Dismantling, Installment 2·May 27, 2026
13 mo
CDC PRAMS team on administrative leave
2023
Dataset finished · never released
81%
U.S. live births PRAMS covered
1,495 hrs
Annual burden cut · March 9, 2026
PartI
The Boondoggle in the Basement
Ninety years after critics of the New Deal coined the word, the basement of CDC's Division of Reproductive Health holds its purest example — and it is being run by conservatives, not liberals.
Do you know what the word boondoggle means?
It comes from the Boy Scouts. A boondoggle is a braided leather cord — a small useless craft project meant to keep your hands busy. In the 1930s, critics of the New Deal grabbed the word and used it as a slur for federal make-work programs: taxpayer money going to people doing nothing important, looking busy because someone had to look busy.
Ninety years later, in the basement of the CDC's Division of Reproductive Health, we have what is arguably the purest boondoggle in the modern history of American public administration. Except this time, it isn't being run by liberals defending public investment from conservative critics. It's being run by conservatives. And the administration that built it would prefer you never noticed it exists.
Let me describe it for you.
Imagine you are one of the roughly forty people still employed at the Division of Reproductive Health — not one of the 110 who got the Reduction in Force notice on April 1, 2025. You are one of the ones who survived. Officially, your job still exists. Officially, you still have a portfolio. Your badge still works. Your paycheck still hits your account every two weeks.
But the team you ran point with — the epidemiologists who cleaned the data, the program officers who managed the state grants, the senior staff who knew where the bodies were buried (sometimes literally) — they are on administrative leave or have moved on. The work you were trained to do, that you came to government to do, has been quietly liquidated around you.
You still get emails. You still attend meetings. Sometimes the meetings are about the work that no longer exists. Sometimes the meetings are about how to describe the work that no longer exists in language that won't trigger the new restrictions on what federal employees are allowed to say. You cannot use the word "women" in certain documents now. You cannot use the word "Black." "Disability" is on the list. "Tribal" is on the list. "Trauma" is on the list. There are nearly two hundred words on the list.
You can technically log into the data systems. You can technically file the paperwork. In November 2025, somebody at the agency filed an OMB extension request for PRAMS — the surveillance system whose entire operational team had been on leave for seven months. The paperwork went through. In March 2026, somebody filed a revision cutting 1,495 hours of data-collection burden. That paperwork also went through. Nobody on your floor seems to know who is going to do the work the paperwork now authorizes.
This is not the kind of boondoggle the New Deal critics meant. They imagined waste in the form of activity — federal money going to people doing pointless work. This is the inverse. This is federal money going to people who have been deliberately prevented from doing the work they were hired to do, while the bureaucratic shell that documents the work continues to file the paperwork claiming it is being done.
It is The Office, if Michael Scott had been disappeared by executive order and Toby was the only one left in the branch — expected to keep doing HR for a company that no longer manufactures paper but is still legally registered to manufacture paper, and there are still trucks pulling up to the loading dock, and the trucks are empty.
This is the architecture of what we are calling The Quiet Dismantling. PRAMS is one piece of it. To understand how it works — and what comes next — you have to look at the whole building.
PartII
The Timeline: How Thirteen Months Disappeared a Data System
Read the calendar straight through. Each step was lawful on its surface. Each step required an active choice by an identifiable office. Every step moved in the same direction. Click any event to expand.
Jan 20, 2025
Two executive orders define the predicate
EO 14168 defines sex as immutable. EO 14151 ends DEI programs. Neither names PRAMS. Neither has to.
Defending Women From Gender Ideology Extremism stated that "'Sex' is not a synonym for and does not include the concept of 'gender identity.'" Ending Radical and Wasteful Government DEI Programs and Preferencing set a March 20, 2025 deadline for agency action. The Office of Personnel Management memorandum on January 29 gave federal agencies until 5 p.m. on January 31 to "take down all outward facing media" of DEIA offices. Programs that asked women about their pregnancies, depression, partner violence, contraception became targets without being named.
Click
Feb 2025
CDC.gov pages disappear in batches
The PRAMS portal goes dark. Researchers locked out without notice.
STAT News (March 3, 2025): researchers "suddenly discovered they were locked out of the database, without any notice." Marian Jarlenski, University of Pittsburgh: "If we can't see this information, we cannot develop public health strategies to improve our maternal morbidity and mortality in the United States."
Click
Mar 12, 2025
19 lawmakers write to CDC. CDC does not respond.
Booker–Kelly letter, 17 cosigners (Black Maternal Health Caucus orbit). Silence becomes the grammar.
Senator Cory Booker and Representative Robin Kelly led a letter to Acting CDC Director Susan Monarez signed by Senators Duckworth, Warren, Klobuchar, Wyden + Reps Adams, Clarke, Watson Coleman, Quigley, Sewell, Auchincloss, DeGette, Velázquez, McIver, Morrison, Holmes Norton. CDC did not respond. The non-response would become the dominant grammar of the next thirteen months.
Click
Apr 1, 2025
The entire PRAMS team is RIF'd
2,400-person CDC RIF. ~110 of ~165 Division of Reproductive Health staff eliminated. MEC, ART, ERASE MM-supporting infrastructure all gone the same day.
CDC epidemiologist Jennifer Bombard emails state PRAMS coordinators: "the entire CDC PRAMS team, including myself, has received the Reduction in Force (RIF) notice from HHS today." The MEC contraceptive guidelines team is eliminated. The six-person Assisted Reproductive Technology surveillance team is eliminated. The ERASE MM infrastructure is eliminated. Dr. Wanda Barfield's directorship is disrupted. Lee Warner, PhD, chief of Women's Health and Fertility Branch, retires. On April 16, Booker and Kelly send a second letter directly to Secretary Kennedy. It goes unanswered.
Click
Spring 2025
Mississippi pauses. The February-March 2025 birth cohort is permanently lost.
The state with the highest infant mortality rate in the country. The cohort that overlapped with the federal RIF. Gone.
By the time Mississippi rejoined in early 2026, the mothers who had given birth in February and March 2025 were no longer eligible to be surveyed. Arkansas, Kentucky, Georgia, Alaska, New Mexico, Oklahoma, Kansas continued. Ohio (2016 survey) and North Carolina (2021 survey) ran their own. California's CMQCC continued parallel state surveillance. The well-resourced states stayed standing. The under-resourced states began to lose entire birth-year cohorts.
Click
Jun 12, 2025
400+ RIFs reversed. PRAMS team is not among them.
HHS restores HIV/Hep/STD/TB positions but the maternal surveillance team stays on leave. Selective reinstatement as statement.
The selective reinstatement was its own form of statement: the executive branch had decided which categories of public health surveillance could return and which could not.
Click
Jul 31, 2025
Senate Appropriations funds PRAMS (26-3 vote)
$53M maternal-health increase across CDC/NIH. 90-day report required. Statutory staffing language. The administration does not rehire.
The bill required HHS to "support staffing levels necessary to fulfill its statutory responsibilities" and to submit a reorganization plan "not less than 60 days prior to initiating the execution of any reorganization moving functions… carried out by the Centers for Disease Control and Prevention to another component of the Department of Health and Human Services." The administration had no statutory reply, because none was required. The administration simply did not rehire.
Click
Oct 1 – Nov 11, 2025
Longest U.S. government shutdown · 42 days
When the lights come back on, the PRAMS team is still gone.
The shutdown technically reset many federal operations. The PRAMS team's absence persisted across it unchanged.
Click
Nov 21, 2025
CDC files Federal Register notice for 3-year OMB extension
FR Doc. 2025-20583 · Docket CDC-2025-0750. 419 public comments. AMCHP files in support. The team has been on leave for 7 months.
A federal agency was asking permission to operate, for three more years, a data collection program no one inside the agency remained to operate. AMCHP (January 7, 2026): PRAMS "covers approximately 81 percent of U.S. live births. For many states and jurisdictions, PRAMS is the only source of data on critical maternal and infant health indicators." Kristin Rankin (UIC) public comment: 76% of PRAMS site administrators could not navigate the PRAMS weighting process for 2024 data without CDC support; 97% required CDC technical assistance.
Click
Feb 3, 2026
P.L. 119-75 enacted · PRAMS funded
Consolidated Appropriations Act, 2026. 90-day report on data-collection barriers required by statute. PRAMS team is not rehired.
Congress kept the money. The administration kept the team on leave.
Click
Mar 9, 2026
"Extension" quietly reclassified as "Revision"
FR Doc. 2026-04565. 1,495-hour burden cut (1,395 from callback surveys). The procedural lever for future instrument alteration is now in place.
Under federal information-collection rules, a "Revision" reserves administrative authority to alter the instrument — to drop modules, to remove race and ethnicity questions, to eliminate the pregnancy intention or intimate partner violence items — without triggering a fresh 60-day public comment period. The callback survey is the methodological mechanism that brings low-income, less-educated, and non-white respondents into the sample. Removing it produces a dataset that systematically over-represents women whose outcomes were already best understood.
Click
Apr 17, 2026
Rep. Summer Lee confronts RFK Jr. (Black Maternal Health Week)
"How are we going to solve the Black maternal mortality crisis if we cannot say 'Black'?" Kennedy frames DEI as the source of divisiveness.
House Education and Workforce hearing: "Examining the Policies and Priorities of the Department of Health and Human Services." Kennedy's response, per Philadelphia Inquirer: "a mumbo jumbo rabbit hole of claiming that DEI is to blame for racial divisiveness."
Click
Apr 30, 2026
State PRAMS grants expire
State coordinators describe ad hoc bridge extensions. HHS issues no public timeline for renewal.
The grant calendar did the political work, so no one had to vote.
Click
May 8, 2026
Mississippi Today: "at a later time"
HHS spokesperson: "HHS is committed to optimizing maternal and infant health outcomes and will share PRAMS data at a later time." HHS would not elaborate.
Anna Hu and Sophia Paffenroth, "Mississippi leads the nation on infant deaths. But gaps in state data collection may make those deaths harder to track." The same construction — "at a later time" — had been used to defer release of the 2023 ERASE MM aggregate data and Maternal Mortality Review Information Application outputs. The phrase is its own genre.
Click
The executive orders defined the predicate. The website takedowns established the practice. The April 1 RIF eliminated the people. The congressional letters went unanswered. The appropriations bill funded a workforce that did not exist. The Federal Register notices kept the paperwork in motion. The category quietly changed. The state grants expired. The 2023 data set, finished and ready, has not been released. Every step moved in the same direction.
PartIII
The Parallel Erasures: The Rest of the Building
PRAMS is one room. The building is larger. Most of it has been emptied by the same method.
1
The PRAMS team
Pregnancy Risk Assessment Monitoring System — entire team on administrative leave since April 1, 2025. 81% of U.S. live births covered. 2023 data set finished, never released.
Eliminated · Apr 1
2
The MEC contraceptive guidelines team
U.S. Medical Eligibility Criteria for Contraceptive Use — the guideline ob-gyns "turn to every day" per ACOG president Stella Dantas. 3rd-most-viewed MMWR publication of the prior 12 months.
Eliminated · Apr 1
3
The ART / IVF surveillance team
Six-person team. Only federal source for IVF cycle outcomes nationwide. The Westat data-collection contract runs through October 14, 2027 — the input still flows; the analytic output stops.
Eliminated · Apr 1
4
ERASE MM supporting infrastructure
CDC's $118M, 5-year investment in state Maternal Mortality Review Committees (46 states + 6 territories). The MMRCs adjudicate which pregnancy-related deaths were preventable. Texas/Florida had already opted out of sharing data before the cuts.
Eliminated · Apr 1
5
The Maternal & Infant Health Branch
Only branch of three in the Division of Reproductive Health to survive the April 1 RIF. Reduced to a skeleton. Per RFK Jr., CDC's "core mission" is now epidemics and outbreaks — not maternal health surveillance.
Skeleton · Surviving
That is the corridor on the basement floor of the CDC. Now walk to the equity offices, and to the NIH, and to the language itself.
CDC / HHS / CMS / FDA / HRSA
5 federal equity offices eliminated
Office of Health Equity (CDC) · Office of Minority Health (HHS, CMS, FDA) · Office of Health Equity (HRSA) — functionally eliminated through April 1 RIF and website takedowns. CMS/HHS OMH eliminations may be illegal under the ACA, which statutorily authorized them.
CDC
"Racism and Health" portal offline
Launched April 2021 by then-Director Rochelle Walensky. Removed from CDC.gov. Preserved only at RestoredCDC.org with a January 6, 2025 snapshot. The federal government has formally retracted its position that racism is a public health issue.
NIH
1,392 grants terminated · ~$1.7B
1,392 awards by April 2026 per CRS IF13131. JAMA (Liu et al., May 2025) earlier window: 694 grants / $1.81B between Feb 28 – Apr 8, 2025. Prior baseline: fewer than 6 midstream terminations 2012–Jan 2025 (per Justice Jackson dissent).
NIH / NIMHD
29.6% of NIMHD funding gone
29.6% of previously active funding — $223.5M across 77 grants. The highest proportional cut of any NIH institute. The institute whose entire reason for existing is studying racial disparities in health.
NIH / Morehouse
Morehouse maternal health grant cut
$2.9M total, $1.6M remaining when terminated. One of ten partners in NIH's project on pregnancy and postpartum care for Black women. Dr. Valerie Montgomery Rice: "diversity, equity and inclusion, as it relates to health, is not a political term."
Congress
Momnibus retitled
Black Maternal Health Momnibus Act reintroduced March 2026 as the "Momnibus Act." The word "Black" appears once across the package. The Black Mamas Matter Alliance declined to endorse the retitling.
HHS
~200-word ban list (Head Start filings)
Surfaced December 5, 2025 in Head Start litigation. Includes "Black," "women," "disability," "tribal," "racism," "trauma," "Hispanic," "Latinx," "minority," "mental health," "Native American," "race," "racial," "transgendered," and more. Senators Murray and Sanders noted many banned terms are explicitly required by the 2007 Head Start Act.
CDC
Black women: the only group not declining
In the most recent CDC maternal mortality data, Black women remain the only racial group whose pregnancy-related mortality rate did not decline. Every other group's rate fell.
Every one of these actions used the same method PRAMS used. The funding was not cut. The program was not formally ended. The agency simply removed the people, removed the words, removed the categories, and let the surface paperwork continue. Action through omission, repeated across a building. This is not a series of decisions. It is one decision, executed in parallel.
PartIV
How Labora Is Surveilling Without PRAMS
When the gold-standard instrument is suppressed, the surveillance frame must shift. Labora's methodological pivot — a six-layer all-cause proxy stack — externally validated at r = +0.59 by the Commonwealth Fund.
The methodological pivot rests on a single validated finding. In July 2025, the Commonwealth Fund's Maternal Mortality in the United States, 2025 (Berchick, Radley, Zephyrin) demonstrated that state-level pregnancy-related mortality ratios between 2019 and 2023 broadly mirror state-level all-cause death rates for women ages 15 to 44, with a Pearson correlation of r = +0.59. Alabama, Mississippi, Tennessee — high on both. California, Massachusetts, Minnesota, Utah — low on both. That correlation is the methodological license.
Layer1
All-cause mortality, women 15–44
State + race-stratified deaths per 100,000 from CDC WONDER underlying-cause-of-death files. Data through 2023. A woman dying of pregnancy-related cardiomyopathy coded I42 instead of O90.3 still shows up here. The dashboard is the insurance policy.
CDC WONDER · public as of May 2026
Layer2
Cause-specific spikes in non-O-coded categories
WONDER multiple-cause-of-death stratification: cardiovascular (I00–I99), septicemia (A40–A41), suicide/self-harm (X60–X84), unintentional injury (V01–X59), substance-related (F10–F19, X40–X44). Linkage to birth certificate via MCD flags deaths within 42 days / 1 year of live birth even when underlying cause is outside ICD-10 Chapter XV.
CDC WONDER MCD · ICD-10 linked to NVSS natality
Layer3
Maternal ICU admission
From U.S. Standard Certificate of Live Birth via NVSS natality. NCHS Data Brief 485 baseline: 1.4–6.5 per 1,000 by maternal age. Birth certificates are state-administered and cannot be eliminated without ending the legal registration of births itself.
NCHS Data Brief 485 · December 2023
Layer4
NICU admission as sentinel
Rose 13% from 2016 (8.7%) to 2023 (9.8%). Largest increases in mothers 20–29 (+11%) and 30–39 (+12%). Downstream of poor prenatal care, untreated preeclampsia, undetected gestational diabetes — the things PRAMS measured upstream. The bedside echo of the surveillance that has been turned off.
NCHS Data Brief 525 · March 2025
Layer5
Hospital utilization & severe maternal morbidity
HCUP NIS (~20% U.S. discharges), KID, Fast Stats; Medicaid TAF for ~42% of births. SMM identified via ICD-10. State workarounds: CMQCC (California, 20+ years), Ohio survey (2016), North Carolina survey (2021). NY/MA/IL/WA can build versions. MS/AL/LA/AR can't — Mississippi's Feb–Mar 2025 birth cohort has already disappeared.
HCUP · Medicaid TAF · state IPs
Layer6
The money trail
CMS spending dashboards · state Medicaid expenditure reports · IRS Form 990 Schedule H community benefit filings. Pre-mortality maternal events generate intense hospital spending. If O-code mortality is declining while pregnancy-related spending rises — the divergence is the flag. The money trail is harder to manipulate than the cause-of-death certificate because the money was already paid.
CMS · IRS 990 Schedule H · state Medicaid reports
Stacked together, the layers produce a quarterly state scorecard. A state where O-code maternal mortality is declining while the other five columns are rising is a state where deaths are being miscoded or undercaptured. The divergence is the Labora finding.
State
All-cause F15–44 Δ
Maternal ICU Δ
NICU Δ
SMM Δ
O-code MM Δ
Spend / delivery Δ
Mississippi
▲
▲
▲
▲
▼
▲
Louisiana
▲
▲
▲
▲
▼
▲
Texas
▲
▲
▲
▲
—
▲
Ohio
—
▲
▲
—
—
—
New York
▼
—
▲
—
▼
—
California
▼
▼
—
▼
▼
▼
Illustrative pattern for Q3 2026 pilot · ▲ rising · ▼ falling · — stable. Highlighted rows show the divergence signature: O-code maternal mortality declining while every other indicator rises.
First state-level scorecard release covering California, New York, Mississippi, Texas, Ohio targeted Q3 2026. Scaled to all 50 states by year-end. Methodology paper with Eugene Declercq (Boston University), Marie Thoma (Maryland), Jamie Daw (Columbia) as candidate co-authors.
None of this replaces PRAMS. PRAMS asked women whether they had wanted to become pregnant, whether their partner had hit them, whether their depression had been treated, whether their contraception of choice had been available. No proxy stack recovers those answers. What the proxy stack does is keep the field from going blind while the instrument is rebuilt.
PartV
Three Scenarios for What Comes Next
None is good. Two are recoverable. One is not. Click each scenario for probability, leading indicators, and what the field can do now.
Scenario 1 · The slow thaw
OMB approves the three-year extension. Congress holds the line on appropriations through FY27 and FY28. A subset of the PRAMS team — perhaps eight to twelve former staff — is rebuilt. The 2023 data set is released in late 2026 or early 2027 in stripped form, with some race-stratified analyses degraded by sample-size suppression. The 2024 cohort is partially reconstructed from state-held raw responses; 2025 cohort partially recovered, permanent gaps where state collection paused. Annual data releases slip to biennial. Supplemental modules contract. The time series survives with documented breaks.
Field implication
PRAMS continues as a useful but methodologically wounded instrument; the 2023–2025 window is treated as a single discontinuous segment requiring footnote in every downstream analysis.
Leading indicators
A named PRAMS team lead hired by January 31, 2027 · public release schedule for 2023 and 2024 data sets published by same date · restoration of the public PRAMStat dashboard · reinstatement of the callback survey budget line.
What the field can do now
Maintain the academic user network in publishable readiness so the rehired team has external partners on day one · preserve the methodological documentation for Phases 1–9 in citable form so institutional memory survives outside CDC.
Scenario 2 · The formal sunset
PRAMS is officially discontinued or — more likely given the political costs of explicit cancellation — replaced with a substantially shorter and less probing instrument under a new acronym. The OMB authority continues; the infrastructure of state-CDC data flow continues; the questions worth asking do not. The replacement instrument drops the pregnancy intention items, the intimate partner violence module, the postpartum depression screen, the discrimination questions. It keeps smoking, breastfeeding initiation, prenatal care timing — the items least politically costly to retain. The PRAMS shell becomes a vehicle for tracking the maternal behaviors the administration considers permissible to measure, and stops tracking the maternal conditions the administration considers permissible to ignore.
Field implication
Surveillance frame collapses from population-level maternal experience to a narrow set of preventive-care indicators that already overlap with existing HRSA Title V and Healthy People 2030 measures. Structural inequities PRAMS revealed become formally invisible at the federal level.
Leading indicators
A new Federal Register notice naming module removals · an OMB-approved instrument that does not include the standard PRAMS race and ethnicity stratification · a renamed program in CDC budget documents.
What the field can do now
Build out the state-by-state independent surveillance coalition (CMQCC + Ohio + North Carolina + active PRAMS states) so the questions PRAMS asked continue to be asked somewhere · advance the legislative campaign to statutorily codify PRAMS — analogous to MMRC support under the Preventing Maternal Deaths Act of 2018, P.L. 115-344 — so future instrument changes require an act of Congress, not a Federal Register footnote.
Scenario 3 · Permanent capability loss
No team is rebuilt. The state collection apparatus, deprived of CDC technical assistance, decays past the threshold where restoration is technically feasible. The 76 percent of PRAMS site administrators who told Rankin they could not navigate the weighting process without CDC support stop trying. State IRB approvals lapse. State data use agreements expire. Vendor relationships that supported mail, web, and telephone callback administration dissolve. The mid- to late-career epidemiologists with methodological memory of Phases 1–9 take other positions, retire, or both. A future administration attempting restoration confronts a starting point closer to 1987 than to 2024. Realistic rebuild timeline: 24 to 36 months from restoration decision; analytic dark zone covers 2024 through restoration year; the time series breaks in ways that affect every clinical guideline derived from PRAMS data for a generation.
Field implication
A generation of maternal health policy is built on data that does not exist, or built on proxy data with all of the bias and none of the depth of the original instrument.
Leading indicators
Silence from state PRAMS coordinator positions as incumbents leave and are not replaced · explicit state withdrawals from the PRAMS network · OMB extension lapse without renewal · private contractor announcement consistent with Project 2025 "public-private partnership" framework.
What the field can do now
Treat the next twelve months as the window in which institutional memory can still be captured through oral history with former PRAMS team members · press for statutory protections and legal challenges that prevent infrastructure decay from hardening into infrastructure absence · build the parallel independent maternal surveillance entity, housed in an academic consortium (Columbia, Harvard, Minnesota, Pittsburgh), to hold the methodological standard until federal capacity returns.
Across all three scenarios, one fact does not move: the 2025 birth cohort, in the states where collection paused, is permanently lost. The mothers who gave birth in Mississippi in February and March of 2025 will not be surveyed. Their experiences are gone, regardless of which scenario unfolds. That loss is the irreducible price of the thirteen months that have already passed — the floor under every projection above. The choice that remains is whether the loss stops with that cohort, or whether it grows.
About PRAMS — Centers for Disease Control and Prevention. Founding history (1987); original infant mortality focus.
"What Is PRAMS, and Why Is It at Risk?" — Daw, Allen, Maksut, Zephyrin. Commonwealth Fund (January 20, 2026). DOI 10.26099/gaeg-wm86.
"PRAMS maternal mortality database in limbo as CDC staff placed on leave" — Anil Oza, STAT News (April 1, 2025). Bombard email, Kozhimannil quote, HHS non-response.
"How Trump's CDC Purge Will Affect Reproductive Health" — Rolling Stone (2025). Two of three Division of Reproductive Health branches eliminated; RFK Jr.'s "core mission" framing.
"Red Flag #2: Cut Public Health Programs" — Center for Reproductive Rights. CDC 25% workforce reduction; ERASE MM scale-back.
Senate Appropriations Committee FY26 LHHS markup — July 31, 2025 (26–3 vote). Consolidated Appropriations Act, 2026 (P.L. 119-75) signed February 3, 2026.
Project 2025 — Mandate for Leadership, Chapter 14 (HHS). CDC split proposal; data infrastructure to public-private partnership.
"How Project 2025 Seeks to Obliterate Sexual and Reproductive Health and Rights" — Guttmacher Institute.
AMCHP comments to CDC — Association of Maternal & Child Health Programs (January 7, 2026) to Docket CDC-2025-0750.
"CDC team that updated go-to physician reference on contraceptive science is fired" — Science (May 2025). MEC team disbanded.
"Unintended Pregnancy Rates at the State Level" — Guttmacher Institute.
Rep. Summer Lee press release — RFK Jr. House Education and Workforce hearing (April 17, 2026).
Padilla, M. "The word 'Black' has disappeared from a set of bills aimed at addressing Black maternal health" — The 19th News (May 19, 2026).
"Black maternal health advocates, researchers press on amid federal funding cuts" — Stateline (April 2025). Morehouse $2.9M / $1.6M remaining when cut.
Liu, Kadakia, Patel, Krumholz. JAMA (May 8, 2025). doi:10.1001/jama.2025.7707. NIMHD lost 29.6% of previously active funding ($223.5M / 77 grants).
Congressional Research Service product IF13131 (April 2026). CRS cumulative figure: 1,392 NIH awards terminated by April 2026.
"Black Maternal Health Week 2025" — Georgetown CCF. Black women only racial/ethnic group whose 2023 maternal mortality rate did not decline (49.5 → 50.3 per 100,000; CDC noted change not statistically significant).
"Unexplained Pauses Hit Nearly Half of Monthly-Updated CDC Databases" — Annals of Internal Medicine via AJMC (January 2026).
Hu, A. and Paffenroth, S. "Mississippi leads the nation on infant deaths. But gaps in state data collection may make those deaths harder to track" — Mississippi Today (May 8, 2026).
Federal Register notice 2025-20583 (Docket CDC-2025-0750) — PRAMS 60-day notice, November 21, 2025. FR Doc. 2026-04565 — PRAMS 30-day notice, March 9, 2026.
Rankin, K. — public comment submitted to Docket CDC-2025-0750 (January 2026). 76% of site administrators unable to weight without CDC support; 97% requiring CDC technical assistance.
Berchick, Radley, Zephyrin. Maternal Mortality in the United States, 2025 — Commonwealth Fund (July 2025). r = +0.59 correlation between state pregnancy-related and all-cause female 15–44 mortality.
NCHS Data Brief 485 (December 2023). Maternal ICU admission rates during delivery: 1.4–6.5 per 1,000 by maternal age.
NCHS Data Brief 525 (March 2025). NICU admission rose 13% from 2016 (8.7%) to 2023 (9.8%).