Federal maternal, infant health data collection system remains weak, puts health outcomes in jeopardy
Medicaid funding cuts are jeopardizing the health of U.S. mothers and infants—and with a weak federal database to monitor maternal health outcomes, the consequences may not be fully seen or understood, according to researchers at Harvard T.H. Chan School of Public Health.
Since January 2025, the Pregnancy Risk Assessment Monitoring System (PRAMS), a federal program collecting data on pregnant and postpartum women and their babies, has experienced a series of disruptions. Initially, the federal government halted all PRAMS data collection, removed access to existing data, and put the Centers for Disease Control and Prevention (CDC) team that oversaw PRAMS and provided technical assistance to researchers and policymakers utilizing its data on administrative leave. Since then, there’s been a partial reversal regarding data collection and processing: Short-term funding renewals have restarted some of it. But the CDC oversight team remains on leave. And the public portal containing decades of prior PRAMS data remains offline.
On Oct. 8, a group of experts including former PRAMS staff, academic researchers, nonprofit and advocacy organizations, and private foundations released a report detailing the risks created by PRAMS disruptions. The report was compiled following the June 3 National PRAMS Convening, led by Rita Hamad, professor of social epidemiology and public policy and director of the Harvard Center for Population and Development Studies.
“Stopgap measures do not resolve the loss of national coordination or the uncertainty surrounding PRAMS’s future,” Hamad and colleagues wrote in the report. “All these disruptions … threaten the continuity and quality of current and future data collection, maternal and child health program planning and operations, as well as access to decades of existing data for researchers, policymakers, and the public.”
The report included a number of recommendations to address the challenges surrounding PRAMS data, including the full restoration of the CDC oversight team and the provision of stable, long-term PRAMS funding.
Hamad emphasized the importance of restoring and protecting PRAMS in an Oct. 11 Guardian article. “There are no other datasets like it. Teams like mine used to have access to this data before the portal was shut down, and so now there’s no way to study the more recent trends in maternal and infant health,” she said. “Now we’re very worried that the cuts to U.S. safety net policies or barriers that keep people able to access those programs are going to have detrimental effects on maternal and infant health.”
Among these cuts and barriers are changes to Medicaid, including funding reductions and stricter work requirements, currently being rolled out by states. Benjamin Sommers, Huntley Quelch Professor of Health Care Economics, also spoke with The Guardian about the likely impacts of these changes. Funding cuts to Medicaid—which covers around 40% of births in the U.S.—will “add financial strain to the providers and the insurance program that [pregnant women] rely on,” he said. He added that many pregnant women may not know to specifically enroll in the Medicaid pregnancy pathway, which would exempt them from work requirements and allow them to keep their coverage no matter what—and some could lose coverage as a result.
According to Hamad, in previous years, instances of lost coverage and narrowed access to care would have been reflected in PRAMS data. Now, such instances are likely to add up but will be invisible to researchers and policymakers working to understand and improve maternal and infant health trends. “I think we’re going to see those geographical and maternal disparities widening,” she told the Guardian. “Or we’re not going to see it because we don’t have the data, but that’s what is going to happen.”
Read the National PRAMS Convening report:
US Maternal and Infant Health Data: Pregnancy Risk Assessment Monitoring System (PRAMS) in Crisis
Read the Guardian article:
US maternity wards face wave of closures as Medicaid cuts kick in
Learn more:
With federal maternal health database in limbo, a risk to mother and infant health (Harvard Chan School news)
Opinion: Data disruptions put powerful maternal and child health tool at risk (Harvard Chan School news)
Mothers, infants in Mississippi at health risk due to lost data (Harvard Chan School news)
