With federal maternal health database in limbo, a risk to mother and infant health
For nearly four decades, data from the Pregnancy Risk Assessment Monitoring System (PRAMS) has provided insights for improving the health of mothers and their babies. Overseen by the Division of Reproductive Health at the Centers for Disease Control and Prevention (CDC), PRAMS uses survey information collected by 46 participating state health departments from women soon after they give birth. In April 2025, the entire CDC team managing PRAMS was placed on administrative leave before it could release 2023 data. At least one state has suspended data collection for PRAMS (Mississippi, in September) and the future of the national database remains uncertain.
Rita Hamad, professor of social epidemiology and public policy at Harvard T.H. Chan School of Public Health, has used the dataset to examine questions such as the impact of paid family leave policies on rates of postpartum depression. She recently spoke about how losing PRAMS puts the health of mothers and infants in the U.S. at risk, and how she hopes to help keep PRAMS data accessible.
Q: Why is PRAMS important?
A: It’s the only national long-term survey we have in the U.S. on the prenatal and postpartum period. That makes it a really critical resource for studying maternal and child health. There are so many opportunities to answer important policy-relevant research questions using this rich dataset. My team has used PRAMS data in more than 10 studies looking at the effects of social and economic policies on health.
Data is not always a sexy topic, but we know that we need data to understand trends in health and risk factors for poor health. We also need data to understand what interventions and policies are working, and for whom. All of these questions will be almost impossible to figure out in the absence of the national PRAMS dataset.
Q: Who is affected by the loss of PRAMS data?
A: PRAMS is not just something for researchers at universities to use. The CDC processes PRAMS data for the states so that the states can then use it to inform their policies and programs. After the CDC PRAMS team was eliminated, we received an email from a state health department that no longer had access to the data and was looking for help.
Recently, I was interviewed in a Guardian article about Mississippi stopping PRAMS data collection. That same article noted that Mississippi has declared that infant mortality is a public health emergency in the state. The irony is that PRAMS is exactly the kind of data that you want to use in that situation to understand the possible causes, what circumstances have changed for mothers in the state, and how Mississippi compares to other states in the region.
Without data, we can’t fix problems. I can’t overstate how bad losing PRAMS will be for maternal and child health in the U.S.
Q: If other states keep collecting PRAMS data but there is no team at the CDC to manage it, what is your team prepared to do?
A: Without CDC staff at the national level to gather, clean, and release the data, it’s going to be a very fractured and labor-intensive process for researchers. So, my team is prepared to do the work that the CDC team was doing. We’ve reached out to a handful of participating states, and some have already agreed to share their data once we submit our applications. Ideally, the states will also agree that we can then share the dataset with other researchers, because it’s very burdensome on both researchers and state agencies to have to deal with individual requests.
At the moment, we’re looking for funding to be able to do this work. The stakes are too high to let a resource like PRAMS disappear, with the well-being of mothers and babies at risk. We’ve used these data more than almost any other research team in the country, so we know we have the expertise to surmount these logistic hurdles.
