One of the casualties of Tuesday’s massive purge of workers from the Department of Health and Human Services (HHS) is an office dedicated to promoting healthy pregnancies. Most of the more than 100 employees at the Division of Reproductive Health lost their jobs this week, including some who conduct work mandated by federal law, according to seven former staffers who provided Mother Jones with the most complete public overview of its inner workings to date.
“How does cutting this program support the administration’s position? I don’t understand at all.”
The move runs afoul of President Donald Trump’s and members of his administration’s pledge to prioritize healthy pregnancies and family planning. The mass purge came less than a week after Trump, at a Women’s History Month event at the White House, promised to be “the fertilization president.” And in January, at the anti-abortion March for Life, Trump said he would “work to offer a loving hand to new mothers and young families” and “protect women and vulnerable children.”
Experts and former staff say the latest firings will halt the IVF and family planning work Trump campaigned on.
The CDC’s reproductive health division functioned as “a key source of support for maternal and child health programs nationwide,” Elizabeth Kielb, director of maternal and infant health at March of Dimes, a nonprofit organization focused on maternal and infant health, said in a post on LinkedIn. “Cuts to this division risk disrupting prenatal care, contraception access, and efforts to reduce maternal and infant mortality.”
Kielb added: “Additionally, state and local health departments will now face added burdens without the federal backing they’ve relied on for decades. The ability to monitor, research, and improve reproductive health outcomes is at risk.”
Some of the former officials told Mother Jones they hope their firings will be reversed after Robert F. Kennedy Jr. admitted Thursday to ABC News that some HHS firings were mistakes. Spokespeople for HHS and the White House did not respond to questions from Mother Jones by Friday morning for this story. The division had an estimated $99 million budget as of fiscal year 2023, according to an internal document.
Employees of the division who received reduction in force (RIF) notices included the approximately 40-person women’s health and fertility branch, which included a team working on assisted reproductive technology (ART). Trump campaigned on expanding access to in vitro fertilization (IVF), the most common type of ART. In February, he signed an executive order demanding “a list of policy recommendations on protecting IVF access and aggressively reducing out-of-pocket and health plan costs for IVF treatment.” But, by eliminating the six-person ART team at the reproductive health division, Trump is stopping the very work he promised to promote.
The ART team collected data from assisted reproductive technology clinics on their pregnancy success rates, as mandated by Congress in 1992, and maintained a nationwide database of clinics. The team also produced an online tool people could use to estimate their success of IVF and was in the middle of researching how to make treatments cheaper through state-mandated insurance, according to a former team member. “I don’t know if anyone else [in the federal government] that has the expertise that our team does,” the former staffer said. “How does cutting this program support the administration’s position? I don’t understand at all.”
Barbara Collura, president and CEO of RESOLVE: The National Infertility Association, said in a statement that as a result of the firings, “there will be no experts on infertility who will be able to inform public policy, brief members of Congress, publish articles and reports, and advance public awareness on the causes and treatments for infertility.” Micah Hill, president of the Society for Assisted Reproductive Technology, which worked with the CDC team, called their work “vital to the field of reproductive medicine.”
“Dismantling PRAMS will make America less healthy, not more.”
The women’s health and fertility branch also included a team that collected national data about maternal and infant health outcomes through the Pregnancy Risk Assessment Monitoring Program (PRAMS). The massive, nearly 40-year-old annual survey collects anonymized information about peoples’ health and access to doctors before, during, and after their pregnancies, which state officials and health care providers then use to improve health outcomes. Researchers also use it to investigate promising interventions. As of 2020, the survey data represented more than 80 percent of births, with all but three states participating, HHS said.
Two members of the PRAMS team, which former staffers said consisted of about 15 people, told Mother Jones getting RIF notices and being fired came as a shock. “Our team is basically considered the gold standard for survey data collection,” Isaac Michael, a mathematical statistician on the team, said.
Michael says that while support for PRAMS should be bipartisan, it should also be a particular priority for the Trump administration, given that Vice President JD Vance and Trump’s sidekick, Elon Musk, have said they want to encourage more Americans to have more kids.
“This data will directly help their agenda,” Michael said. “If Republicans are interested in decreasing the infant and maternal mortality rates and increasing fertility rates, we have those variables. You can’t make any solid decisions without the data, and we’re the ones with the data.” Without the state-level data, another former PRAMS team member added, federal officials “won’t know where the funding for necessary resources have to go, and that will put women and infants at risk.”
Last month, a group of congresspeople wrote to CDC Acting Director Susan Monarez—now the new nominee tapped to replace Dave Weldon, whose nomination was withdrawn—raising their concerns of the potential loss of PRAMS under the reorganization of HHS, noting its “increasing importance as the US is experiencing a maternal health crisis.” But it’s unclear if Monarez ever responded to that letter, and spokespeople for the senator’s offices did not respond to questions from Mother Jones on Thursday night.
Laura Lindberg, a professor at the Rutgers School of Public Health, has used the PRAMS data in her own research on unintended pregnancy and in her classes as a teaching tool. “Abruptly shutting down PRAMS jeopardizes women and infants health at a time when maternal mortality rates in the US have been rising and access to maternity care is increasingly difficult,” Lindberg told me. “Dismantling PRAMS will make America less healthy, not more.”
The approximately ten-person fertility epidemiology studies team was also eliminated from the women’s health and fertility branch, according to an official. That team wrote the CDC’s contraception guidance for healthcare providers and conducted the annual abortion surveillance report, which collects voluntary data about legal abortions (and which, despite the cuts Trump is imposing, Project 2025 advocates for expanding).
A former official familiar with the team’s work said it was especially critical in light of mounting threats to contraception and increasing abortion restrictions nationwide. “We need guidance like this so that clinicians across the country can help women to make the best decisions for themselves—especially at a time when the ability to make those decisions is being threatened,” the official said.
Everyone in the reproductive health division’s field support branch was also fired, which included an approximately eight-person team that worked on providing guidance on the needs of pregnant and postpartum people and infants in emergencies, such as COVID-19, Zika, and Ebola, all of which posed particular risks for pregnant women.
That team’s work was mandated by Congress, which has repeatedly reauthorized a law first passed in 2006 requiring that HHS take pregnant women and other vulnerable populations into account when planning emergency responses.
“Pregnant, postpartum, lactating women have very special needs in emergencies,” the former official told me. “If they’re pregnant, they need to have continued access to prenatal care; if they’re postpartum or lactating, they potentially need assistance with feeding their infants or postpartum care.” The former official believes the firings of the emergency response team were “an unintended casualty,” adding, “I don’t think they realized it when they cut the entire branch.”
The field support branch also had a team of about a dozen senior CDC epidemiologists who deployed to state health departments to improve reproductive health, youth mental health, and healthcare access for parents and infants, in part by training more junior staffers in those fields. Prior participants helped establish state Maternal Mortality Review Committees, collected state-level data about COVID-19 in pregnant people, and worked to increase the enrollment of families on food stamps, according to an internal document describing the program.
“Many state and local health departments are understaffed and overworked, so they do not have the capacity to take on more focused research on topics like reproductive health, maternal health, and infant and child health,” a former scientist in the division said. “Cutting the entire branch will cause maternal and child health in those states and territories to worsen.”
The CDC only pays for 20 percent of the program, and states are responsible for paying for the rest—so it’s unclear why the program was targeted for termination.
The only team of the reproductive health division that remains is maternal and infant health branch, which works on tracking and preventing maternal and infant mortality. According to HHS, a new, so-called “Administration for a Healthy America” agency will take over maternal and child health issues. The fired staffers said they were glad that team will remain, given the maternal mortality crisis in the US, which ranks the highest among all wealthy nations and is worsening in light of expanding abortion bans. But, even so, the fate of that team remains unclear. “There’s a lot of unknowns, even for the programs that have survived,” one of the former officials said.
Michael, the statistician who was on the PRAMS team, knows one thing for sure: This was not what he signed up for when he voted for Trump. “I agree with a lot of the Trump administration,” he said. “But I think our team fell through the cracks, and I’ve got to advocate for it, because it’s important.”
This post has been syndicated from Mother Jones, where it was published under this address.