PRAMS Funding Expires in April. Here’s What We Lose.

By Dr. Yamicia Connor, MD, PhD, MPH · March 10, 2026

The Pregnancy Risk Assessment Monitoring System has been collecting state-level data on maternal experiences before, during, and after pregnancy since 1987.[1] It is the only population-based surveillance system of its kind in the United States — or, for that matter, in the world.[2] Federal funding expires April 30, 2026.[3]

This is not bureaucratic overhead. This is the evidence base. The clinical practice guidelines you follow, the risk estimates you use when counseling patients, the disparity data that motivates policy change — these come from population surveillance systems like PRAMS. When you use a protocol for preeclampsia management, it was built on data these systems generated. When you cite Black maternal mortality rates to advocate for policy change, those numbers come from infrastructure like this.

Without PRAMS, maternal mortality review committees lose the population-level context they need to investigate deaths meaningfully. Quality improvement initiatives lose their baseline. Researchers cannot identify emerging complications before they become crises. The improvement cycle depends on data that is now expiring.

What Has Already Been Lost

Two of three branches of the CDC’s Division of Reproductive Health were eliminated in 2025 layoffs[4] — including the Women’s Health and Fertility Branch, which was responsible for federal contraceptive safety guidelines, the CDC’s contraception app, and the Assisted Reproductive Technology surveillance team.[5] Only the Maternal and Infant Health branch survived.

PRAMS expiration doesn’t happen in isolation. It is the last piece of a surveillance infrastructure that has already been significantly dismantled. We are operating on the last clean data this system will produce for years, possibly longer.

The asymmetry of what we’re losing is worth stating plainly. It took decades to build the evidence base behind maternal care guidelines. It is being dismantled in months. And the consequences will not arrive suddenly — they will arrive slowly, as guidelines become outdated, as disparity patterns become invisible, as complications that should have been preventable aren’t prevented because no one had the data to see them coming.

The states that cannot replace PRAMS funding independently — which is most of them — will be flying blind.[7] The states with resources to maintain some version of maternal surveillance will have data. The states without those resources will not. The disparity in what we know about maternal outcomes will map directly onto the disparity in maternal outcomes themselves.