A Critical Maternal Health Data System Is at Risk
PRAMS has shaped maternal health policy for decades. Now its future is uncertain.
For decades, the Pregnancy Risk Assessment Monitoring System, known as PRAMS, has been one of the most important tools we have to understand what happens to women before, during, and after pregnancy. Led by the CDC in partnership with state and city health departments, PRAMS collects data directly from people who have recently given birth, capturing experiences, behaviors, and health outcomes that are often invisible in medical records alone.
PRAMS has helped shape how policymakers, researchers, and advocates understand maternal and infant health across the country. It tracks issues like postpartum care, breastfeeding, mental health, substance use, insurance coverage, and experiences during pregnancy. For Black women, whose maternal health outcomes are shaped by both clinical care and social conditions, PRAMS has been one of the few systems consistently documenting these realities at scale.
What’s Happening to PRAMS
Earlier this year, PRAMS data collection was abruptly halted. States were instructed to stop contacting mothers who had recently given birth, cutting off ongoing surveys midstream. At the same time, the federal PRAMS team was eliminated, leaving state health departments without technical support or clear guidance.
The funding uncertainty has only deepened concerns. The federal grants that support state PRAMS programs are set to expire in 2026, and some states have already paused or discontinued participation. Others are attempting to build their own maternal health surveillance systems, creating fragmentation in what was once a consistent national data source.
Access to PRAMS data has also been disrupted, limiting the ability of researchers, advocates, and policymakers to analyze trends and identify emerging risks. At a moment when maternal health outcomes are worsening in many parts of the country, the loss of timely, reliable data is especially concerning.
Why This Data Matters
PRAMS is not just a survey. It is foundational to maternal health accountability. States rely on PRAMS to produce maternal health reports, evaluate programs, and guide policy decisions. National benchmarks and maternal health goals have long depended on PRAMS data to track progress and expose gaps.
PRAMS has also been essential for understanding inequities. It has helped identify disparities in postpartum care access, documented improvements linked to policy changes like paid family leave, and revealed where systems are failing women after delivery. Without PRAMS, these insights become harder to surface and easier to overlook.
When data disappear, inequities do not. They simply become harder to prove.
What’s at Stake If PRAMS Is Lost
If PRAMS is not restored and sustained, the consequences will be far-reaching. We risk losing consistent national data on maternal health behaviors and experiences. States lose a trusted tool for planning and evaluation. Policymakers lose evidence to guide legislation. Advocates lose one of the strongest tools for accountability.
For Black women, the stakes are particularly high. Maternal deaths in the United States increasingly occur in the postpartum period, a phase PRAMS is uniquely designed to capture. Without this data, identifying who is missing care, when, and why becomes far more difficult.
How BWHI Stepped In
Recognizing what was at risk, the Black Women’s Health Imperative submitted a formal public comment urging federal leadership to extend PRAMS data collection authority and stabilize the program.
In our letter, we emphasized that PRAMS is the only national surveillance system that captures maternal health experiences before, during, and after pregnancy. We underscored how BWHI relies on PRAMS data to inform our programs, policy priorities, and advocacy work, particularly around postpartum care and maternal mortality. We made clear that protecting PRAMS is essential to protecting maternal health and advancing equity. Read our letter HERE.
Why This Moment Matters
PRAMS sits at the intersection of data, policy, and accountability. Whether it is restored and strengthened or allowed to erode will signal how seriously this country takes maternal health and the lives of those most affected by systemic inequities.
At the Black Women’s Health Imperative, we will continue to advocate for maternal health systems that center lived experience, evidence, and equity. Because Black women’s health should never be invisible, and the data that help protect it should never be optional.