PRAMS has shaped maternal health policy for decades. Now his future is uncertain.
For decades, the Pregnancy Risk Assessment Monitoring System, known as PRAMS, has been one of the most important tools we have for understanding what happens to women before, during and after pregnancy. Led by CDC in collaboration 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 only in medical records.
PRAMS has helped shape how policymakers, researchers and advocates understand maternal and infant health across the country. It tracks topics such as 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 that consistently documents these realities at scale.
What’s up with the strollers?
Earlier this year, PRAMS data collection came to an abrupt halt. States were instructed to stop contacting mothers who had recently given birth, halting ongoing investigations in the middle. At the same time, the federal PRAMS team was eliminated, leaving state health departments without technical support or clear guidance.
Uncertainty about funding has heightened concerns. Federal grants supporting state PRAMS programs are set to expire in 2026, and some states have already suspended or discontinued participation. Others are trying to create their own maternal health surveillance systems, creating fragmentation in what was once a solid 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 time when maternal health outcomes are deteriorating in many parts of the country, the loss of timely and reliable data is particularly concerning.
Why this data matters
PRAMS is not just a survey. It is fundamental to maternal health accountability. States rely on PRAMS to produce maternal health reports, evaluate programs and guide policy decisions. National maternal health benchmarks and targets have long depended on PRAMS data to monitor progress and reveal gaps.
PRAMS was also essential for understanding inequalities. She has helped identify disparities in access to postpartum care, documented improvements linked to policy changes such as paid family leave, and revealed where postpartum systems fail women. Without PRAMS, these ideas become harder to come up with and easier to overlook.
When data disappears, inequalities do not. They just become harder to prove.
What’s at stake if PRAMS is lost
If PRAMS is not restored and maintained, the consequences will be far-reaching. We risk losing consistent national data on maternal health behaviors and experiences. States are losing a reliable planning and evaluation tool. Policy makers are missing out on data to guide legislation. Advocates are missing out on one of the most powerful accountability tools.
For black women, the stakes are especially 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 much more difficult.
How BWHI came into being
Recognizing what was at stake, the Black Women’s Health Imperative submitted a formal public comment calling on federal leadership to expand the PRAMS data collection authority and stabilize the program.
In our letter, we highlighted that PRAMS is the only national surveillance system that records maternal health experiences before, during and after pregnancy. We highlighted how the BWHI draws on PRAMS data to inform our programmes, policy priorities and advocacy work, particularly around postnatal care and maternal mortality. We have made it clear that protecting PRAMS is essential to protect maternal health and promote equality. Read our letter HERE.
Because this moment matters
PRAMS sits at the intersection of data, policy and accountability. Whether it is restored and strengthened or left 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 helps protect it should never be optional.
