Why They Came for PRAMS

PRAMS did not fall alone. The entire CDC Division of Reproductive Health was killed the same day. Why this division, why this surveillance system, and why the paperwork keeps moving when the team has not existed for a year. ━━━━━━━━━━━━━━━━━━━━━━━━━━━━ You can usually identify what a political project is actually about by watching what it kills first. Not what itargues against — what itdefunds. Argument is cheap. Defunding is expensive, slow, and only worth it for a reason that does not survive being said out loud. PRAMS did not fall alone. On the same April 2025 day that the PRAMS team got their layoff notices, four other programs in the same CDC Division of Reproductive Health were killed — the team that maintains the U.S. Medical Eligibility Criteria for Contraceptive Use (the clinical guidelines OB/GYNs use every day), the IVF outcomes surveillance team, ERASE MM,and the Women's Health and Fertility Branch. Two of the three branches of the Division of Reproductive Health were structurally eliminated in a single day. Then it got more pointed. At the April 17, 2026 House Education and Workforce hearing during Black Maternal Health Week, Rep. Summer Lee confronted HHS Secretary Kennedy with the existence of a list of nearly 200 words that federal grant applications had been instructed to remove.The wordBlackwas on the list.The Black Maternal Health Momnibus Act was reintroduced weeks earlier as the 'Momnibus Act.' The wordBlackappears once in the entire text. Morehouse School of Medicine's federal grant for a research center on Black pregnantand postpartum women's health was terminated. The CDC's 'Racism and Health' portal was taken offline. Race and ethnicity variables were removed from federal datasets. You cannotcount what you have agreed not to name. You cannot fund what you have agreed not to study. You cannot reduce a disparity you have agreed does not exist. PRAMS is not on the hit list because it failed.PRAMS is on the hit list because it worked. Read the full Briefing There is a way to kill a federal program without admitting you killed it. Congress kept the money. The administration killed the program. If you missed it, start there.→https://quietdismantling.laboracollective.com/week-2/signal/ Sixteen weeks pregnant. A stable subchorionic bleed. Nothing to do but watch— in part because the federal system that could have built better evidence is being dismantled by administrative action, without a vote. Read the full six-week series ━━━━━━━━━━━━━━━━━━━━━━━━━━━━ Stay inside the record. I did not build The Labora Collective because I had time. I built it because after fifteen years of practicing obstetrics in this country, I couldnot keep watching women die inside a system that had decided their care was optional — and say nothing. Every Tuesday, we publish what we can prove. The policy. The mechanism. The patient. The receipt. Because when the federal government has decided to stop keeping the record, someone has to hold what it drops. If this piece landed, do two things. Neither is small. 1. Subscribe to the Substack.Free. Weekly. It keeps youinsidethe record instead of downstream of it — so the next dismantling does not catch you at the ER.→https://laboracollective.substack.com/subscribe 2. Join the community.This is where clinicians, midwives, doulas, researchers, patients, and organizers turn the record into a response — where the fight becomes coordinated instead of isolated.→https://laboracollective.com/join/ The dismantling is fast. It is designed to be. The counter-record only exists because a small number of readers decided to stop scrolling and start showing up. If that is you — come in. The room is open. Founder & CEO, Diosa Ara | Creator & Editor-in-Chief, The Labora Collective