How Trump's CDC Purge Will Affect Reproductive Health: ‘Women Will Die'

Yahoo

05-04-2025

The consequences of the Trump administration's purge of thousands of federal workers from the Department of Health and Human Services on April 1 are so enormous, they can be difficult to grasp. But the impacts won't be abstract — experts say the destruction of critical departments could put women's lives at risk.
On Tuesday morning, more than 7,000 federal employees across the Centers for Disease Control and Prevention, the National Institutes of Health, the Food and Drug Administration, and the Centers for Medicare and Medicaid Services were placed on administrative leave. The cuts — part of Donald Trump and Elon Musk's broader purge of the federal workforce — were widespread and erased entire departments, without regard to experience. Two of the three branches in the CDC's Division of Reproductive Health were eliminated, as was their leadership, leaving only the Maternal and Infant Health branch. 'We got obliterated,' says Taylor, who received a reduction in force (RIF) letter on Tuesday. (They asked to use a pseudonym to avoid retribution.) The Division of Violence Prevention was similarly affected, with three of the four branches cut. Only its leadership and a surveillance branch remain.
The firings led to more confusion when Robert F. Kennedy Jr., the vaccine skeptic made head of the HHS, said on Thursday about 20 percent of the cuts could be mistakes — and that they need to be corrected. The chaos and uncertainty left many working for the department and those who rely on their life-saving research concerned about those who will be disproportionately impacted by these changes — women.
When the Supreme Court overturned Roe v. Wade in June 2022, ending federal protection for abortion rights, reproductive health experts sounded the alarm on how it would be catastrophic for women's health. And now, especially in states where abortion is banned, the collection and interpretation of data around reproductive health is crucial, as is medical research on IVF, contraception, and high-risk pregnancies. With the layoffs at the Reproductive Health and Violence Prevention divisions, a lot of research and programs that focused on women have been gutted. The repercussions will be far-reaching, as violence against women and pregnancy are linked. In fact, the leading cause of death for pregnant people is homicide. And the groups that are the most vulnerable to both violence and maternal health mortalities are Black women and communities of color. This is in addition to the risks this lack of resources poses for domestic abuse and rape victims because the teams studying how to prevent this type of violence have been decimated.
The CDC's Division of Reproductive Health team that focused on emergency preparedness for pregnant and postpartum women and infants was also slashed this week. Those staffers were responsible for responding to how pandemics like Covid-19 can impact pregnant women and making sure to include them in their health response plans. The entire Pregnancy Risk Assessment Monitoring System (PRAMS) team was laid off. That program was developed to identify women and infants at high risk of health problems, with the goal of reducing infant mortality and morbidity.
'We cannot understand factors associated with poor pregnancy outcomes without surveillance like PRAMs,' Taylor says. The U.S. has the highest maternal mortality rate of all high-income countries, and experts fear that reducing research on prevention will make things even worse. 'If we don't understand those factors, U.S. maternal morbidity and mortality will continue to worsen. This means more women will die.'
'Black women in America are three times more likely to die from pregnancy-related causes than white women, we know this in large part because of the data collected and analyzed by the CDC,' says Jennifer Driver, who runs the reproductive rights council at the State Innovation Exchange, a strategy center collaborating with state lawmakers on progressive public policy.
Dr. Nicole Freehill is an OB-GYN in Louisiana, and many of her patients have high-risk pregnancies. She's not directly funded by these programs, but she and other doctors across the country will feel the impacts of these cuts. 'Anything like PRAMS that's monitoring for pregnancies with adverse outcomes, even though [the CDC] didn't cut the maternal mortality branch, these things are intertwined,' she says. 'If you're potentially cutting services, monitoring, and research, how can we keep pregnancies healthy?'
Freehill also says she was concerned about how cuts to the Assisted Reproductive Technology (ART) team will affect fertility research. 'That's an ever-changing field, trying to find the best techniques to help patients get pregnant and stay pregnant,' she says. 'A lot of these patients have tried for years, they want to be parents. If this administration is so pro-life, why are they cutting this?'
Among the employees who were cut were researchers who studied contraception, abortion, and fertility. For example, staffers would investigate success rates of IVF across clinics nationwide. The CDC is one of the only federal agencies tracking success rates and overseeing fertility clinics. The IVF cuts were especially ironic, considering Trump recently declared himself the 'fertilization president' at a Women's History Month event at the White House on March 26 when talking about the executive order he signed pledging to expand access to fertility treatment.
And for people who don't want to get pregnant, the CDC cuts also pose challenges. In a state like Louisiana, where Freehill practices and abortion is banned, contraception is more important than ever. But, as Rolling Stone reported this week, the team that worked on the contraception guidelines at the CDC was also shuttered.
The guidelines, which provide recommendations for health care providers for safe use of contraception, are used as a standard of care by OB-GYNs, midwives, and primary care doctors. Freehill says she often checks them when patients who have specific medical conditions and are on medication come in and want to know which birth control option is safest and most effective for them. She is also worried about the gutting of the FDA, which releases guidelines on how many years IUDs can be effective, something that can be constantly updated with new research and data.
Trump and Kennedy's attacks on science have been rolled out in stages. One of the first ways the CDC was affected was after Trump's executive order in January claiming to 'defend women from gender ideology extremism.' CDC researchers had to change how they talked about gender, even when it was central to their work. For example, in January an agency website about violence had to scrub the term 'gender-based violence,' and a website about racism in health was removed.
'This will close a lot of doors for sexual assault survivors that relied on these programs.'
– a health scientist on the violence prevention team
'The executive order drastically affected the way that we study, report, and all the different ways we can talk about violence against women because it is gender based,' says Jordan, a CDC staffer who researches violence prevention and was sent a RIF letter on Tuesday. They also requested a pseudonym for fear of retribution. 'Gender is associated with a likelihood of experiencing violence.'
Intimate partner violence, for example, primarily affects women, and the Intimate Partner Violence Prevention team was dismantled. The team worked with state and local domestic violence coalitions to put prevention strategies in place. All of the employees working on rape prevention education were also placed on leave. They'd funded and evaluated programs aimed at reducing sexual violence, especially in communities with marginalized individuals. They provided funding to state coalitions which distributed the money to rape crisis centers and local organizations and educated communities on resources they had available.
One program that was funded was a hotspot mapping app called 'Like a Girl.' If girls and women don't feel safe in a neighborhood they can mark the spot on the map and then that data can be used to target high-impact areas and see if there are improvements that can be made to the area, like adding streetlights or using other proven ways of reducing violence.
'This will close a lot of doors for sexual assault survivors that relied on these programs,' says a health scientist on the violence prevention team who asked to remain anonymous.
'When you experience violence, you are more likely to have mental health issues, to have physical health issues, you're more likely to live in poverty,' Jordan says. 'All of these things are related. If we can't work on preventing violence, we can't work on preventing a whole wide range of health issues for women. You can't tease [these issues] apart and just work on one and not the other.'
While the CDC's Division of Violence Prevention's leadership remains, its branches were almost entirely eliminated except for the surveillance team, which looks at data available across the states to see where violence happens, and where help is needed. Many of the positions eliminated were responsible for using this data from the field to determine which methods are successful in preventing violence.
'We're not just giving money to people and walking away; we connect national partners together and create guidance and technical assistance for local communities and states to implement violence prevention activities,' Jordan says. 'If those connections go away, and nobody's funding them, it's leaving these communities out to dry, especially in rural areas. They're going to be left with no resources.'
They added, 'If we can't track how and why and what to do about it, there's no point in knowing that [violence] is happening. We already know that.'
As the massive layoffs have hit federal health agencies, reproductive health advocates are trying to amp up the involvement of state legislators. 'States rely on [CDC] information to help them understand the gaps,' says advocate Driver. 'How can states address the racial disparities in maternal deaths if the data no longer exists? Erratic and wholesale elimination of programs has and will continue to harm people in the states.'
The consequences could have reverberations far outside of the U.S., as well. Cutting funding to all of these agencies could create irreversible damage that trickles out to countries that rely on the U.S. for things like vaccine innovation, detailed guidelines on medicine, and decades-long research on issues that harm people.
'Research-cutting in any area of medicine is dangerous,' Freehill says. 'Currently, the United States is the world leader in medical research, and if that gets significantly cut, then I'm worried about what's going to happen with the overall health of our country — of the entire world.'
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