Why They Came for PRAMS
The Briefing — PRAMS did not fall alone. The entire CDC division it lived inside was killed the same day — without a bill, without a vote, by layoff.
You can usually identify what a political project is actually about by watching what it kills first. Not what it argues against — what it defunds. Argument is cheap. Defunding is expensive, slow, and only worth it for a reason that does not survive being said out loud.
The Pregnancy Risk Assessment Monitoring System has run since 1987. It covers 81 percent of U.S. live births across 46 states. Its annual federal cost is in the low tens of millions. It does not regulate anyone. It does not deliver care. It does not even know your name. And it is being shuttered. Not by a vote. By a layoff.
The whole division died. PRAMS died loudest.
On April 1, 2025, the entire CDC PRAMS team was placed on leave. Four other programs in the same Division of Reproductive Health were killed the same day — the U.S. Medical Eligibility Criteria team, the IVF/ART surveillance team, ERASE MM, the Women’s Health and Fertility Branch. Two of three branches eliminated in a single action.
The CDC’s stated reason — for once — was on the record. The cuts were made “in accordance with President Trump’s January 20 Executive Orders on ‘Defending Women from Gender Ideology Extremism’ and ‘Ending Radical And Wasteful Government DEI Programs.’”
The paperwork keeps moving. The team has not existed for a year.
Seven months after the layoffs, CDC filed a Federal Register notice asking OMB for a three-year extension of PRAMS authority. The team that would administer the extended authority had been on administrative leave since April. The paperwork moved through the system without interruption. The work the paperwork authorized had stopped seven months earlier.
Then it got more pointed. In March 2026, CDC quietly reclassified the request from “Extension” to “Revision” — a procedural change that reserves authority to alter the instrument without further public comment. The same notice cut 1,495 hours of annual data collection. 1,395 of those hours were the callback surveys that protect the sample against non-response bias.
Action through omission is the method. The Bureaucratic Ghost is its signature.
Blindness is the policy.
The word, the dataset, the office, the institute, the campus, the grant, the page, the policy framework: every one of them, moving in the same direction, in the same year. That is not coincidence. That is intent.
PRAMS is not on the hit list because it failed. PRAMS is on the hit list because it worked.
By the end of this Briefing you will know the playbook well enough to recognize it the next time it runs. There are four more programs in this series. The playbook will run on all of them.
Free to Read — No Paywall
From Yesterday — The Signal
The federal surveillance system that has asked American mothers what actually happened to their pregnancies every year since 1987 is being killed administratively.
Tomorrow — Viva Voce
From the exam room: what it looks like when the data system that warned you about a crisis is the same data system being taken away.
Read the full series:
✊🏽 WHY SUBSCRIBE
You can read me anywhere. There are louder takes. There are faster newsfeeds. There are bigger names. What you get here that you don’t get anywhere else is THE SPINE — a permanent argumentative scaffold you can stand on, walk along, share with the people you’re trying to convince, and keep coming back to over years.
The reason your premium went up $1,000. The reason your sister’s cancer trial got pulled. The reason Pap smears are disappearing from rural counties.
THEY ARE THE SAME REASON.
That’s the case we’re making, week after week, until the country can see it.
Thank you for being here. Forward this to one person who needs the spine.
— YC
Dr. Yamicia Connor, MD, PhD, MPH
Founder & CEO, Diosa Ara | Creator & Editor-in-Chief, The Labora Collective
