A sweeping purge of staff at the US Department of Health and Human Services’ (HHS) Division of Reproductive Health has ignited alarm among public health experts, advocates, and former officials, amid fears that the essential infrastructure supporting maternal, infant, and fertility care is now in jeopardy. More than 100 employees were abruptly dismissed this week, gutting teams mandated by federal law to collect and analyze data critical to healthy pregnancies, maternal outcomes, and assisted reproduction—including in vitro fertilization (IVF) support—according to multiple former staffers interviewed by Mother Jones (source).
This move, which comes on the heels of President Donald Trump’s high-profile pledges to champion family planning and expand IVF access, directly contradicts the administration’s recent public positions and campaign promises. During Women’s History Month events and at the March for Life, President Trump vowed to encourage healthy pregnancies and offer tangible support to mothers and young families, positioning himself as “the fertilization president.” Yet, in a stunning reversal, the administration has dismantled the very federal division responsible for carrying out those goals.
The US Centers for Disease Control and Prevention’s (CDC) Division of Reproductive Health held a “key source of support for maternal and child health programs nationwide,” as highlighted by the head of maternal and infant health at a major nonprofit. The expert warned that cuts risk “disrupting prenatal care, contraception access, and efforts to reduce maternal and infant mortality” (source). Without the division’s backing, already overstretched state and local health departments could struggle to maintain standards and respond effectively to emerging maternal health challenges.
Among the casualties are teams charged with some of the most critical and data-driven aspects of US reproductive health. The women’s health and fertility branch, for example, was eliminated, taking with it the scientists who maintained the national database of assisted reproductive technology (ART) clinics. These experts not only tracked clinic performance and IVF outcomes but also provided vital online resources to help families estimate their IVF success rates and researched methods for reducing treatment costs—work explicitly mandated by Congress since 1992.
In a particularly paradoxical twist, President Trump signed an executive order in February pressing for expanded IVF access and lower out-of-pocket costs, only to see the ART team—which possessed unique, irreplaceable expertise—eliminated weeks later. “I don’t know if anyone else [in the federal government] has the expertise that our team does,” said a former team member, questioning how such a cut aligns with stated administration priorities.
The impact on data collection and public policy is expected to be profound. Experts stress that federal policymakers now risk losing the ability to allocate resources effectively, evaluate interventions, and identify at-risk populations. “If Republicans are interested in decreasing infant and maternal mortality rates and increasing fertility rates, we have those variables. You can’t make any solid decisions without the data, and we’re the ones with the data,” noted a mathematical statistician formerly responsible for the CDC’s gold-standard Pregnancy Risk Assessment Monitoring Program (PRAMS), a nearly 40-year-old survey covering more than 80% of US births (source).
The loss of PRAMS is especially concerning as the US faces a rising maternal mortality crisis, with recent data placing the nation among the worst-performing developed countries. Academics and healthcare providers rely on PRAMS for evidence-based intervention, health provider guidance, and even classroom teaching. “Dismantling PRAMS will make America less healthy, not more,” stated a leading professor of public health.
Other eliminated branches included teams central to contraception guidance, abortion surveillance, and emergency maternal health response. The latter is mandated by Congress and has played vital roles during crises ranging from COVID-19 to Zika, ensuring pregnant and postpartum women receive specialized care and support during disasters.
There is palpable uncertainty about what comes next. While an HHS spokesperson insisted that “critical CDC programs will continue as a part of Secretary Kennedy’s vision to streamline HHS to better serve the American people,” no details were given on how or if the Division of Reproductive Health’s terminated functions would be absorbed or replaced. A new “Administration for a Healthy America” agency is reportedly slated to take over some responsibilities, but even the remaining teams face ongoing ambiguity about their fate.
This episode is not only a technical challenge but also a signal to public health systems abroad—including Thailand—about the vulnerability of reproductive health policy to political shifts. Thailand, which has long invested in improving maternal and child health outcomes, can draw lessons from this US shake-up: even the world’s most advanced data collection systems and support networks can be swiftly undermined. For example, the CDC’s PRAMS program, once regarded as a gold standard, mirrors Thailand’s efforts to track maternal health, infant outcomes, and the efficacy of fertility treatments nationwide (WHO maternal health profiles). Thai public health officials should note the risks posed by sudden, politically-motivated administrative overhauls, especially if similar central resources were weakened.
Taking a broader lens, the US firings also highlight the vital, yet often underrecognized, work of field epidemiology and emergency maternal health teams—a feature of Thailand’s top-tier maternal health system. During the COVID-19 pandemic, Thailand deployed targeted maternal and child health guidelines, with ministry experts and public health nurses ensuring continued prenatal care, vaccination outreach, and maternal nutrition support even in remote areas (Thai MOPH COVID-19 response). Should Thailand ever diminish its cadre of maternal and reproductive health specialists or disrupt essential data pipelines, the pitfalls now facing the American system could be repeated at home.
Furthermore, the US’s abrupt reduction in expert staff directly impacts its ability to advance research and adapt policy to pressing demographic trends—including declining birth rates and rising infertility—issues increasingly relevant in Thailand as well. Infertility is a growing concern in the Kingdom, particularly as birth rates fall below replacement level and more couples seek ART services (Bangkok Post: Thailand’s falling birthrate). Having robust, government-backed data collection and scientific oversight ensures transparency, quality, and accessibility in such services—lessons driven home by the American example.
Looking forward, experts worry that the short-term cost savings of these layoffs will be dwarfed by the longer-term health and socioeconomic costs of lost expertise, diminished accountability, and weakened research capacity. If critical surveillance, prevention, and service guidance functions are not rapidly restored, experts warn that both maternal and infant morbidity and mortality rates could rise. As the US landscape becomes more uncertain, Thailand’s policymakers should prioritize the protection and strengthening of the country’s reproductive health infrastructure, invest in skilled epidemiological and data teams, and ensure continuity of emergency and routine maternal health supports.
For Thai officials, healthcare providers, and the public, this episode is a call to action: maintain vigilance around the staffing and support for core maternal, child, and fertility programs. Safeguard national data collection and subject-matter expertise, even in the face of political or financial pressures. And, in the tradition of past successes in Thai maternal health, continue to draw on interdisciplinary teams, strong public communication, and robust government leadership to advance the well-being of all Thai families.