In 2024, Black women died from pregnancy-related causes at 44.8 per 100,000 live births. White women died at 14.2. A 3.15-fold gap. The only maternal mortality rate in the country that did not statistically improve over the prior two years. The number is the CDC’s own. The federal government has spent the year since making it harder to produce the next one.
The Act
On January 20, 2025, the President signed Executive Order 14151 — “Ending Radical and Wasteful Government DEI Programs and Preferencing.” The next day, Acting HHS Secretary Dorothy Fink issued the communications-pause memo that triggered the largest scrub of federal health information in modern American history. Between January 21 and February 11, 203 federal datasets went dark. The CDC altered or removed more than 3,000 pages. Internal emails ordered staff to strip “forbidden terms” from manuscripts. Grant applications came back with instructions to delete “Racism,” “Race,” “Racial.” Head Start was told to drop “Black,” “disability,” “female,” “minority,” “trauma,” “women” — among nearly 200 banned terms. The word the rule was written around is “Black.”
The Body It Lands On
In January 2025, for the first time in three decades, the Pregnancy Risk Assessment Monitoring System (PRAMS) — the CDC system that tracks maternal outcomes by race and state — was shut down mid-survey. In April, the entire PRAMS team was laid off, alongside most of the CDC’s Division of Reproductive Health. The CDC Office of Minority Health was gutted. HHS Office of Minority Health, Office of Women’s Health, HRSA Office of Health Equity — staff cut, directors removed. The Social Vulnerability Index, the tool counties use to find where Black mothers are dying, was pulled offline and only restored February 11 by federal court order.
PRAMS is how a state knows Black mothers in its rural counties die at multiples of white mothers in its suburbs. Without PRAMS, the death still happens. Nobody counts it. Nobody is permitted to say why.
The Data Underneath
Black women have died at three to four times the rate of white women in every year the federal government has measured it. The gap has not narrowed in forty years. It widened post-Dobbs. Black infant mortality runs more than double the white rate — 10.9 versus 4.5 per 1,000 live births. The systems built to make these numbers visible — Maternal Mortality Review Committees, MMRIA, ERASE MM, PRAMS, race-stratified reporting across every major federal health dataset — have been defunded, suspended, gutted, or told to stop using the word that names who is dying.
You cannot solve a crisis you have made illegal to name.
The Diagnosis
This is Goal Two. Women in the home. White men restored to unchallenged power. Black Americans returned to a permanent underclass. The third no longer requires a new Jim Crow statute. It only requires that the federal government stop counting. Shelby County gutted the Voting Rights Act. SFFA v. Harvard ended affirmative action. EO 14151 finishes the job at the level of data — where epidemiology, grant funding, intervention, and accountability live. The disparity does not vanish. The record of it does. The Black woman bleeding out in a Mississippi hospital is still bleeding. The federal government is now structurally prevented from knowing she was Black.
The cruelty isn’t a side effect. It is the architecture. I am a physician. I deliver babies. I know what surveillance data prevents — the next death. Erasing it is a policy choice to let the next Black mother die uncounted. My tradition was hijacked. So was hers.
The Ask
Call your representative. Demand restoration of PRAMS, MMRIA, and ERASE MM funding, and reinstatement of the CDC Office of Minority Health. Donate to the Black Mamas Matter Alliance and Pregnancy Justice, doing the surveillance the federal government refuses to. Share this receipt. Subscribe at bringtheboltcutters.laboracollective.com. Receipt #3 lands next Friday.
The Roberts Court tied us to the tracks. They forgot we brought bolt cutters. The train is coming. We are not the ones getting hit.
— Yamicia Connor, MD