On January 20, 2026, the Policy Center for Maternal Mental Health submitted a formal letter to the Centers for Disease Control and Prevention expressing strong support for continued funding of the Pregnancy Risk Assessment Monitoring System (PRAMS).
PRAMS is a cornerstone of maternal and infant health data in the United States and the only reliable source tracking both the prevalence of maternal mental health conditions and screening rates nationwide. Below is the full letter outlining why sustained investment in PRAMS is essential to preventing maternal mortality and improving care for mothers and families.
See the full letter below.
January 20, 2026
Mr. Jeffrey M. Zirger
Lead, Information Collection Review Office
Office of Public Health Ethics and Regulations
Centers for Disease Control and Prevention.
Regarding Docket No. CDC-2025-0750
Pregnancy Risk Assessment Monitoring System (PRAMS)
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) Centers for Disease Control and Prevention
Department of Health and Human Services
(OMB Control No. 0920-1273, Exp. 3/31/2026)
Dear Mr. Zirger,
My name is Joy Burkhard, and I am the Executive Director of the Policy Center for Maternal Mental Health, a 501(c) (3) nonprofit think tank facilitating programmatic and policy change.
I am writing to strongly support the 3-year extension of funding for the Pregnancy Risk Assessment Monitoring System (PRAMS).
As you know, PRAMS is a cornerstone of maternal and infant health data in the United States and is essential to addressing the maternal mortality crisis. No other data source captures women’s experiences like PRAMS, nor the breadth, depth, and longitudinal insight that PRAMS provides across states and populations.
PRAMS data are critical to advancing maternal health including maternal mental health (MMH). Maternal Mental Health disorders affect one in five women during the perinatal period. Suicide and overdose related to untreated maternal mental health conditions are now the leading causes of maternal mortality.
Right now, PRAMS is the only reliable data source of (1) prevalence and (2) screening rates in the U.S.
- Prevalence: asks if patients “felt down, depressed or hopeless… or have had little interest or little pleasure in doing things.”
- Screening rates: asks mothers if they were asked about these things by a healthcare provider.
As depicted below, the prevalence cited by the CDC of maternal mental health disorders comes from this critical data source, illustrating variations by population and state, which help organizations like ours prioritize technical assistance to the states and populations with the highest reported rates.
For example, states with the highest rates of perinatal depression included Kentucky and Mississippi.
And those groups reporting rates of 20% or higher ≤19 years, were:
- American Indian/Alaska Native,
- Smoked during or after pregnancy, Experienced intimate partner violence before or during pregnancy,
- Self-reported depression before or during pregnancy,
- or whose infant had died since birth.
https://www.cdc.gov/mmwr/volumes/69/wr/mm6919a2.htm?s_cid=mm6919a2_w
Screening is the first step to understanding a woman’s symptoms, to identify if she may be suffering or at risk for an MMH disorder.
In addition to organizations like ours, state health departments, Maternal Mortality Review Committees and state Perinatal Quality Collaboratives who lead quality improvement efforts in their states depend on PRAMS to understand where systems fail women and families, and where targeted interventions can save lives.
We urge you to continue PRAMS through authorization of funding and adequate CDC staffing.
Thank you for consideration -mothers and families are counting on you to ensure that we measure what we treasure and prevent maternal and child suffering.
Please feel free to contact me at [email protected] with any questions or requests for additional information.
Respectfully submitted,
Sincerely,
Joy Burkhard, MBA
Executive Director
