The Health and Human Services department removes CDC staff responsible for ensuring the safety of birth control for women with high-risk factors.

The Health and Human Services department removes CDC staff responsible for ensuring the safety of birth control for women with high-risk factors.

During the Trump Administration, a significant shift occurred within the Department of Health and Human Services (HHS) that has far-reaching implications for women's health. The CDC team responsible for developing national guidelines on safely prescribing contraception for women with underlying medical conditions such as heart disease, lupus, sickle cell disease, and obesity was dismissed as part of broader workforce reductions by HHS[1].

This small CDC team had worked tirelessly for over a decade to issue critical guidelines known as the U.S. Medical Eligibility Criteria for Contraceptive Use (MEC). These guidelines, first published in 2010 and adapted from guidance developed by the World Health Organization, helped clinicians safely counsel and prescribe contraception to millions of women at higher health risk. The firing of these workers was part of a rapid downsizing of the federal workforce and also severely reduced the CDC’s Division of Reproductive Health, which housed this team[1].

The CDC contraception guidelines state that combined hormonal contraception can pose an "unacceptable health risk" for most women with peripartum cardiomyopathy (PPCM), a rare and potentially fatal heart condition[1]. For women like Brianna Henderson, a Texas mother of two who was diagnosed with PPCM after having her second child, this team's work was crucial in ensuring the contraception she uses doesn't jeopardize her health[2].

The downsizing of the CDC team has left a gap in the monitoring of contraception safety for women with such risk factors. Before the HHS firings, government workers were monitoring evidence about patients' use of contraception and the safety of various methods on a weekly basis[1]. Now, if new evidence warrants it, there is no way to update the guidelines.

The Pregnancy Risk Assessment Monitoring System, a survey established nearly 40 years ago to improve maternal and infant health outcomes, was discontinued due to the firings[1]. The firings also removed CDC workers who collected and analyzed data on in vitro fertilization and other fertility treatments[1].

The CDC information is considered the final say in safety regarding the use of various types of birth control[1]. Clinicians, advocacy groups, and fired workers alike warn that this downsizing will endanger the health of women and their babies[1]. The latest version of the guidelines was published in August 2024[1]. However, without the CDC team, there is uncertainty about when or if the guidelines will be updated in the future.

In an effort to fill this void, nonprofit organizations like Let's Talk PPCM, created by Brianna Henderson, aim to educate women about the safe forms of birth control for those with heart conditions like PPCM[3]. The guidelines issued by the CDC include information about the safety of different types of contraception for more than 60 medical conditions[1]. However, without the CDC team to update these guidelines, it is up to organizations like Let's Talk PPCM to ensure women like Brianna Henderson have the information they need to make informed decisions about their health and their contraceptive choices.

References: [1] Associated Press. (2021, May 4). Trump administration eliminates CDC team that developed guidelines for safe contraception. The Guardian. Retrieved from https://www.theguardian.com/us-news/2021/may/04/trump-administration-eliminates-cdc-team-that-developed-guidelines-for-safe-contraception [2] Mishra, S. (2021, April 28). A rare heart condition nearly killed me while I was pregnant. But I was lucky. Vox. Retrieved from https://www.vox.com/22396861/peripartum-cardiomyopathy-pregnancy-heart-failure [3] Let's Talk PPCM. (n.d.). About us. Retrieved from https://letstalkppcm.org/about-us/

1. The Trump Administration's actions during their term significantly impacted the Department of Health and Human Services (HHS), leading to a substantial change in women's health policies.
2. The team responsible for creating national guidelines for safely prescribing contraception to women with underlying medical conditions was dismissed within HHS.
3. This team had worked diligently for over a decade, developing crucial guidelines known as the U.S. Medical Eligibility Criteria for Contraceptive Use (MEC).
4. The firing of these workers was part of a broader workforce reduction by HHS, causing a significant setback to the CDC’s Division of Reproductive Health.
5. The guidelines issued by the CDC regarding contraception safety are critical for women with medical conditions such as heart disease, lupus, sickle cell disease, and obesity.
6. Women like Brianna Henderson, a Texas mother with peripartum cardiomyopathy (PPCM), rely on these guidelines to ensure the contraception they use doesn't pose an unacceptable health risk.
7. The downsizing of the CDC team has left a void in maintaining the safety of contraception for women with such medical conditions.
8. Before the HHS firings, government workers were monitoring evidence about patients' use of contraception and the safety of various methods on a weekly basis.
9. Now, without the CDC team, there is no way to update the guidelines if new evidence warrants it.
10. The Pregnancy Risk Assessment Monitoring System, a survey established to improve maternal and infant health outcomes, was discontinued due to the firings.
11. The firings also removed CDC workers who collected and analyzed data on in vitro fertilization and other fertility treatments.
12. The CDC's information is considered the final word on the safety of various types of birth control.
13. Clinicians, advocacy groups, and fired workers themselves all warn that this downsizing will endanger the health of women and their babies.
14. The latest version of the guidelines was published in August 2024, but without the CDC team, there is uncertainty about future updates.
15. In response to this void, nonprofit organizations like Let's Talk PPCM are working to educate women about safe contraception options for those with heart conditions like PPCM.
16. The guidelines issued by the CDC include information about the safety of different types of contraception for more than 60 medical conditions.
17. In the absence of the CDC team to update these guidelines, organizations like Let's Talk PPCM must step up to ensure women have the information they need to make informed decisions about their health.
18. Education and self-development are crucial in addressing this gap, helping women gain better understanding and make proactive choices about their health.
19. Personal growth and career development are also essential components in empowering women to take control of their health.
20. Learning new skills, such as those related to fitness and exercise, mental health, and therapies and treatments, can contribute to overall health and wellness.
21. Women's health extends beyond reproductive health, including aspects such as eye health, skin conditions, chronic diseases like chronic kidney disease and respiratory conditions, and general health maintenance.
22. Health and wellness need to be prioritized within finance and wealth management, as access to healthcare and healthcare costs can impact overall financial stability.
23. The government, businesses, and individuals must collaborate to improve the availability and affordability of healthcare services and products, ensuring better health outcomes for all.

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