Maternal Health: Funding Cuts Amid an Ongoing Crisis

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The United States continues to grapple with a maternal health crisis characterized by significant racial and ethnic disparities in morbidity and mortality. Maternal mortality rates here are at least double (and sometimes triple) those of most other high-income countries, according to a 2024 Commonwealth Fund report. The Centers for Disease Control and Prevention (CDC) estimates that 80% of U.S. maternal deaths are preventable.

Recent data show some improvement in mortality and morbidity but persistent disparities in who is at greatest risk. Pregnancy-related deaths in 2023 decreased to 18.6 deaths per 100,000 live births from a rate of 22.3 the year before, according to the National Center for Health Statistics. Yet the maternal mortality rate for Black women and American Indian and Alaska Native women continues to be more than three times that of White women.

Federal changes threaten efforts to improve care and disparities 

As nurses and other maternal health providers work to address the complex underlying causes of these disparities, their efforts have been challenged in recent months by rapid and unprecedented federal funding and infrastructure cuts. The Trump administration has suspended Title X family planning and preventive health services funding, initiated widespread layoffs of federal health […]

The Repercussions of Trump Administration Cuts to NIH and Research Funding

From the first week of his administration, President Trump has targeted medical and academic research, cutting research funding to universities and slashing the workforce and budget for the National Institutes of Health (NIH). Concerns about the future of medical research in the United States began on January 22, just three days into the new administration, when all meetings to review grant submissions at NIH were cancelled with no plan for rescheduling.

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Within days, NIH abruptly cut off funding for research projects that incorporated principles or language associated with diversity, equity, and inclusion (DEI) in any form, such as clinical trials focused on populations underrepresented in past research. In early February, NIH announced drastic reductions in the indirect costs rate, the percentage paid to universities for administrative and overhead costs of funded research studies. NIH funding of new grants fell precipitously; an analysis in STAT found a 28% reduction in new grant funding in the first three months of the administration. Then in March universities got hit, most notably Columbia and Harvard, with the Trump administration threatening to terminate all federal funding if universities did not comply with the administration’s policy demands. The loss […]

The Harm Done by Dismantling USAID

The Trump administration dismantled the U.S. Agency for International Development (USAID) abruptly in February, placing nearly all of its over 10,000 employees on administrative leave, freezing appropriated funds, and cancelling nearly 5,800 USAID-managed foreign assistance awards—effectively closing an agency that has led in global humanitarian assistance since it was created by President John F. Kennedy in 1961.

Shutting down the agency has dealt a devastating blow to low- and middle-income countries’ efforts to alleviate poverty, provide health care, and improve public health and education. USAID supported a wide variety of critical global programs, including  family planning, disease prevention and treatment, immunizations, and famine relief. Nurses played a critical role in USAID, providing education and training to strengthen severely limited in-country nursing and midwifery workforces, delivering direct care, and leading immunization and other health programs.

Deadly results.

A child in Tajikistan receives a polio vaccination during a campaign to halt a polio outbreak. Photo: USAID, via Wikimedia Commons

An estimated 119,000 children and 57,000 adults have died as a result of USAID funding cuts, according to a real-time tracking tool developed by Boston University associate professor […]

A Tumultuous Seven Weeks for Public Health in the United States

Editor’s note: AJN news director Karen Roush, PhD, RN, FNP, will be providing regular updates on AJN Off the Charts about the details and implications of rapid and potentially momentous changes being made by the Trump administration to the public health system in the United States.

It’s been a tumultuous seven weeks since President Trump’s inauguration. Changes in leadership and priorities have swept across every federal department, bringing uncertainty and disruption. Trump signed more than 70 executive orders (EOs) in his first month in office, including orders to erase diversity, equity, and inclusion efforts from federal agencies and the military (EO 14151); limit the rights of transgender people and declare that only two “sexes,” biological males and females, would be recognized by the federal government (EO 14168); end birthright citizenship (EO 14160); and further limit access to abortion (EO 14182). Elon Musk’s Department of Government Efficiency, known as DOGE, has fired tens of thousands of federal employees, dismantled entire agencies, including USAID, and pulled grant funding from universities, nongovernmental organizations, and the National Institutes of Health (NIH).

The appointment of Robert F. Kennedy, Jr. to head HHS.

Many of the […]

Nurse Staffing Standards Act Is First Step in Solving Nursing Shortage

Nurses planning to leave the profession.

The nursing shortage continues, with no end in sight. In my current position as faculty in a university DNP program, I hear from students about caring for overwhelming numbers of patients and fearing for their patients’ safety and health. Nurses are suffering burnout because they are caring for so many patients they know nursing care is being missed. A recent survey found that job satisfaction has been dropping for nurses, while the percentage who say they may leave the profession is as high as 30% overall, with younger nurses most likely to say they may leave.

Nurse educators do our best, but we know that we are sending new graduates into the fire. Retired nurses worry about our family members (and ourselves) when we need nursing care.

Congress recently reintroduced the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act. This bill would mandate direct care registered nurse-to-patient staffing ratio requirements in hospitals. It has been introduced in several prior congressional sessions with little progress. We cannot let this window of opportunity pass.

Nurse staffing and patient outcomes.

Linda Aiken’s two decades of research demonstrate the effects of nurse staffing on patient outcomes. Despite legislative efforts in Massachusetts and […]

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