HHS Eliminates CDC Staff Who Made Sure Birth Control Is Safe for Women at Risk

For Brianna Henderson, birth control is not only to prevent pregnancy.

The mother of two children from Texas was diagnosed with a rare and potentially fatal heart disease after having her second child. In addition to avoiding another pregnancy that could be fatal, Henderson must ensure that the contraception she uses does not compromise her health.

For more than a decade, a small team of people from Centers for Disease Control and Prevention worked to do this, issuing national directives for clinicians on how to prescribe contraception in complete safety for millions of women with underlying medical conditions – including heart disease, lupus, sickle cell disease and obesity. But the Ministry of Health and Social Services, which oversees the CDC, dismissed these workers in the rapid reduction by the Trump administration of federal workforce.

He also decimated the largest genesic health division of the CDC, where the team was hosted – a decision that clinicians, advocacy groups and dismissed workers endanger the health of women and their babies.

Clinicians have declared in interviews that advising patients on birth control and prescription is relatively simple. But for women with conditions that expose them to a higher risk of serious health complications, special care is necessary.

“We were really the only source of security surveillance in this country,” said a CDC staff member who worked on guidelines, known as medical eligibility criteria in the United States for contraceptive use, or guy. “There is no one who can really do this work.” Kff Health News agreed not to appoint this worker and others who were not allowed to speak to the press and feared reprisals.

The issues are raised for people like Henderson. About six weeks after having her second baby, she said, her heart “ran”.

“I feel like I was underwater,” said Henderson. “I felt like I couldn’t breathe.” She finally went to the hospital, where she was told that she was “in full-fledged heart failure,” she said.

Henderson was diagnosed with a peripartum cardiomyopathy, a rare type of heart failure that can occur towards the end of pregnancy or shortly after childbirth. The risk factors of the disease include the age of at least 30 years, being of African origin, high blood pressure and obesity.

CDC contraception guidelines indicate that combined hormonal contraception, which contains both estrogen and progestogen to prevent pregnancy, may have an “unacceptable health risk” for most women with peripartum cardiomyopathy, also known as PPCM. For some women with diagnosis, an injection of commonly known contraception of the Depo-Provera brand also includes risks which prevail over its advantages, according to directives. Progressing pills only or an implant of contraception, inserted in an arm, are the safest.

Henderson said her cardiologist had to Greenlight what contraception she could use. It uses a progestin contraception implant only which is more effective in preventing pregnancy.

“I did not know that some things can cause blood clots,” said Henderson, “or worsen your heart failure.” Heart insufficiency is a main cause of maternal mortality and morbidity in the United States, the PPCM representing up to 70% of heart failure during pregnancy.

HHS dismissals sweeping at the end of March and in early April emptied the CDC reproductive health division, upsetting several programs designed to protect women and infants, said three dismissed workers.

About two -thirds of the approximately 165 employees and entrepreneurs in the division have been reduced, through layoffs, retirement or reallocations to other parties of the agency, said a worker.

Among the dismissed persons were members of CDC staff who carried out the monitoring system for the risk assessment of pregnancy, an investigation established almost 40 years ago to improve the results of maternal and infant health by asking detailed questions to women who recently gave birth. The survey was used “to help inform and reduce the contributory factors that cause maternal and morbidity mortality,” said a dismissed worker, allowing government workers to examine medical care that people have received before and during pregnancy, if necessary, and other risk factors that can cause maternal and child health.

The shots also deleted CDC workers who have collected and analyzed data on in vitro fertilization and other fertility treatments.

“They didn’t leave anything behind,” said a worker.

American contraception guidelines were published for the first time in 2010, after the directives adapted by the CDC developed by the World Health Organization. The latest version was published last August. It includes information on the safety of different types of contraception for more than 60 medical conditions. Clinicians said it was the first source of evidence on birth control security.

“It gave us so much information that was not available for clinicians at hand,” said Michael Policar, doctor and obstetrics, gynecology and reproductive sciences at the University of California-San Francisco University.

“If you have a person with it, let’s say, long -standing diabetes of type 2, someone who has a connective tissue disease like lupus, someone who has hypertension or who may have been treated for a precursor of breast cancer – something like that? In these circumstances,” said Policar, “before guy, it was really difficult to know how to manage these people.”

The CDC updates the directives in a global manner every five years. On a weekly basis, however, government employees would monitor the evidence of the use of patients in contraception and security of various methods, which they did when HHS suddenly dismissed them this spring, two dismissed workers said. This work does not occur now, said one of them.

Sometimes the agency would issue provisional changes outside more important updates if new evidence justified it. Now, if something new or emergency appears, “there will be no way to update the directives,” said a dismissed worker.

In 2020, for example, the CDC revised its contraception recommendations for women at high risk of HIV infection, after new evidence showed that various methods were safer than we thought before.

HHS spokesperson Emily Hilliard refused to say why CDC staff working on contraception guidelines and other genesic health problems has been dismissed, or to answer other questions raised by KFF Health News reports.

Most women of reproductive age in the United States use contraception. The most recent CDC data, the most recent available, show that more than 47 million women aged 15 to 49 were counting on birth control. About 1 in 10 used prolonged action methods such as intrauterine devices and implants; 1 in 7 used oral contraception.

The latest guidelines included updated safety recommendations for women with dynamic disease, lupus or PPCM, and those who are breastfeeding, among others. Clinicians are now informed that combined hormonal contraception has an unacceptable health risk for women with sickle cell anemia, as this could increase the risk of blood clots.

“This can really be summed up in life or death,” said Teonna Woolford, CEO of the sickle cell anemia of the Directive on Large Health Education, a non -profit organization that advocates improved genesic health care for people with the disease.

“We have really seen the CDC guidelines as a victory, like a victory-they are going to pay attention,” she said.

The 2024 guidelines also included birth control recommendations for women with chronic kidney disease. Research has shown that these women are more at risk of serious complications of pregnancy, especially preeclampsia and premature delivery. Their state of health also increases their risk of blood clots, which is why it is important for them not to use combined hormonal contraception, declared dismissed CDC workers and clinicians.

CDC information “is the last word in terms of security,” said Patty Cason, a family practitioner and president of sexual and reproductive invision Health. Having only static information on the security of various types of birth control is “very frightening”, she said, because new evidence could be released and entirely new methods of contraception are being developed.

Henderson said he had taken the heart of two years to recover. She created the non -profit organization Let’s Talk PPCM to educate women on the type of heart failure with which it was diagnosed, including forms of contraception.

“We do not want blood clots, to worsen heart failures,” said Henderson. “They already feel like not to trust their doctors, and we don’t need more.”

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