Author: Grace Hall

The National Institutes of Health (NIH) is part of the United States Department of Health and Human Services (HHS). It consists of twenty-seven organizations known as Institutes and Centers. The NIH aims to foster creative discoveries and innovative research strategies; develop, maintain, and renew scientific human and physical resources to prevent disease; expand the knowledge base in medical and related sciences to enhance the nation’s economic well-being; and exemplify and promote the highest levels of scientific integrity, public accountability, and social responsibility. Although each Institute and Center has its own research agenda, they all receive their funding directly from Congress. 

The NIH allocates the majority of its $48 billion budget to medical research. A significant portion of this funding is awarded to universities, medical schools, and other institutions to conduct extramural research through grants. One major category supported by the NIH is cancer research, which receives approximately $8 billion annually. Since President Trump took office on January 20, 2025, he and his administration have implemented substantial cuts to federal health agencies. His administration, as of last week, has sent termination notices to thousands of federal health workers, including those at the NIH, which anticipates a loss of 1,200 employees. 

In addition to cuts affecting federal employees at the NIH, the Trump administration has stalled grant authorization and funding. The NIH cannot consider new grant applications because President Trump has blocked it from posting new notices in the Federal Register, a requirement before any federal meeting can be convened. As a result, the agency had to cancel planned meetings to review thousands of grant applications. Due to the freeze, the NIH has reportedly stalled over 16,000 applications, all competing for approximately $1.5 billion in NIH grant funding. An anonymous committee member who reviews grant funding meetings states that even though the freeze remains in place, “applications still come in, and essentially they go into a black hole, and nothing can be done with them.” In addition to workforce cuts, the Trump Administration has hit the NIH with a cap of 15% on the rate they pay for the indirect cost of medical research. This is much lower than many other federal institutions get to maintain buildings and equipment.

Anjee Davis, the CEO of Fight Colorectal Cancer, expresses her fear regarding employee cuts and a funding freeze: “We are scared that these blanket mandates could erase decades of progress in the fight against cancer. This isn’t about politics. It’s about protecting the advancements we’ve fought so hard to achieve in cancer care and research over the past two decades.” Dr. Celine Gounder, CBS News Medical Contributor, explained that the NIH is “how we end up with new drugs and other advancements in medicine.” CBS further explains that while there are immediate impacts from the freeze and firings, concerns grow among individuals that there are both immediate and long-term worries about a slowdown in biomedical research and potential delays in drug approvals. Davis and her company surveyed patients currently being treated for colorectal cancer, and 75% of respondents indicated they were worried that these government actions would delay their care and hinder new research into their cancer. 

While the funding freeze is new, and the federal workforce cuts at healthcare agencies are even newer, there is not much to say to ease the fear and anxiety felt by individuals, more specifically cancer patients. It is very concerning regarding the immediate impact on health care and public health and the longer-term implications for whether we will maintain our leadership in the health space. 

In the United States, there are approximately 22 maternal deaths for every 100,000 live births. The rate of maternal deaths in the United States is more than double, almost nearly triple the rate for any other first-world/high-income nation. Many of these pregnancy-related deaths occur during the postpartum period. The postpartum period is days 1- 42 after the baby’s birth and ends around the time a mother’s body nearly returns to pre-pregnancy state. The postpartum time is critical because it lays the foundation for long-term health for the mother and baby. 

The American College of Obstetricians and Gynecologists (ACOG) explains that postpartum care for both the mother and the baby must become an ongoing process, not just a single encounter the mother gets before she leaves the hospital and one more visit at her six-week check-in. ACOG further implements that postpartum care should evolve over six weeks. Starting within the first three weeks postpartum, a mother should have a visit to address acute postpartum issues. After the 3-week check-in, postpartum care should include ongoing care as needed, which includes a comprehensive women’s exam and a transition into women’s care after pregnancy. 

Although many doctors and health agencies acknowledge the correlation between high maternal deaths and lack of postpartum care, the US still has the highest maternal death rate. In June 2022, the Biden-Harris Administration addressed the Maternal Health Crisis in our country. In their address, Vice President Kamala Harris explains that the systematic barriers and failure to recognize, respect, and listen to patients of color have meant that Black and American Indian/Alaska Native (AI/AN) women experience a greater share in maternal mortality than their counterparts. VP Harris goes on to extend that the Biden-Harris administration is committed to cutting the rates of maternal mortality and morbidity, reducing disparities in maternal health outcomes, and improving the overall experience of pregnancy, birth, and postpartum across the country. 

In July 2024, nearly two years after implementation, VP Harris announced that there had been key accomplishments from the administration’s effort to combat maternal mortality and morbidity. Starting off, their administration has created the first-ever baseline federal health and safety requirements for maternal emergency and obstetric services in hospitals. These new standards ensure that hospitals have the protocols and supplies for obstetrical emergencies, and if hospitals are unable to perform during the emergencies, they have procedures to transfer patients to other facilities. Second, the administration has expanded postpartum Medicaid coverage from two to twelve months, which ultimately provides lifesaving coverage to thousands of new moms. Extending has given postpartum moms the ability to seek doula care, and some states can cover the services. In addition to having designated hospitals, VP Harris launched the Newborn Supply Kit Pilot Project, which distributes kits with essential supplies to families. Supplies include diapers, baby lotion, baby socks, blankets, and wipes. The goal of this program is to reduce time, stress, and the burden on new parents to obtain supplies immediately needed. 

Specifically looking at the United States hospital system, the administration has also created “Birthing Friendly” Hospitals. These hospitals are designated to describe high-quality maternity care. To earn the designation of “birthing friendly,” hospitals have to participate in statewide or national perinatal quality improvement programs and implement evidence-based quality interventions in their hospital to improve maternal health. 

On August 27^th, 2024, it was released that the U.S. Department of Health and Human Services (HHS) announced more than $558 million in additional funding to improve maternal health. $440 million of their projected funding is to expand evidence-based maternal, infant, and early childhood home visiting services across the country. $118.5 million of their funding comes from the CDC to aid in building the public health infrastructure to better identify and prevent pregnancy-related deaths. 

As we pass the two-year mark on the Biden-Harris administration’s maternal mortality and morbidity project, it is safe to say the U.S. has made great strides in moving towards lowering its maternal death rate. There are still many areas that need work and change, but it is safe to say necessary changes to alter and protect the mothers of the U.S. are being made.