Doctors Fight To Protect Women’s Health Amid Trump-Era Cuts And Rising Maternal Deaths

In the wake of renewed political efforts to dismantle diversity and equity initiatives, many OB-GYNs and public health professionals say the U.S. is backsliding in the fight against racial disparities in women’s health care.

Dr. Emily Hawes-Van Pelt, an OB-GYN in Minneapolis, was not originally focused on activism. But after the murder of George Floyd near her hospital in 2020, everything changed. “I was angry, I was bitter, I was frustrated,” she told a room full of doctors at a recent national medical conference. “I thought, what can I do? How can I help?”

She joined advocacy groups and Minnesota’s Maternal Mortality Review Committee (MMRC), which investigates pregnancy-related deaths—many of which disproportionately affect women of color. Like many OB-GYNs, she believed in using data, education, and policy reform to reduce harm. But now, that work is being threatened.

At the annual meeting of the American College of Obstetricians and Gynecologists (ACOG) in May, attendees voiced alarm over the direction of the country’s health policies. With the Trump administration rejecting the concept of systemic racism and targeting diversity, equity, and inclusion (DEI) programs, doctors fear that recent progress is at risk.

One change was already clear at the conference: ACOG’s former “District DEI Delegation” has been renamed the “Collective Action Advancing Respect & Equity Delegation”—a softer title for a climate that’s becoming increasingly hostile toward equity-focused work.

Dr. Hawes-Van Pelt reminded her colleagues that not all change requires funding. “This is change that we can make as individuals in our own practices,” she said, urging OB-GYNs to listen more carefully to patients and act with empathy and respect.

Still, many attendees couldn’t ignore the broader political storm brewing. During Trump’s first term, COVID-19 disproportionately killed Black and brown Americans. The racial disparities were laid bare. Then came the fall of Roe v. Wade, triggering a wave of state laws restricting abortion access. Many OB-GYNs—who also provide transgender and reproductive care—were left navigating a legal minefield.

Today, conservative groups are specifically targeting ACOG. Project 2025, a policy guide from the Heritage Foundation, accuses the group of pushing “pro-abortion ideology.” At the conference, ACOG’s deputy general counsel Francisco Negron warned that Trump’s executive orders could force investigations into medical associations. “What we thought was fairness, the administration sees as unlawful discrimination,” he said.

The field of OB-GYN has long wrestled with its racist history—from 19th-century experiments on enslaved women to the forced sterilization of Black women in the 20th century. Disparities persist today. Black women are three times more likely to die from pregnancy-related causes than white women.

Dr. Sharon Malone, a prominent OB-GYN in Washington, D.C., used her keynote address to highlight this history. Referring to her own family’s experiences in segregated Alabama, she asked, “How are we going to implement health equity when we can’t even say the words ‘disparity,’ ‘race,’ or ‘women’?”

The rollback of DEI programs is affecting everything from research to patient care. Under the Trump administration, the Department of Health and Human Services (HHS) has seen major staffing cuts. Offices at the CDC, FDA, and Medicaid have been dismantled or downsized. Key public health resources—like federal guidelines on treating sexually transmitted infections—disappeared from government websites until courts forced partial reinstatement.

Federal funding for research on maternal and infant mortality, cervical cancer in Black women, and pregnancy-related stress disorders has also been slashed. Grant applicants have been told their studies no longer align with the administration’s priorities—often because they mentioned racism or inequality.

At the ACOG conference, that anxiety was everywhere. Exhibitors included midwives, abortion pill manufacturers, and recruiters from red-state hospitals. Many said their projects had lost funding. Others were concerned about looming Medicaid cuts, which could threaten care for millions of low-income patients. “How are we going to function?” asked Kristin Swenson, a midwife from the University of Washington. “The mood is ‘hold on, button up, batten down.’”

Some physicians declined to speak publicly, fearing professional retaliation. A doctor in Texas said her hospital banned staff from criticizing government cuts. Others, like a maternal-fetal medicine specialist in Cleveland, requested anonymity. She treats high-risk pregnancies and said cuts to food assistance programs could worsen outcomes. Her own research has been paused, and legal advisors warned her against traveling outside the country.

Another OB-GYN, Dr. Caroline Cochrane of Wake Forest University, said she was finalizing an 80-page study proposal on menopause disparities when she realized the project might be politically toxic. It focused on how Black and Hispanic women are often excluded from research. Now, she’s unsure if the project can move forward. “My whole career is in jeopardy,” she said.

LGBTQ health research is also suffering. Dr. Brent Monseur at Stanford lost funding for a study on family-building for queer individuals. “This is still a very new area of research,” he said. “There’s so much we don’t know. But now, that work is on hold.”

Just days after the conference, a car bomb exploded outside a fertility clinic serving LGBTQ families in Palm Springs, killing the attacker and injuring four others.

One of the biggest concerns at the ACOG meeting was maternal mortality. The U.S. has the highest maternal death rate among wealthy countries. Most of these deaths are preventable, and Black women are especially vulnerable.

During Trump’s first term, he signed the Preventing Maternal Deaths Act, which helped fund state-run Maternal Mortality Review Committees (MMRCs). These groups study the causes of pregnancy-related deaths and share the data in a CDC database. In 2020, new criteria were added to include discrimination and racism as possible causes of death.

But that work may not survive another Trump administration. At the conference, one doctor noted that it had become harder to contact CDC officials. Others asked if ACOG could take over the national database if federal support disappeared. “That’s a really complicated question,” one ACOG official replied.

Some MMRCs are already being dismantled. Idaho shut down its committee. Arkansas restructured its own after it recommended expanding postpartum Medicaid coverage. In Georgia, all 32 MMRC members were dismissed after ProPublica revealed that two maternal deaths were linked to the state’s abortion ban. In Texas, an anti-abortion activist was appointed to the committee, which was then barred from reviewing deaths for two years.

In a statement, ACOG’s new president, Dr. Steven Fleischman, expressed concern. The group has partnered with the government since the 1980s to improve maternal health. “We are worried that sweeping policy changes and spending cuts will undo all the progress we’ve made,” he said.

He specifically warned that MMRCs, the national database, and the Alliance for Innovation on Maternal Health—a program that trains hospitals to prevent fatal complications—are all at risk.

Dr. Malone concluded her keynote by recalling her mother’s experiences giving birth in the 1930s. The care was so poor that she chose to deliver most of her children at home. Though maternal mortality has decreased since then, racial disparities have widened.

“We do not have an engaged federal partner,” Malone told the audience. “So we’re going to have to do it on our own.” That means working with state leaders, local health departments, and private organizations. “The answer,” she said, “is not to do nothing. We can’t afford to do nothing.”