Jaime Slaughter-Acey was in a state of shock and anger when she learned that her National Institutes of Health (NIH)-funded study on birth outcomes in Black families was cancelled this spring. The University of North Carolina at Chapel Hill associate professor in epidemiology said that she felt like “the rug was pulled out from under us” when the university called her to share the news. The termination notice said that the study no longer met the agency’s priorities and didn’t promise to increase life expectancy.
“It was heartbreaking,” Slaughter-Acey told the Guardian, “and honestly, infuriating given the high rates of maternal and infant mortality in this country.”
The cancellation came as the Trump administration terminated 1,902 NIH grants totalling more than $4.4bn between his January inauguration and the end of July, according to Grant Witness data. NIH followed guidance from the so-called “department of government efficiency” (Doge) and Trump’s executive orders to cut costs. Additionally, in April, the Trump administration let go of a majority of the staff at the federal Division of Reproductive Health, a Centers for Disease Control and Prevention (CDC) office that collects data on maternal experiences. It also surveils pregnancy-related deaths in an effort to reduce infant mortality and improve health outcomes for mothers and their children.
Slaughter-Acey’s several-year study funded by a more than $2.4m NIH grant aimed to look at how social and biological factors affect outcomes for more than 500 Black women in Detroit. The grant termination froze the team’s more than $581,000 remaining funding. Through blood samples and surveys of Black mothers and grandmothers, Slaughter-Acey and her team aimed to understand if social environments accelerated how bodies physiologically age, otherwise known as biological ageing, which may lead to adverse pregnancy outcomes for Black women. She said that the research is “designed to tell us how social environment and the pathways that social environment affects us physiologically, to then increase this risk that Black moms and Black babies have with respect to pregnancy”.
While most studies that look at racism only focus on one point in time, Slaughter-Acey said that hers was “the first study to comprehensively examine how exposure to structural, cultural and intergenerational racism throughout a Black woman’s life impacts her epigenome and her child’s birth outcomes.” It was also innovative because Black women are underrepresented in epigenomic studies, a field where researchers look at how environment and behavior impacts a person’s genes, said Slaughter-Acey, due to medical mistrust and experiences of racism in the healthcare system.
‘When science is silenced, communities suffer’
The NIH-grant cancellation in late March followed the release of data from the CDC revealing that Black women were the only race or ethnic group who didn’t experience a decline in deaths from pregnancy related causes in 2023. Out of every 100,000 live births, 50.3 Black mothers died, compared with 14.5 deaths for white people, 12.4 for Latinos and 10.7 for Asians. The NIH didn’t respond to a request for comment.
Slaughter-Acey fears that the grant-cancellation signals that research and efforts to close the maternal death gap are at risk of coming to a standstill under the Trump administration. Other NIH grants that have been terminated include one that looked at prenatal exposure to public drinking water contaminants and a study that analyzed why women of color die of cervical cancer at a disproportionate rate. On Thursday, the Trump administration froze UCLA research grants from federal agencies including NIH and the National Science Foundation totaling nearly $200m, accusing the university of antisemitism and discrimination in admissions.
“It’s part of a larger pattern of political interference in science that puts the health of all people at risk, especially vulnerable populations,” Slaughter-Acey said. The study “is about understanding the root causes of poor maternal and infant health in this country – something that affects all of us, regardless of race or background. When science is silenced, communities suffer”.
Still, Slaughter-Acey and her team are hopeful that the study will continue for years to come as they search for alternative funding sources, including donations. On Slaughter-Acey’s LinkedIn page, she called upon her followers to donate to the University of North Carolina Department of Epidemiology, and to include a note that they support Slaughter-Acey’s work, or the name of the study, “LIFE-2”.
“The voices of these 500 plus moms and babies should not die or be silenced with the termination of this grant,” she told the Guardian. The pull in funding “is an example of erasure of black mothers and infants”.
There has been some temporary relief. This June, Slaughter-Acey’s team received short-term funding from Michigan State University to continue their study over the next few months. Now nearly 600 moms are enrolled in the study, but without additional funding, it will probably pause again at the end of the year.
‘We need research that reflects Black women’s experiences’
The nearly 600 women who have joined the study were recruited from local delivery hospitals in Detroit, Michigan, in the day or two following childbirth. Slaughter-Acey chose Detroit since she completed her post-doc at the University of Michigan, where she researched the influence of social environments on Black maternal health. Participants for her study, which began in 2021, completed a post-delivery survey where they answered questions about social determinants of health including housing and food insecurity throughout their life.
Along with collecting their blood through a finger prick, researchers also collect the babies’ and mothers’ birth certificates from the state health department as well as the mothers’ blood that was collected at birth and stored in a biobank. About 20% of the babies’ grandmothers are also participating in the study by answering questions about the social environment during their pregnancies and their daughters’ early childhoods.
The multilevel data collection allows the researchers to create “this robust and triangulated dataset that includes social determinants of health, like information about food and housing insecurity”, Slaughter-Acey said. “It’s capturing a more holistic view than what’s been captured previously for moms in terms of maternal and infant health.”
After the moms are discharged from the hospital, the researchers also follow up with a majority of the women eight to 10 weeks after they give birth to ask about their adjustment to motherhood, whether they’ve received support for breastfeeding, a postpartum healthcare visit, or if they’ve experienced discrimination from their healthcare providers.
At the time of the funding termination, the research team was in the process of creating a 12-month postpartum checkup with the mothers to help define maternal thriving. “When we are talking about maternal morbidity and mortality, we’re defining maternal health by the absence of disease, by mom not dying, by mom not having a severe morbidity,” Slaughter-Acey said. “But the field in general does not have a good understanding or even definition of, ‘what does maternal thriving look like?’ And we need to get past this conversation of maternal survival, and move to thriving.”
More than two years of funding remained in the NIH grant, during which her team had planned to recruit more mothers and to conduct data analysis. They also aimed to create a website for participants to read about the study’s findings.
But the data that the team has analyzed thus far has revealed that mothers with a lot of adverse childhood experiences were more likely to have conflict with the father of the child. The finding, Slaughter-Acey said, “underscores the importance of understanding how the social environment influences relationship dynamics and maybe perinatal outcomes. We know that social support is key during pregnancy”.
The team also found that one in five study participants experienced housing insecurity during their pregnancy, a factor that she said greatly affects perinatal health and is rarely documented in hospital records. They also created a tool to measure racial microagressions from healthcare providers and in the mothers’ everyday life, since many in the cohort said that they experienced harmful interactions that Slaughter-Acey said may explain why they felt unsupported.
For Slaughter-Acey, the study findings “highlight how structural inequities – across housing, healthcare, and personal history – intersect to shape maternal and infant outcomes. And they underscore why we need research that listens to and reflects the full complexity of Black women’s experiences.”
NIH research funding will probably continue to take a hit under the Trump administration. A new Trump administration policy requiring that multiyear grants be paid upfront lowers the odds that a research proposal will be accepted. As a result, university labs may close.