Expert reviewGeneral gynecologyUnintended pregnancy and contraception among active-duty servicewomen and veterans
Section snippets
Existing military health care structure
The DOD provides medical benefits for active duty personnel, retirees, Reservists, and National Guard members called to active duty, and certain dependents under the worldwide health care plan called TRICARE. Under TRICARE, most health care is provided by a military treatment facility.12 Military personnel covered by TRICARE may be referred to a civilian medical provider if care is unavailable at the local military treatment facility or if they live and work more than 50 miles from the nearest
Reproductive health needs of military women
Active-duty and veteran women are largely of childbearing age. Approximately 75% of new military recruits are younger than 22 years of age.19 In total, 42% of all female veterans are currently of childbearing age, and more than 90% of female veterans who served after Sept. 11, 2001, are between 18 and 44 years of age.18 These women have reproductive health issues that may not be typically thought of when considering military and veteran health care.
Because of its potentially high burden for
The burden of unintended pregnancy
Although all members of the US armed forces are prohibited from engaging in sexual intercourse outside marriage,24 when surveyed, unmarried service personnel do endorse sexual activity.25, 26, 27, 28, 29 The specific context of these sexual encounters is unknown but may occur in violation of military policy, during vacation from active duty,30 while under the influence of alcohol or drugs,29 or be forced.27 Because sexual intercourse is prohibited in most situations, active-duty personnel often
The burden of unintended pregnancy
Unlike in the active-duty population, there are no published data regarding the prevalence of unintended pregnancy among women veterans. However, women veterans share many of the risk factors for unintended pregnancy found among active-duty servicewomen and civilian women. Similar to active-duty servicewomen, women veterans are predominantly unmarried, have lower educational levels, and disproportionately represent racial and ethnic minorities, all of which are associated with unintended
Comment
The population of active-duty servicewomen and women veterans of child-bearing age is growing. Given the existing health care structure, health care providers in the military, at VA medical centers, and within the civilian community must work together to care for these women. Data reveal that, compared with the civilian population, military women are at relatively high risk for unintended pregnancy. This may be because women in the military are predominantly young, are unmarried, have lower
References (71)
- et al.
A policy of discrimination: reproductive health care in the military
Womens Health Issues
(2011) - et al.
Abortion restrictions in the US military: voices from women deployed overseas
Womens Health Issues
(2011) - et al.
Knowledge and attitudes about emergency contraception in a military population
Obstet Gynecol
(2000) - et al.
Army women's reasons for condom use and nonuse
Womens Health Issues
(2008) - et al.
Evaluation of a cognitive-behavioral, group, randomized controlled intervention trial to prevent sexually transmitted infections and unintended pregnancies in young women
Prev Med
(2005) Military women's menstrual experiences and interest in menstrual suppression during deployment
J Obstet Gynecol Neonatal Nurs
(2007)- et al.
Menstrual suppression for combat operations: advantages of oral contraceptive pills
Womens Health Issues
(2011) - et al.
Intimate partner violence victimization among women veterans and associated heart health risks
Womens Health Issues
(2011) - et al.
Pregnancy coercion, intimate partner violence and unintended pregnancy
Contraception
(2010) - et al.
Prescription of teratogenic medications in United States ambulatory practices
Am J Med
(2005)
Women veterans' reproductive health preferences and experiences: a focus group analysis
Womens Health Issues
Availability of gynecologic services in the department of veterans affairs
Womens Health Issues
Veterans: definitions and conceptsUS Census Bureau [Internet]
Dictionary of military termsDepartment of Defense [Internet]
Systematic review of women veterans health research, 2004-2008Department of Veterans Affairs, 2010 [Internet]
Statistics on women in the militaryWomen in Military Service for America Memorial Foundation, Inc, 2010 [Internet]
Post-9/11 women veterans
Creating a sampling frame for population-based veteran research: representativeness and overlap of VA and Department of Defense databases
J Rehabil Res Dev
Integration of women veterans into VA quality improvement research efforts: what researchers need to know
J Gen Intern Med
Department of Veterans Affairs health care overviewDepartment of Veterans Affairs, 2009 [Internet]
Projected female veteran population 17 years and older: 2000 to 2036Department of Veterans Affairs, 2007 [Internet]
Women's health issuesDepartment of Defense Health Affairs, 1993 [Internet]
Women veterans health care: about the programDepartment of Veterans Affairs, 2011 [Internet]
Military advantageTRICARE prime overview
Military advantageTRICARE prime overview
Prepared statement of Karen H. Seal, MD, MPH, Deparment of Medicine and Psychiatry, San Francisco Department of Veterans Affairs Medical Center, Veterans Health Administration, US Department of Veterans AffairsHouse Committee on Veterans Affairs, 2011 [Internet]
Access to care for women veterans: delayed healthcare and unmet need
J Gen Intern Med
FY 2007 population representation in the military services: Department of Defense, 2007 [Internet]
Unintended pregnancy rates among a US military population
Paediatr Perinat Epidemiol
Unplanned pregnancy among active duty servicewomen, US Air Force, 2001
Mil Med
Uniform Code of Military JusticeArticle 120: rape and carnal knowledge
Adolescent pregnancy in the US military: what we know and what we need to know
Mil Med
Cited by (0)
The project described was supported by Award K12HD050108 from the Office of the Director, National Institutes of Health, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
The views expressed herein are solely those of the authors and do not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health.
The authors report no conflict of interest.