Impact of Deployment on Reproductive Health in U.S. Active-Duty Servicewomen and Veterans

Abstract

Reproductive-age women are a fast-growing component of active-duty military personnel who experience deployment and combat more frequently than previous service-era women Veterans. With the expansion of the number of women and their roles, the United States Departments of Defense and Veterans Affairs have prioritized development and integration of reproductive services into their health systems. Thus, understanding associations between deployments or combat exposures and short- or long-term adverse reproductive health outcomes is imperative for policy and programmatic development. Servicewomen and women Veterans may access reproductive services across civilian and military or Veteran systems and providers, increasing the need for awareness and communication regarding deployment experiences with a broad array of providers. An example is the high prevalence of military sexual trauma reported by women Veterans and the associated mental health diagnoses that may lead to a lifetime of high risk-coping behaviors that increase reproductive health risks, such as sexually transmitted infections, unintended pregnancies, and others. Care coordination models that integrate reproductive healthcare needs, especially during vulnerable times such as at the time of military separation and in the immediate postdeployment phase, may identify risk factors for early intervention with the potential to mitigate lifelong risks.

The impact of US policy on contraceptive access: a policy analysis

“…There have also been changes in recent years to military guidelines on healthcare and contraception. The Veterans Access, Choice, and Accountability Act of 2014 expanded healthcare options for veterans with specific “burden[s]” to receive healthcare with “choice” contracted providers [ 58 ]. Specific branches of the military have also introduced new policies impacting the availability of contraception for service members.…”

“…Several policy changes have also increased contraceptive appropriateness for military members and veterans. The VA Mission Act of 2018 increased the appropriateness of care by providing continuing education for community providers who serve veterans [ 58 ]. Similarly, in 2019, the Defense Health Agency [ 84 ] established procedures for comprehensive contraceptive counseling with Military Health System beneficiaries through the policy entitled Comprehensive Contraceptive Counseling and Access to the Full Range of Methods of Contraception.…”

Policy impacts on contraceptive access in the United States: a scoping review

“…The Veterans Access, Choice, and Accountability Act of 2014 expanded healthcare options for veterans with specific burdens by allowing them to receive healthcare with choice contracted providers (Gawron et al, 2018). Studies exploring the impact of this Act showed that it increased provider education and patient healthcare access, including reproductive healthcare access, especially in rural areas (Albanese, 2018;Hussey et al, 2016;Mattocks et al, 2017;Stroupe et al, 2019).…”