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Unintended pregnancies on the rise in servicewomen

By Genevra Pittman

NEW YORK (Reuters Health) - Just over ten percent of women in the military said in 2008 they'd had an unintended pregnancy in the last year - a figure significantly higher than rates in the general public, according to a new study.

The findings come amid news that the Pentagon will lift the ban on women in front-line combat jobs starting in 2016.

"It does definitely have implications for troop readiness, ability to deploy (and) troops in combat missions if they are potentially at high risk for unintended pregnancy and pregnant women can't be deployed," said Dr. Vinita Goyal, who has studied unintended pregnancy in female veterans at Warren Alpert Medical School of Brown University in Providence, Rhode Island.

Access to birth control can be a problem for troops deployed for long periods of time - and if women do become pregnant, abortion is legally restricted on U.S. military bases. Women who get pregnant while overseas must be evacuated.

Dr. Daniel Grossman from the University of California, San Francisco, who worked on the study, called the rates of unintended pregnancy "really shocking."

"Women in the military certainly deserve more than that. This needs to be addressed across all branches of the military," he said.

The Pentagon could not provide a comment by deadline.

Grossman's results are based on surveys of more than 7,000 active-duty women, between 18 and 44 years old, conducted in 2008, the last such available survey. About 800 of the women said they'd had an unintended pregnancy in the previous year - including a similar proportion of deployed and non-deployed women.

In total, about 900 women had been unable to deploy in the past year due to a pregnancy, whether intentional or unintended, according to findings published in February's Obstetrics & Gynecology.

The rate of unintended pregnancy - 105 for every 1,000 women - was a small increase over the rate in 2005 of 97 per 1,000 servicewomen. That figure is also 50 percent higher than rates of unintended pregnancy among similarly aged women the general, non-military public.

"Clearly unintended pregnancy is an important public health problem for everyone. It seems particularly important for the military population because obviously it can disrupt a woman's career," Grossman said.

He said confusion and concern over military policies on sexual activity may affect women's access to contraception.

Consensual sex among members of the same rank is legal. But women may be afraid to ask for condoms, for example, for fear people will think they are violating policy, Goyal, who wasn't involved in the new research, told Reuters Health.

Sexual assault in the military may be another contributor to high rates of unintended pregnancy, the researchers noted.

"There are studies showing anywhere between 20 and 40 percent of servicewomen (experience) rape or attempted rape during their military career, and the vast majority don't report it," Grossman, who is also the vice president for research at Ibis Reproductive Health, told Reuters Health.

According to data from the Department of Defense, there were between two and three sexual assaults for every 1,000 active duty soldiers, men and women, reported in 2011.

Earlier this month, laws were amended to allow the military health care program TRICARE to cover abortions for victims of rape or incest. Abortion remains illegal at military bases for reasons other than rape, incest and when a woman's life is in danger.

Grossman said contraception should be discussed with military women before they deploy - as is now policy in the Navy - and those women should at least be allowed to pay out of pocket for abortion while on U.S. bases.

"These women should have access to the same services that they could access if they were here in the U.S.," he said.

SOURCE: http://bit.ly/V82WWC Obstetrics & Gynecology, February 2013.

(This story was refiled to clarify paragraph 17 to reflect that new law changes when military insurance covers abortion, not when abortions may be performed at military bases)

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