Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-28T18:16:21.442Z Has data issue: false hasContentIssue false
  • English
  • Français

Damage Control: Unintended Pregnancy in the United States Military

Published online by Cambridge University Press:  01 January 2021

Kathryn L. Ponder  and
Melissa Nothnagle
Get access Rights & Permissions [Opens in a new window]

Extract

Military reproductive health policies affect large numbers of women. In 2006 servicewomen numbered nearly 350,000 and comprised 14.5% of active-duty forces and 17.4% of the reserve force. In addition, approximately 165,000 female dependents of active duty military personnel and 157,000 female dependents of reserve duty personnel are between the ages of 12 and 22 and are eligible for military health care services. Dependents of military personnel are eligible for military health care coverage until age 21, or up to the age of 23 if considered a full-time student.

About 10% of active duty female servicemembers become pregnant each year. Pregnant servicewomen are considered non-deployable and are usually not assigned to overseas commands. Pregnant women in the Army, the service branch with the greatest number of women on active duty, can choose to remain on active duty, request temporary leave from service, or request separation from service. Separation options include either discharge, honorable or uncharacterized depending on rank, or transfer to individual ready reserve.

Type
Independent
Information
Journal of Law, Medicine & Ethics , Volume 38 , Issue 2 , Summer 2010 , pp. 386 - 395
Copyright
Copyright © American Society of Law, Medicine and Ethics 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Office of the Deputy Under Secretary of Defense (Military Community and Family Policy), Department of Defense, Profile of the Military Community: 2006 Demographics, 2006, available at <http://cs.mhf.dod.mil/content/dav/mhf/QOL-Library/Project%20Documents/MilitaryHOMEFRONT/Reports/2006%20Demographics.pdf> (last visited May 10, 2010). The Department of Defense defines active duty service branches as the Army, Navy, Marine Corps and Air Force. Reserve duty forces include the Department of Defense's Army National Guard, Army Reserve, Navy Reserve, Marine Corps Reserve, Air National Guard and Air Force Reserve. The figures above do not include the U.S. Coast Guard, which is under the Department of Homeland Security.+(last+visited+May+10,+2010).+The+Department+of+Defense+defines+active+duty+service+branches+as+the+Army,+Navy,+Marine+Corps+and+Air+Force.+Reserve+duty+forces+include+the+Department+of+Defense's+Army+National+Guard,+Army+Reserve,+Navy+Reserve,+Marine+Corps+Reserve,+Air+National+Guard+and+Air+Force+Reserve.+The+figures+above+do+not+include+the+U.S.+Coast+Guard,+which+is+under+the+Department+of+Homeland+Security.>Google Scholar
Id.Google Scholar
Klein, D. A. and Adelman, W. P., “Adolescent Pregnancy in the US Military: What We Know and What We Need to Know,” Military Medicine 173, no. 7 (2008): 658–665; TRICARE Management Activity, Military Health System, available at <http://www.tricare.mil/mybeneft/home/Prescriptions/Medications> (last visited May 3, 2010).CrossRefGoogle Scholar
Government Accountability Office, Report to the Subcommittee on Personnel, Committee on Armed Services, U.S. Senate: Military Personnel: Active Duty Benefits Reflect Changing Demographics, But Opportunities Exist to Improve, September 2002, available at <http://www.gao.gov/new.items/d02935.pdf> (last visited May 3, 2010).+(last+visited+May+3,+2010).>Google Scholar
U.S. Army Center for Health Promotion and Preventive Medicine, HOOAH 4 Health, A Guide to Female Soldier's Readiness, Technical Guide 281, September 2006, available at <http://www.hooah4health.com/deployment/femreadiness.htm> (last visited May 3, 2010). (last visited May 3, 2010).' href=https://scholar.google.com/scholar?q=U.S.+Army+Center+for+Health+Promotion+and+Preventive+Medicine,+HOOAH+4+Health,+A+Guide+to+Female+Soldier's+Readiness,+Technical+Guide+281,+September+2006,+available+at++(last+visited+May+3,+2010).>Google Scholar
See Office of the Deputy Under Secretary of Defense, supra note 1.Google Scholar
See U.S. Army Center for Health Promotion and Preventive Medicine, supra note 5.Google Scholar
Department of the Army, Army Regulation 635–200, Active Duty Enlisted Administrative Separations, December 19, 2003, at 70, available at <http://www.sdmcp.org/Regs/army-enlistedseps.pdf> (last visited May 3, 2010).+(last+visited+May+3,+2010).>Google Scholar
Clark, J. B., Holt, V. L., and Miser, F., “Unintended Pregnancy Among Female Soldiers Presenting for Prenatal Care at Madigan Army Medical Center,” Military Medicine 163, no. 7 (1998): 444–448; Finer, L. B. and Henshaw, S. K., “Disparities in Rates of Unintended Pregnancy in the United States, 1994 and 2001,” Perspectives on Sexual and Reproductive Health 28, no. 2 (2006): 90–96; Robbins, A. S., Chao, S. Y., Frost, L. Z., and Fonseca, V. P., “Unplanned Pregnancy Among Active Duty Servicewomen, US Air Force 2001,” Military Medicine 170, no. 1 (2005): 38–43.CrossRefGoogle Scholar
Navy and Marine Corps Public Health Center: Sexual Health and Responsibility Program (SHARP), Military Sexual Health Indicators, available at <http://www-nehc.med.navy.mil/downloads/healthyliv/sexualhealth/planned_navy.pdf> (last visited May 10, 2010).+(last+visited+May+10,+2010).>Google Scholar
Klein, D. A. and Adelman, W. P., “Adolescent Pregnancy in the US Military: What We Know and What We Need to Know,” Military Medicine 173, no. 7 (2008): 658–665.Google Scholar
Dao, J., “At War: General Backs Of Court-Martial Threat for Pregnant Soldiers,” The New York Times, December 22, 2009, available at <http://atwar.blogs.nytimes.com/2009/12/22/general-backs-off-court-martial-threat-for-pregnant-soldiers/?emc=eta1> (last visited May 10, 2010).Google Scholar
See Government Accountability Office, supra note 4.Google Scholar
Hanna, J. H., “An Analysis of Gynecological Problems Presenting to an Evacuation Hospital During Operation Desert Storm,” Military Medicine 157, no. 5 (1992): 222–224.CrossRefGoogle Scholar
See Government Accountability Office, supra note 4.Google Scholar
Battista, R. M., Creedon, J. F., and Salyor, S. W., “Knowledge and Use of Birth Control Methods in Active Duty Army Enlisted Medical Trainees,” Military Medicine 164, no. 6 (1999): 407–409.CrossRefGoogle Scholar
See Clark, et al. Finer, and Henshaw, , and Robbins, et al., supra note 9.Google Scholar
See Office of the Deputy Under Secretary of Defense, supra note 1.Google Scholar
U.S. Census Bureau, Annual Estimates of the Resident Population by Sex and Selected Age Groups for the United States: April 1, 2000 to July 1, 2008 (NC-EST2008–02), available at <http://www.census.gov/popest/national/asrh/NC-EST2008-sa.html> (last visited May 10, 2010).+(last+visited+May+10,+2010).>Google Scholar
See Office of the Deputy Under Secretary of Defense, supra note 1.Google Scholar
Office of the Deputy Under Secretary of Defense (Military Community and Family Policy), Department of Defense, Profile of the Military Community: 2006 Demographics, 2006, available at <http://cs.mhf.dod.mil/content/dav/mhf/QOL-Library/Project%20Documents/MilitaryHOMEFRONT/Reports/2006%20Demographics.pdf> (last visited May 10, 2010).; U.S. Census Bureau, Annual Estimates of the Resident Population by Sex and Selected Age Groups for the United States: April 1, 2000 to July 1, 2008 (NC-EST2008–02), available at <http://www.census.gov/popest/national/asrh/NC-EST2008-sa.html> (last visited May 10, 2010).+(last+visited+May+10,+2010).;+U.S.+Census+Bureau,+Annual+Estimates+of+the+Resident+Population+by+Sex+and+Selected+Age+Groups+for+the+United+States:+April+1,+2000+to+July+1,+2008+(NC-EST2008–02),+available+at++(last+visited+May+10,+2010).>Google Scholar
Id.Google Scholar
Id.Google Scholar
Id.Google Scholar
Id.Google Scholar
See Office of the Deputy Under Secretary of Defense, supra note 1.Google Scholar
Borsay-Trindle, L. A., Pass, C. M., and Gilzean, S. M., “Unplanned Pregnancy among Active-Duty Army Females as a Readiness Issue,” Military Medicine 156, no. 2 (1991): 82–86.CrossRefGoogle Scholar
Mosher, W. D., Martinez, G. M., Chandra, A., Abma, J. C., and Wilson, S. J., “Use of Contraception and Use of Family Planning Services in the United States: 1982–2002,” National Center for Health Statistics, Vital Health Stat Series, no. 350 (2004).; Wu, J., Meldrum, S., Dozier, A., Stanwood, N., and Fiscella, K., “Contraceptive Nonuse among US Women at Risk for Unplanned Pregnancy,” Contraception 78, no. 4 (2008): 284–289.Google Scholar
Bray, R. M., Rae Olmsted, K. L., Williams, J., Sanchez, R. P., and Hartzell, M., “Progress Toward Healthy People 2000 Objectives among U.S. Military Personnel,” Preventive Medicine 42, no. 5 (2006): 390–396.CrossRefGoogle Scholar
Thomson, B. A. and Nielsen, P. E., “Women's Health Care in Operation Iraqi Freedom: A Survey of Camps with Echelon I or II Facilities,” Military Medicine 171, no. 3 (2006): 216–219.CrossRefGoogle Scholar
Id.Google Scholar
Brown, D., “Ban on Sex for Soldiers in Afghanistan Lifted…Sort Of,” Stars and Stripes, May 15, 2008, available at <http://www.military.com/features/0,15240,167950,00.html?ESRC=dod.nl> (last visited May 3, 2010); Yevich, S., “Preventive Medicine and the Operation Plan,” Military Preventive Medicine: Mobilization and Deployment, Vol.1, available at <http://www.bordeninstitute.army.mil/published_volumes/mpmvol1/pm1ch13.pdf> (last visited May 3, 2010); Abizaid, J. P., United States Central Command, Office of the Commander, Department of Defense, General Order Number 1B, March 13, 2006, available at <http://www.tac.usace.army.mil/deploymentcenter/tac_docs/GO-1B%20Policy.pdf> (last visited May 3, 2010).Google Scholar
Brown, D., “Ban on Sex for Soldiers in Afghanistan Lifted…Sort Of,” Stars and Stripes, May 15, 2008, available at <http://www.military.com/features/0,15240,167950,00.html?ESRC=dod.nl> (last visited May 3, 2010); Yevich, S., “Preventive Medicine and the Operation Plan,” Military Preventive Medicine: Mobilization and Deployment, Vol.1, available at <http://www.bordeninstitute.army.mil/published_volumes/mpmvol1/pm1ch13.pdf> (last visited May 3, 2010).Google Scholar
TRICARE Management Activity, Military Health System, available at <http://www.tricare.mil/mybenefit/home/Prescriptions/Medications> (last visited May 3, 2010).+(last+visited+May+3,+2010).>Google Scholar
Id.Google Scholar
Id.Google Scholar
See Thomson, and Nielsen, , supra note 30.Google Scholar
Mosher, W. D., Martinez, G. M., Chandra, A., Abma, J. C., and Wilson, S. J., “Use of Contraception and Use of Family Planning Services in the United States: 1982–2002,” National Center for Health Statistics, Vital Health Stat Series, no. 350 (2004); United Nations, World Contraceptive Use, 2003, April 2004, available at <http://www.un.org/esa/population/publications/contraceptive2003/wcu2003.htm> (last visited May 3, 2010).Google Scholar
United Nations, World Contraceptive Use, 2003, April 2004, available at <http://www.un.org/esa/population/publications/contraceptive2003/wcu2003.htm> (last visited May 3, 2010).+(last+visited+May+3,+2010).>Google Scholar
See TRICARE, supra note 34.Google Scholar
Duke, M. R. and Ames, G. M., “Challenges of Contraceptive Use and Pregnancy Prevention Among Women in the U.S. Navy,” Qualitative Health Research 18, no. 2 (2008): 244–253; Gehlbach, D., “Talks From the Forum on the Health of Women in the Military: Contraceptive Needs, Complications, and New Directions for Research,” Womens Health Issues 6, no. 6 (1996): 355–358.CrossRefGoogle Scholar
See Thomson, and Nielsen, , supra note 30.Google Scholar
See Battista, et al., supra note 16.Google Scholar
Boatman, J. M. and Dorko, J. J., U.S. Army Maneuver Support Center and Fort Leonard Wood Department of the Army Headquarters, Department of Defense, FLW Regulation No. 350–13, Training: Trainee Conduct, August 15, 2002, available at <http://www.wood.army.mil/doimspt/FLW%20Publications/r350-13.pdf> (last visited May 3, 2010).+(last+visited+May+3,+2010).>Google Scholar
See Thomson, and Nielsen, , supra note 30.Google Scholar
Id.Google Scholar
Thomson, B. A. and Nielsen, P. E., “Women's Health Care in Operation Iraqi Freedom: A Survey of Camps with Echelon I or II Facilities,” Military Medicine 171, no. 3 (2006): 216–219; Hawley-Bowland, C., “Selected Talks From the Forum on the Health of Women in the Military: Epidemiologic Overview of Common Gynecologic Disorders and First-Trimester Complications Among Active-Duty Women,” Womens Health Issues 6, no. 6 (1996): 353–355.CrossRefGoogle Scholar
Duke, M. R. and Ames, G. M., “Challenges of Contraceptive Use and Pregnancy Prevention Among Women in the U.S. Navy,” Qualitative Health Research 18, no. 2 (2008): 244–253.CrossRefGoogle Scholar
Christopher, L. A. and Miller, L., “Women in War: Operational Issues of Menstruation and Unintended Pregnancy,” Military Medicine 172, no. 1 (2007): 9–16; Hawley-Bowland, C., “Selected Talks From the Forum on the Health of Women in the Military: Epidemiologic Overview of Common Gynecologic Disorders and First-Trimester Complications Among Active-Duty Women,” Womens Health Issues 6, no. 6 (1996): 353–355; Luukkainen, T. and Toivonen, J., “Levonorgestrel-Releasing IUD as a Method of Contraception with Therapeutic Properties,” Contraception 52, no. 5 (1995): 269–276; Thomson, B. A. and Nielsen, P. E., “Women's Health Care in Operation Iraqi Freedom: A Survey of Camps with Echelon I or II Facilities,” Military Medicine 171, no. 3 (2006): 216–219.CrossRefGoogle Scholar
Westhoff, C., Jain, J. K., Milsom, I., and Ray, A., “Changes in Weight with Depot Medroxyprogesterone Acetate Subcutaneous Injection 104 mg/0.65 mL,” Contraception 75, no. 4 (2007): 261–267.Google Scholar
See TRICARE, supra note 34.Google Scholar
Hefling, K., “All Bases Required to Offer Morning-After Pill,” Army Times, February 4, 2010, available at <http://www.armytimes.com/news/2010/02/ap_military_emergency_contraception_020410/> (last visited May 10, 2010).Google Scholar
See TRICARE, supra note 34.Google Scholar
Remund, D. D. and Egland, T., Minutes of the Department of Defense Pharmacy and Therapeutics Executive Council Meeting, May 2, 2002, available at <http://www.tricare.mil/Pharmacy/PT_Cmte/archives.htm> (last visited May 3, 2010).; Maze, R., “Emergency Contraception Still Available,” Marine Corps Times, 2007, available at <http://www.marinecorpstimes.com/news/2007/04/military_emergency_contraceptives_070430w/> (last visited May 3, 2010).+(last+visited+May+3,+2010).;+Maze,+R.,+“Emergency+Contraception+Still+Available,”+Marine+Corps+Times,+2007,+available+at++(last+visited+May+3,+2010).>Google Scholar
Text of H.R. 2064: Compassionate Care for Servicewomen Act, available through <http://www.govtrack.us/congress/billtext.xpd?bill=h110-206> (last visited May 3, 2010).+(last+visited+May+3,+2010).>Google Scholar
Mateczun, J. M., U.S. Navy Memorandum, Prescribing, Dispensing, and Distribution of PlanB (Levonorgestrol), February 27, 2007, available at <http://www.med.navy.mil/bumed/womenshealth/Training%20%20Resource%20Files/BUMED%20POLICY%20Plan%20B%20Feb07%20%282%29.pdf> (last visited May 10, 2010).+(last+visited+May+10,+2010).>Google Scholar
Id.Google Scholar
See Hefling, , supra note 52.Google Scholar
See U.S. Army Center for Health Promotion and Preventive Medicine, supra note 5.Google Scholar
See Duke, and Ames, , supra note 48; Christopher, L. A. and Miller, L., “Women in War: Operational Issues of Menstruation and Unintended Pregnancy,” Military Medicine 172, no. 1 (2007): 9–16; Chung-Park, M., “Emergency Contraception Knowledge, Attitudes, Practices, and Barriers Among Providers at a Military Treatment Facility,” Military Medicine 173, no. 3 (2008): 305–312.Google Scholar
See Duke, and Ames, , supra note 48.Google Scholar
Id.Google Scholar
Id.Google Scholar
Vuic, K. D., “‘I'm Afraid We're Going to Have to Just Change Our Ways’: Marriage, Motherhood, and Pregnancy in the Army Nurse Corps during the Vietnam War,” Signs: Journal of Women in Culture and Society 32, no. 4 (2007): 997–1022.CrossRefGoogle Scholar
Id., at 1016.Google Scholar
Roe v. Wade, 410 U.S.113 (1973), available at <http://laws.fndlaw.com/us/410/113.html> (last visited May 4, 2010); see Vuic, , supra note 64.+(last+visited+May+4,+2010);+see+Vuic,+,+supra+note+64.>Google Scholar
Department of Defense Appropriation Act, 1979 § 863, Pub L No 95–457, 92 Stat 1231, 1254 (1978); Crawford, A. E., “Under Siege: Freedom of Choice and the Statutory Ban on Abortions on Military Bases,” University of Chicago Law Review 71, no. 4 (2004): 1549–1582.Google Scholar
Mayer, W., Department of Defense, Department of Defense Policy Regarding Providing Non-Funded Abortions in Outside the Continental United States Military Medical Treatment Facilities, Memorandum for Secretaries of the Military Departments, June 21, 1988, available at <http://www.tricare.mil/policy/memos/abortion.html> (last visited May 4, 2010); Maze, R., “Senate Votes to End Ban on Overseas Abortions,” Army Times, June 21, 2002, available at <http://www.armytimes.com/legacy/new/0-292925-976893.php> (last visited May 4, 2010).; see Crawford, , supra note 67.Google Scholar
Maze, R., “Senate Votes to End Ban on Overseas Abortions,” Army Times, June 21, 2002, available at <http://www.armytimes.com/legacy/new/0-292925-976893.php> (last visited May 4, 2010); see Crawford, , supra note 67.Google Scholar
National Defense Authorization Act for Fiscal Year 1996 § 738, Pub L No 104–106, 110 Stat 186, 384 (1996); see Maze, , supra note 69; Crawford, , supra note 67.Google Scholar
10 USC § 1093(b) (2000); see Crawford, , supra note 67, at 1554.Google Scholar
See U.S. Army Center for Health Promotion and Preventive Medicine, supra note 5.Google Scholar
See Crawford, , supra note 67.Google Scholar
Id.Google Scholar
Id., at 1571.Google Scholar
Department of Defense, Task Force Report on Care for Victims of Sexual Assault, 2004, available at <http://www.defense.gov/News/May2004/d20040513SATFReport.pdf> (last visited May 10, 2010).+(last+visited+May+10,+2010).>Google Scholar
Id.; Skiba, V. and Durham, C., “Challenges of Meeting New Department of Defense Sexual Assault Guidelines,” Military Medicine 172, no. 8 (2007): iv–vi; Valente, S. and Wight, C., “Military Sexual Trauma: Violence and Sexual Abuse,” Military Medicine 172, no. 3 (2007): 259–265; Mullen, C., Washington Coalition of Sexual Assault Programs, “Understanding Sexual Assault in the United States Military Culture,” Connections (Fall/Winter 2005): 10, available at <http://www.wcsap.org/pdf/Connections%20Military.pdf> (last visited May 4, 2010); Lumpkin, J. J., Washington Coalition of Sexual Assault Programs, “Military Sexual Assault Victims Faced Inconsistent System Treatment,” Connections (Fall/Winter 2005): 12, available at <http://www.wcsap.org/pdf/Connections%20Military.pdf> (last visited May 4, 2010).Google Scholar
See Roe v. Wade, supra note 66.Google Scholar
Casey, 505 US at 874.Google Scholar
See Crawford, , supra note 67, at 1564.Google Scholar
Id., at 1570.Google Scholar
See Borsay-Trindle, et al., supra note 27.Google Scholar
Finer, L. B. and Henshaw, S. K., “Disparities in Rates of Unintended Pregnancy in the United States, 1994 and 2001,” Perspectives on Sexual and Reproductive Health 28, no. 2 (2006): 90–96.CrossRefGoogle Scholar
See Crawford, , supra note 67, at 1571.Google Scholar
Speidel, J. J., Harper, C. C., and Shields, W. C., “The Potential of Long-Acting Contraception to Decrease Unintended Pregnancy,” Contraception 78, no. 3 (2008): 197–200.CrossRefGoogle Scholar
See Thomson, and Nielsen, , supra note 30.Google Scholar
Christopher, L. A., and Miller, L., “Women in War: Operational Issues of Menstruation and Unintended Pregnancy,” Military Medicine 172, no. 1 (2007): 9–16.CrossRefGoogle Scholar
Luukkainen, T. and Toivonen, J., “Levonorgestrel-Releasing IUD as a Method of Contraception with Therapeutic Properties,” Contraception 52, no. 5 (1995): 269–276.CrossRefGoogle Scholar
See Thomson, , and Nielsen, , supra note 30.Google Scholar
Halpern, V., Grimes, D.A., Lopez, L. M., and Gallo, M. F., “Strategies to Improve Adherence and Acceptability of Hormonal Methods of Contraception,” Cochrane Database of Systematic Reviews, 2006(1): Art. No.:CD004317; Canto De Cetina, T. E., Canto, P., and Luna, M.O., “Effect of Counseling to Improve Compliance in Mexican Women Receiving Depot-Medroxy-progesterone Acetate,” Contraception 63, no. 3 (2001): 143–146.Google Scholar
Moos, M., Bartholomew, N. E., and Lohr, K. N., “Counseling in the Clinical Setting to Prevent Unintended Pregnancy: An Evidence-Based Research Agenda,” Contraception 67 (2003): 115–132; Lopez, L. M., Steiner, M., Grimes, D. A., and Schulz, K. F., “Strategies for Communicating Contraceptive Effectiveness,” Cochrane Database of Systematic Reviews 2008(2): Art. No.:CD006964; Kirby, D., “The Impact of Programs to Increase Contraceptive Use among Adult Women: A Review of Experimental and Quasi-Experimental Studies,” Perspectives on Sexual and Reproductive Health 40, no. 1 (2008): 34–41.CrossRefGoogle Scholar
Hughes, T. C. and Staren-Doby, D., “Reducing Unintended Pregnancy in Young, Single Active Duty Women in an Overseas Environment,” Military Medicine 168, no. 1 (2003): 11–14.CrossRefGoogle Scholar
Chung-Park, M. S., “Evaluation of a Pregnancy Prevention Programme Using the Contraceptive Behavior Change Model,” Journal of Advanced Nursing 61, no. 1 (2008): 81–91.CrossRefGoogle Scholar
Raymond, E. G., Trussell, J., and Polis, C. B., “Population Effect of Increased Access to Emergency Contraceptive Pills: A Systematic Review,” Obstetrics & Gynecology 109, no. 1 (2007): 181–188.CrossRefGoogle Scholar
See Remund, and Egland, , and Maze, , supra note 54.Google Scholar
Act of Sept 30, 1976 § 209, Pub L No 94–439, 90 Stat 1418, 1434.Google Scholar
See Maze, , supra note 69.Google Scholar
“Roll Call: House Nixes Military Abortions,” Human Events, 59, no. 21 (2003): 22.Google Scholar
See Office of the Deputy Under Secretary of Defense, supra note 1.Google Scholar
See Roll Call, supra note 99, at 1.Google Scholar