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Semin Reprod Med 2019; 37(05/06): 211-214
DOI: 10.1055/s-0039-3400461
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contraception and Unintended Pregnancy in the Military Healthcare System

Ryan J. Heitmann
1   Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington
› Author Affiliations Funding None.
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Publication History

Publication Date:
04 February 2020 (online)

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Abstract

The number of women serving in the Armed Forces is growing and readiness has been decreed as the number 1 priority for the total Army. Provision of contraception and unintended pregnancy rates higher than the general population are two key factors in readiness of female soldiers. An in-depth review of women's healthcare in the military identified these two areas of women's health as greatly understudied. Long-acting reversible contraception provides effective and cost-efficient method for contraception and a proven way to decrease unintended pregnancy. Increased research and focus into these two areas of women's health is crucial to providing the best care for our female service members.

Keywords

contraception - unintended pregnancy - military service women
 

  • References

  • 1 United States Department of Defense. FY 2007 population representation in the military services. 2007 . Available at: http://prhome.defense.gov/portals/52/Documents/POPREP/poprep2007/download/ExecSum2007.pdf . Accessed September 15, 2013
    PubMedGoogle Scholar
  • 2 Bean-Mayberry B, Huang C, Batuman F. , et al. Systematic Review of Women Veterans Health Research 2004–2008. 2010 . Available at: http://www.ncbi.nlm.nih.gov/books/NBK49180/ . Accessed August 8, 2013
    PubMedGoogle Scholar
  • 3 Hale T. CSA Milley: ‘Readiness is my No. 1 priority’. 2016. Available at: https://www.army.mil/article/166838/csa_milley_readiness_is_my_no_1_priority . Accessed August 15, 2018
    PubMedGoogle Scholar
  • 4 Yablonsky A, Martin R, Highfill-McRoy R. , et al. Military women's health: A scoping review and gap analysis, 2000–2015 (Report No. N15–015). Silver Spring: Naval Medical Research Center; 2017
    PubMedGoogle Scholar
  • 5 Committee on Health Care for Underserved Women, American College of Obstetricians and Gynecologists. Committee Opinion No. 547: health care for women in the military and women veterans. Obstet Gynecol 2012; 120 (06) 1538-1542
    CrossrefPubMedGoogle Scholar
  • 6 Tepe V, Yarnell A, Nindl BC, Van Arsdale S, Deuster PA. Women in combat: summary of findings and a way ahead. Mil Med 2016; 181 (1, Suppl): 109-118
    CrossrefPubMedGoogle Scholar
  • 7 Modi MN, Heitmann RJ, Armstrong A. Unintended pregnancy and the role of long-acting reversible contraception. Expert Rev OB & GYN. 2013; 8 (06) 549-558
    CrossrefPubMedGoogle Scholar
  • 8 Centers for Disease Control and Prevention. Unintended Pregnancy. 2013 . Available at: http://www.cdc.gov/reproductivehealth/unintendedpregnancy/ . Accessed July 25, 2013
    PubMedGoogle Scholar
  • 9 Santelli J, Rochat R, Hatfield-Timajchy K. , et al; Unintended Pregnancy Working Group. The measurement and meaning of unintended pregnancy. Perspect Sex Reprod Health 2003; 35 (02) 94-101
    CrossrefPubMedGoogle Scholar
  • 10 Finer LB, Sonfield A. The evidence mounts on the benefits of preventing unintended pregnancy. Contraception 2013; 87 (02) 126-127
    CrossrefPubMedGoogle Scholar
  • 11 Finer LB, Zolna MR. Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception 2011; 84 (05) 478-485
    CrossrefPubMedGoogle Scholar
  • 12 Clark JB, Holt VL, Miser F. Unintended pregnancy among female soldiers presenting for prenatal care at Madigan Army Medical Center. Mil Med 1998; 163 (07) 444-448
    CrossrefPubMedGoogle Scholar
  • 13 Goyal V, Borrero S, Schwarz EB. Unintended pregnancy and contraception among active-duty servicewomen and veterans. Am J Obstet Gynecol 2012; 206 (06) 463-469
    CrossrefPubMedGoogle Scholar
  • 14 Grindlay K, Grossman D. Unintended pregnancy among active-duty women in the United States military, 2008. Obstet Gynecol 2013; 121 (2, Pt 1): 241-246
    CrossrefPubMedGoogle Scholar
  • 15 Holt K, Grindlay K, Taskier M, Grossman D. Unintended pregnancy and contraceptive use among women in the U.S. military: a systematic literature review. Mil Med 2011; 176 (09) 1056-1064
    CrossrefPubMedGoogle Scholar
  • 16 Lindberg LD. Unintended pregnancy among women in the US military. Contraception 2011; 84 (03) 249-251
    CrossrefPubMedGoogle Scholar
  • 17 Robbins AS, Chao SY, Frost LZ, Fonseca VP. Unplanned pregnancy among active duty servicewomen, U.S. Air Force, 2001. Mil Med 2005; 170 (01) 38-43
    CrossrefPubMedGoogle Scholar
  • 18 Heitmann RJ, Batig AL, Levy G. , et al. Unintended pregnancy in the Military Health Care System: Who is really at risk?. Mil Med 2016; 181 (10) 1370-1374
    CrossrefPubMedGoogle Scholar
  • 19 Heitmann RJ, Mumford SL, Hill MJ, Armstrong AY. Estimated economic impact of the levonorgestrel intrauterine system on unintended pregnancy in active duty women. Mil Med 2014; 179 (10) 1127-1132
    CrossrefPubMedGoogle Scholar
  • 20 Cheng D, Schwarz EB, Douglas E, Horon I. Unintended pregnancy and associated maternal preconception, prenatal and postpartum behaviors. Contraception 2009; 79 (03) 194-198
    CrossrefPubMedGoogle Scholar
  • 21 Dye TD, Wojtowycz MA, Aubry RH, Quade J, Kilburn H. Unintended pregnancy and breast-feeding behavior. Am J Public Health 1997; 87 (10) 1709-1711
    CrossrefPubMedGoogle Scholar
  • 22 Shah PS, Balkhair T, Ohlsson A, Beyene J, Scott F, Frick C. Intention to become pregnant and low birth weight and preterm birth: a systematic review. Matern Child Health J 2011; 15 (02) 205-216
    CrossrefPubMedGoogle Scholar
  • 23 Belmont Jr PJ, Goodman GP, Waterman B, DeZee K, Burks R, Owens BD. Disease and nonbattle injuries sustained by a U.S. Army Brigade Combat Team during Operation Iraqi Freedom. Mil Med 2010; 175 (07) 469-476
    CrossrefPubMedGoogle Scholar
  • 24 Fanarjian N, Drostin C, Garrett J, Montalvo A. Does the provision of free intrauterine contraception reduce pregnancy rates among uninsured low-income women? A cohort study: a two North Carolina clinics. Contraception 2012; 85 (02) 160-165
    CrossrefPubMedGoogle Scholar
  • 25 Winner B, Peipert JF, Zhao Q. , et al. Effectiveness of long-acting reversible contraception. N Engl J Med 2012; 366 (21) 1998-2007
    CrossrefPubMedGoogle Scholar
  • 26 Grindlay K, Grossman D. Contraception access and use among U.S. servicewomen during deployment. Contraception 2013; 87 (02) 162-169
    CrossrefPubMedGoogle Scholar
  • 27 Chiles DP, Roberts TA, Klein DA. Initiation and continuation of long-acting reversible contraception in the United States military healthcare system. Am J Obstet Gynecol 2016; 215 (03) 328.e1-328.e9
    CrossrefPubMedGoogle Scholar
  • 28 Erickson AK, Nelson DA, Shaw JG, Loftus PD, Kurina LM, Shaw KA. Long-acting reversible contraceptive placement among active-duty U.S. Army servicewomen. Obstet Gynecol 2017; 129 (05) 800-809
    CrossrefPubMedGoogle Scholar
  • 29 Witkop CT, Webber BJ, Chu KM, Clark LL. Contraceptive prescriptions for US servicewomen, 2008-2013. Contraception 2017; 96 (01) 47-53
    PubMedGoogle Scholar
  • 30 Battista RM, Creedon Jr JF, Salyer SW. Knowledge and use of birth control methods in active duty Army enlisted medical trainees. Mil Med 1999; 164 (06) 407-409
    CrossrefPubMedGoogle Scholar
  • 31 Chung-Park MS. Contraceptive decision-making in military women. Nurs Sci Q 2007; 20 (03) 281-287
    CrossrefPubMedGoogle Scholar
  • 32 Manski R, Grindlay K, Burns B, Holt K, Grossman D. Reproductive health access among deployed U.S. servicewomen: a qualitative study. Mil Med 2014; 179 (06) 645-652
    CrossrefPubMedGoogle Scholar
  • 33 Christopher LA, Miller L. Women in war: operational issues of menstruation and unintended pregnancy. Mil Med 2007; 172 (01) 9-16
    CrossrefPubMedGoogle Scholar
  • 34 Nielsen PE, Murphy CS, Schulz J. , et al. Female soldiers' gynecologic healthcare in Operation Iraqi Freedom: a survey of camps with echelon three facilities. Mil Med 2009; 174 (11) 1172-1176
    CrossrefPubMedGoogle Scholar
  • 35 Thomas MD, Thomas PJ, Garland FC. Contraceptive use and attitudes toward family planning in Navy enlisted women and men. Mil Med 2001; 166 (06) 550-556
    CrossrefPubMedGoogle Scholar
  • 36 Deans EI, Batig AL, Cordes S. , et al. a survey of family planning training, knowledge, and practices among health care providers within the military health system at Joint Base Lewis-McChord. Mil Med 2019; 184 (5-6): e394-e399
    CrossrefPubMedGoogle Scholar
  • 37 Carty JR, Batig TS, Heitmann RJ, Hammons CB, Batig AL. Women's health and contraceptive practices of Army physician assistants. Mil Med 2018
    PubMedGoogle Scholar
  • 38 Heitmann RJ, Hammons CB, Batig AL. Women's health knowledge and skills among transitional year internship-trained Military Medical Officers serving as independent health care providers. Mil Med 2017; 182 (07) e1808-e1814
    CrossrefPubMedGoogle Scholar
  • 39 ESHRE Capri Workshop Group. Intrauterine devices and intrauterine systems. Hum Reprod Update 2008; 14 (03) 197-208
    CrossrefPubMedGoogle Scholar
  • 40 American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 121: Long-acting reversible contraception: Implants and intrauterine devices. Obstet Gynecol 2011; 118 (01) 184-196
    CrossrefPubMedGoogle Scholar
  • 41 Harrington LA, Shaw KA, Shaw JG. Contraception in US servicewomen: emerging knowledge, considerations, and needs. Curr Opin Obstet Gynecol 2017; 29 (06) 431-436
    CrossrefPubMedGoogle Scholar
  • 42 Adams KL. Operation PINC: process improvement for non-delayed contraception. Mil Med 2017; 182 (11) e1864-e1868
    CrossrefPubMedGoogle Scholar