A new study set out to determine the pregnancy rate among active-duty military women in 2008 and compare it to the rate in 2005 and the rate among the US population. The study was conducted by researchers affiliated with the University of California, San Francisco. They published their findings in the February edition of the journal Obstetrics and Gynecology.
The researchers note that in the US, 49% of pregnancies are unintended, meaning that they are mistimed, unplanned, or unwanted. Unintended pregnancy is an important public health issue, because it may lead to negative maternal and child health outcomes, including low birth weight and preterm birth, lower rates of breastfeeding, and postpartum depression. For these reasons, the US Department of Health and Human Services identified reducing unintended pregnancy as a national goal in its Healthy People campaign, a set of 10-year national benchmarks and objectives for health promotion and disease prevention. The authors note that unintended pregnancy among women in the US military may have additional consequences, affecting both women’s careers and negatively affecting troop readiness because pregnant women cannot be deployed and must be evacuated from theater if already overseas. With 97% of women in the US military of reproductive age and a growing proportion of active-duty personnel that is female, these issues are of major importance.
For the study, the researchers accessed cross-sectional data came from the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel (Health Related Behaviors Survey). Unintended pregnancy rates per 1,000 women were calculated and compared with rates reported in the 2005 Health Related Behaviors Survey. The age-standardized unintended pregnancy rate was calculated to adjust for differences in age composition between the military and US populations for better comparison with the general U.S. rate.
The researchers found that 11% of women reported an unintended pregnancy in the prior 12 months. The 2008 self-reported unintended pregnancy rate was 105 per 1,000 women, an increase from 2005 (97/1,000 women). Younger, less educated, nonwhite, and married or cohabitating women had significantly higher rates of unintended pregnancy compared with their counterparts. Rates did not differ between women deployed in the prior 12 months and non-deployed women. The age-standardized rate was 78 per 1,000 women, which is 50% higher than the general U.S. population (52/1,000 women).
The authors concluded that unintended pregnancy rates in the military are high and have increased in most key subgroups since the 2005 survey. They noted that efforts are needed to help servicewomen prevent unintended pregnancy, including during deployment.
The authors noted that the majority of respondents to the survey were not counseled on contraception for pregnancy prevention or menstrual suppression as part of their pre-deployment preparations, and some faced barriers to accessing a method while overseas. These overseas barriers included care-seeking stigma and logistic obstacles that made it challenging to visit a healthcare provider as well as a limited amount of contraceptive supplies given at a time to women for deployment. Another factor deterring some women from seeking contraception was confusion about prohibition of sexual activity. Although consensual sexual activity among members of the same rank is legal, current military regulations make sexual relationships a chargeable offense in a number of circumstances. Confusion or concern about these laws led some women to believe they could not access contraception or would not need contraception. Another factor that may contribute to the high rates is the high prevalence of sexual assault. An estimated 20–43% of servicewomen experience rape or attempted rape during their military career.