Military women need better reproductive care at no cost

At a recent military conference, an Air Force pilot said that she and her husband, also an Air Force pilot, paid $20,000 to have a family. They call their twins their deployment babies because they used the money they saved from a deployment to pay for in vitro fertilization treatments. This was just one of many similar stories that emerged during a research effort conducted by the Service Women’s Action Network into the reproductive needs of service women and women veterans. Our findings show that military women from all eras have high rates of infertility, yet they receive very little support from the military or the Veterans Health Administration.

The three categories of reproductive care studied were access to birth control, to infertility services, and to abortion care. Two conclusions merit immediate attention. The first finding is the high rate of infertility among military women. More than 30 percent of military women reported having problems getting pregnant when actively trying to do so, with the highest percentage coming from military women currently serving. This figure is dramatically higher than the national average which, according to the Centers for Disease Control, sits at around 12 percent for civilian women.

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Unfortunately for military women, treatment options are limited by cost, location, and accessibility. Only six military hospitals offer the full range of infertility treatments, but they have long waits lists. Moreover, service women have to pay some of the costs for their own treatment. A service woman who is not able to get care at one of the six designated treatment facilities must use Tricare insurance at a civilian provider. However, Tricare limits coverage to some tests and procedures, and it excludes in vitro fertilization. Service women report paying between $15,000 and $20,000 for just one round of in vitro fertilization treatment.

Women veterans are even more limited in their options for reproductive care. In order to get any kind of Veterans Health Administration infertility care, a woman veteran must be able to show that her infertility is service connected. If she is unable to establish service connected infertility, she will be treated on a random basis depending on the veterans hospital and the provider that she sees. Some are totally denied care, while others receive limited care. None will receive in vitro fertilization treatments.

Interviews show that women who reported infertility believe that their infertility may be the result of military service and related to exposure to toxins on the job, during deployments, and on military installations where they live. One infertile woman officer who had three deployments to Iraq believes contaminated water, overheated plastic water bottles, and poor air quality due to burn pits and other air pollutants might be to blame.

Poorly fitted equipment in the form of oversized body armor designed for men but issued to women was linked to the infertility of another woman veteran. She reported that she wore heavy plates that pressed into her abdomen while riding for extended periods in moving vehicles in Iraq. This caused abdominal hernias and has resulted in her inability to carry a baby to term. This data calls for more research to pinpoint the reasons for high levels of infertility among military women. Meanwhile, those who present fertility problems that are likely a result of military service should have access to all available infertility testing and treatment at no cost.

The second major finding is that care is impacted by military rank. Enlisted service women reported lower access to their preferred method of birth control and higher rates of unintended pregnancies. Unfortunately, the only medical option available to military women who have unintended pregnancies is limited to carrying the baby to term, unless the pregnancy was the result of rape or incest or if the life of the mother is in danger.

One woman said that when she was a private living in the barracks, the cost of an abortion was her pay for a month. When she had complications after the procedure, she was treated like she had done something wrong for seeking care that was not available in the military. Women who are stationed overseas have an even tougher time, especially in countries where abortions are illegal. They must risk going to unregulated clinics or pay to leave the country, pay for the abortion, and then return to duty.

Military women selflessly take on risky jobs to protect our nation, delay having families for operational reasons, and struggle to know what to do when they have unintended pregnancies in order to be mission ready. They should receive access to all forms of reproductive care at no cost.

Ellen Haring, a West Point graduate and retired Army colonel, is the chief executive officer of the Service Women’s Action Network. Haring is also a senior fellow and director of the Combat Integration Initiative at Women in International Security and an adjunct professor at Georgetown University.