The unplanned pregnancy rate among active-duty women in the military is high and on the rise, according to a new study that analyzed Department of Defense survey data.
"It's significantly higher than in the United States population, and it seems higher than the rate in 2005," study author Daniel Grossman, an assistant clinical professor in obstetrics, gynecology and reproductive sciences a the University of California San Francisco and vice president for research at Ibis Reproductive Health, told The Huffington Post.
"It's counterintuitive. This population has really good access to medical care," he continued. "It's concerning that, perhaps, contraceptive access is still a problem."
Grossman and his colleagues analyzed a sample of more than 7,000 women, aged 18 to 44, who had answered questions about pregnancy as part of a 2008 Department of Defense survey of health behaviors among each service branch. The findings, which they compared to the previous survey, conducted in 2005, were published in the February issue of the journal Obstetrics and Gynecology, released Wednesday.
Overall, 10.5 percent of women in the latest survey said they'd had an unplanned pregnancy in the past year. That is higher than the 2005 rate of 9.7 percent and -- when adjusted for age -- also substantially higher than national estimates, the authors claim. The age-adjusted unintended pregnancy rate in 2008 was 78 per 1,000 women, according to the new study. That number is 50 percent higher than the unplanned pregnancy rate in the general population, which recent estimates put at 52 per 1,000 women. Younger, less educated, nonwhite and married or co-habitating women had the highest rates of unintended pregnancy.
The new study is also among the first to look at unplanned pregnancies in deployed women. The unplanned pregnancy rate among women who went overseas was on par with those who had not. That means, the authors write, that efforts to improve pregnancy prevention need to happen among all active-duty servicewomen, at home bases and during deployment. Unplanned pregnancy also prevented deployment for many women. Overall, 11 percent of female service personnel scheduled to ship out were not able to in the previous year because of a pregnancy.
The researchers speculate that there are many factors driving the high rates of unintended pregnancy. Most forms of birth control are covered by TRICARE, the military health insurance program, but a survey Grossman's team conducted in 2011 revealed significant barriers to access. Some 60 percent of women who had been deployed did not speak with a military provider about their contraceptive options before leaving, and 41 percent who had a prescription requiring refills said those refills were difficult to get. That study also revealed widespread confusion among deployed women over what military regulations say with regards to sexual activity, which means many women may not get contraception for fear of breaking the rules.
"It can be particularly hard to consistently use contraceptives when you're crossing time zones, or if you're on a ship or military base where you don't have a lot of privacy, so it's hard to talk openly with your medical provider," said Heather Boonstra, a senior public policy associate with the Guttmacher Institute, a think tank that promotes sexual and reproductive health rights.
"A lot of women are coming into the military when they're very young, for many it's their first time away from home. Binge drinking is very high, they've got new independence, so you've got all of those circumstances as well," she said, adding that at this point, much of what is known about barriers to access is anecdotal.
Grossman singled out the Navy for being aggressive in efforts to promote sexual health. It has tracked unplanned pregnancy rates since the late 1980s, establishing its "Sexual Health and Responsibility Program" in 1999 to promote sexual health among all enlisted men and women. In December, the Navy's Bureau of Medicine and Surgery also mandated that all female sailors and Marines be offered contraception services immediately upon receiving orders to deploy in order to give them time to obtain contraception and "stabilize" on her chosen form, a spokesperson for Navy Medicine said in an email to The Huffington Post.
"This is the latest in what is now a good handful of studies documenting unintended pregnancy among women in the military," said Boonstra, who described the work of tracking and spreading awareness of unplanned pregnancies in the military one of "the necessary steps to really address the problems of barriers to access. It's really important."
From the early 1970s to 2010, the number of active duty women enlisted in the military has more than tripled, growing from 42,000 to 167,000, according to Pew Research estimates.