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Women In Combat Zones Can Face Difficulty Getting Some Contraceptives

Next year, the military will聽officially lift restrictions on ,聽the end of a process that may open聽up as many as that聽have been off limits聽to women. But women who deploy overseas may continue to face obstacles in another area that can have a critical impact on their military experience: contraception.

It鈥檚 not a minor issue. Rates of unintended pregnancy among women in the military are 50 percent higher than those of聽women in the general population. And because of strict federal rules, their insurance does not generally cover abortion.

Tricare, the health care plan for more than 9 million active and retired members of the military, covers most contraceptive methods approved by the Food and Drug Administration. Active-duty service members pay nothing out of pocket. Spouses and dependents of service members 聽in some instances.

(Photo by Chip Somodevilla/Getty Images)

(Photo by Chip Somodevilla/Getty Images)

But all methods aren鈥檛 necessarily available at every military hospital and clinic, and overseas, for example, women may have difficulty getting refills of their specific type of birth control pill.

Nancy Duff Campbell, co-president of the National Women鈥檚 Law Center, says, 鈥淚t is unfortunate that here we have the military, that has one of the best health care systems in the country, and where we still have a gap is in contraception.鈥

Fifteen percent of active duty service members are women, and 97 percent of them are of childbearing age.

In a 2013 study, based on more than 28,000 responses to the 2008 Department of Defense health-related behaviors survey, researchers found that聽after adjusting for the聽larger concentration of young women in the military,聽the among military women was 7.8 percent, compared with 5.2 percent among women in the general population.

鈥淚t鈥檚 critically important to address unintended pregnancy in the military, because it can be particularly damaging to women鈥檚 careers, and it鈥檚 hard to access abortion care,鈥 says , a study co-author who is vice president for research at Ibis Reproductive Health, a research and advocacy group.

Abortion is聽available at a military facility or聽covered by military health care only if a woman鈥檚 life is in danger or if the pregnancy is a result of incest or rape. Women who want an abortion in other circumstances must use a non-military health care provider and pay for the procedure out of pocket, according to Department of Defense聽health聽officials.

Coverage for emergency contraception, meanwhile, has recently been expanded to all active duty service women and female beneficiaries without cost sharing.

It can be challenging to use contraceptives while deployed overseas for many reasons.聽There is the problem of trying to schedule a daily birth control pill when traveling across time zones, and desert conditions may make a contraceptive patch fall off. Although women are allowed a 180-day supply of contraceptives before deploying, obtaining refills of the same pill is sometimes difficult, some women reported in a 2012 study published in Contraception about that was based on survey of 281 servicewomen.

Women also reported that they were told that contraceptives were unnecessary because having sex during deployment was forbidden or that they couldn鈥檛 receive an intrauterine device because they hadn鈥檛 yet given birth. Neither of those claims is true.

The majority of women surveyed also noted that聽they weren鈥檛 counseled about using contraception for either pregnancy prevention or menstrual suppression before deploying.

Pre-deployment counseling that specifically addresses women鈥檚 contraceptive needs could help counter confusion and ensure women have access to birth control methods that meet their needs. According to military health system officials, contraceptive and reproductive counseling is a covered benefit under Tricare and is an expected component of good clinical practice.

The House and Senate versions聽of the Pentagon鈥檚 spending bill for the fiscal year that begins in October contain聽measures that would affect contraception coverage in the military. The Senate version of would guarantee family planning education and counseling, while would make available a broad range of FDA-approved contraceptives at military treatment facilities and ensure that women servicemembers have enough contraceptives to last for the duration of their deployment.聽A congressional conference committee is working to write a compromise between those two bills.

Defense Department officials said they had no comment on the pending legislation.

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