Unintended pregnancies are even more common among women in the Navy than they are in the general population and they can be even more disruptive to their lives and careers. The Navy is spending January addressing this issue through its peer-mentoring group, Coalition of Sailors Against Destructive Decisions (CSADD). Chapters “across the fleet” will spend the month focusing on “Planning a Family During Your Navy Career.”
According to a Navy press release the effort is “intended to facilitate an open discussion with Sailors about the many ways having a child can affect an individual Sailor’s life.”
This focus was spurred by the Navy’s own data which shows extremely high rates of unintended pregnancy among sailors. The Navy’s most recent Pregnancy and Parenthood Survey, conducted in 2010, found that nearly three-fourths of all pregnancies were unplanned. Moreover, only 31 percent of couples reported using birth control when they became pregnant. Interestingly, data going back to 1988 show that the rate of unplanned pregnancies has remained fairly consistent. It is worth noting, though, that the survey used to garner these statistics is voluntary and the responses may not be generalizable to the entire Navy.
The data does show that operational pregnancies among enlisted servicewomen make up less than one percent of the Total Force. Operational pregnancies refer to those that happen when a woman is on sea duty. These present a bigger problem for the Navy as they can result in unplanned losses of manpower on a ship. The average operational pregnancy occurs in a junior enlisted soldier who is 23-years-old and single.
Pregnancy in the Navy
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Pregnancy in the military has been an issue since women began to serve. The Alliance for National Defense explained in a 2005 paper: “From the 1940s into the mid-1970s, pregnancy and motherhood were considered incompatible with military service.” Women who became pregnant were automatically discharged. For many this meant losing benefits they would have accrued if they were allowed to continue to serve. Moreover, unmarried women who were found to be pregnant also risked being punished under the Uniform Code of Military Justice and dishonorably discharged. (Not surprisingly, the same did not happen to military men who caused a pregnancy outside of marriage.)
This policy eventually changed:
With the advent of the All-Volunteer Force, and the realization that the military services needed “womanpower” in order to maintain sufficient personnel levels, in addition to the efforts of a few brave women who challenged the policy of automatic discharge, the policy was changed in the mid-1970s.
The official policies adopted since that time have focused on ensuring the health and safety of the woman and her child. Policies say that women should receive appropriate prenatal care and that they will not be assigned duties that would be hazardous to their pregnancy. The Navy also has a rule that pregnant service women must be within six hours of emergency medical care.
The change in rules, however, did not necessarily change attitudes as many still look at pregnancy as an unfair disruption to the military itself, especially if the woman is assigned to an operational or deployable unit. In fact, the official policies focus not just on the military’s responsibility to the woman but on her responsibility to it. A Coast Guard policy, for example states that:
By itself, pregnancy should not restrict tasks normally assigned to servicewomen and that it is the servicewoman’s responsibility to try to plan her pregnancies with regards to her military duties [around operational necessities] (MCO).
This is also reflected in attitudes around women in the military. The Alliance for National Defense explains:
There is a pervasive sense that if a woman has to be removed from a deployment due to pregnancy, it can cause that military unit to be “under manned” if that member is in a critical billet. The loss may create hardship on the remaining members of the unit if they must perform the work of the pregnant woman, and resentment can result.
The Navy Pushes Family Planning
This seems to be the focus of the new initiative for January. Chief Operations Specialist Jessica Myers, senior enlisted advisor to the Navy’s Office of Women’s Policy described the initiative this way in a press release: “Many times we are taught to separate our personal life from our professional life, but in reality the decisions we make can affect both. It is important that male and female service members, to the best of their ability, plan a pregnancy in order to successfully balance the demands of family responsibilities with their military obligations.”
The initiative will be carried out by chapters of CSADD, a mentoring program designed to help junior sailors between the ages of 18 and 25 make important life decisions. The group’s motto is “Shipmates helping Shipmates,” and participation is completely voluntary.
The Navy created a Powerpoint presentation for chapters to use called “Planning a Family During Your Navy Career.” The presentation defines family planning as “preparing when to have children, taking into account the best personal and professional timing, including contraception and conception.” It goes on to present statistics about unplanned pregnancy and family in the military, examine consequences of unplanned pregnancy, and emphasize commitment to career. One slide says “Unplanned pregnancies, like any unplanned event, can jeopardize operational mission readiness.” While another tells women and men: “Remember that you owe it to yourself, your family, your career, and the mission to plan and think through these life altering decisions before they are made.” An optional activity has participants going on a scavenger hunt to “price” child-related expenses (either by going to the base commissary/exchange or online) such as food, daycare, and clothing.
Having men and women think critically about the importance of family planning can be very useful in preventing unintended pregnancies especially when we think that these sailors are not that far out of high school and may not have thought far enough into the future or considered the impact of parenthood on their lives and their careers. That said they cannot follow through on these plans in the absence of information about birth control and access to methods.
No Focus on Contraception
The presentation has one slide entitled “Birth Control” which includes a clip art compilation of the names of all contraceptive methods as well as some related words like reproduction, fertilization, egg, and taboo. The slide tells participants that “Using effective methods of birth control is an important part of family planning.” It goes on to say: “An ideal form of birth control should be easy to use, have minimal side effects, and reduce transmission of disease.” That appears to be the extent of the information, and possibly the discussion about contraception at least in this presentation. An additional fact sheet that accompanies the presentation online links to a web-based information on contraception and suggests presenters contact their local health clinic to find pregnancy prevention education in their area and that sailors contact their health care provider for individualized education.
The truth is that both women and men in the service receive information on birth control and STD prevention during basic training. It is possible, therefore, that they have all the information they need. However, given that 31 percent of those who experienced an unintended pregnancy were not using any contraception at the time, a refresher course might not be a bad idea. And, the Pregnancy and Parenthood Survey found that 66 percent of enlisted men are not using contraception and that 40 percent of enlisted women would agree to having sex without contraception if their partner wanted to. This certainly suggests that these young sailors could use additional opportunities to think critically about contraception in addition to life planning.
Nancy Duff Campbell, co-president of the National Women’s Law Center, which has advocated for greater health care rights for women in the military, points out that we are talking about a young population, many still in their teens, who have often not had much health education elsewhere. She told me that she thinks it is great that the military discusses sexual health issues including contraception during basic training, but that they need to do this, and other health education, more often: “There’s a lot going on in basic training. So you need to do it then, but that’s not enough. They should give it at occupational training and at deployment as well.”
Potentially more important to service men and women than education about contraception is access to their chosen method—especially when they are deployed and completely dependent on the armed forces for supplies. A recent report by the American College of Obstetricians and Gynecologists found that while contraceptive counseling is available to all women in the military, the actual methods may not be. It found some servicewomen discontinued or disrupted their methods for a variety of reasons:
Depending on the location of the deployment, contraceptive methods may need to be altered because some combat areas are not conducive to stocking certain contraceptives, such as depot medroxyprogesterone acetate [Depo-Provera] and the vaginal ring. Indeed, some women report discontinuation of contraceptive use during deployment because long work shifts and rapid travel across multiple time zones can affect adherence to a regular contraceptive schedule. Also, harsh climate in some deployment areas has been reported to diminish the adhesive integrity of the patch.
Campbell says that things have gotten better. As recently as a few years ago, she says, there were issues with deployed servicewomen having to bring a whole year’s supply of birth control with them when the left home or be forced to change methods.
“The military has been doing a better job—but not a completely effective job—of educating women about health issues during deployment, including longer terms of contraception before they go,” she said.
She noted that Emergency Contraception has also become more available though there are still issues with access, including issues of privacy in close knit units. And, of course, abortion remains unavailable to servicewomen facing unintended pregnancies.
An educational campaign—especially one that focuses on critical thinking and decision making—is a great start and Campbell notes that it is impressive that the Navy has included men in this training as everyone needs to understand that men and women are jointly responsible for decisions about contraception. Still, such a campaign can only work if women and men have access to effective methods of contraception.
I suppose, though, that progress is progress and in a week during which the Department of Defense announced a lifting of the ban on women in combat, I am optimistic that even more progress will be made.