Damage Control: Unintended Pregnancy in the United States Military

Office of the Deputy Under Secretary of Defense (Military Community and Family Policy), Department of Defense, Profile of the Military Community: 2006 Demographics , 2006, available at <http://cs.mhf.dod.mil/content/dav/mhf/QOL-Library/Project%20Documents/MilitaryHOMEFRONT/Reports/2006%20Demographics.pdf> (last visited May 10, 2010). The Department of Defense defines active duty service branches as the Army, Navy, Marine Corps and Air Force. Reserve duty forces include the Department of Defense's Army National Guard, Army Reserve, Navy Reserve, Marine Corps Reserve, Air National Guard and Air Force Reserve. The figures above do not include the U.S. Coast Guard, which is under the Department of Homeland Security.

Id.

Klein D. A. Adelman W. P. , “Adolescent Pregnancy in the US Military: What We Know and What We Need to Know,” Military Medicine 173, no. 7 (2008): 658–665; TRICARE Management Activity, Military Health System, available at <http://www.tricare.mil/mybeneft/home/Prescriptions/Medications> (last visited May 3, 2010).

Government Accountability Office, Report to the Subcommittee on Personnel, Committee on Armed Services, U.S. Senate: Military Personnel: Active Duty Benefits Reflect Changing Demographics, But Opportunities Exist to Improve, September 2002, available at <http://www.gao.gov/new.items/d02935.pdf> (last visited May 3, 2010).

U.S. Army Center for Health Promotion and Preventive Medicine, HOOAH 4 Health, A Guide to Female Soldier's Readiness, Technical Guide 281, September 2006, available at <http://www.hooah4health.com/deployment/femreadiness.htm> (last visited May 3, 2010).

See Office of the Deputy Under Secretary of Defense, supra note 1.

See U.S. Army Center for Health Promotion and Preventive Medicine, supra note 5.

Department of the Army, Army Regulation 635–200, Active Duty Enlisted Administrative Separations, December 19, 2003, at 70, available at <http://www.sdmcp.org/Regs/army-enlistedseps.pdf> (last visited May 3, 2010).

Clark J. B. Holt V. L. Miser F. , “Unintended Pregnancy Among Female Soldiers Presenting for Prenatal Care at Madigan Army Medical Center,” Military Medicine 163, no. 7 (1998): 444–448; Finer L. B. Henshaw S. K. , “Disparities in Rates of Unintended Pregnancy in the United States, 1994 and 2001,” Perspectives on Sexual and Reproductive Health 28, no. 2 (2006): 90–96; Robbins A. S. Chao S. Y. Frost L. Z. Fonseca V. P. , “Unplanned Pregnancy Among Active Duty Servicewomen, US Air Force 2001,” Military Medicine 170, no. 1 (2005): 38–43.

Navy and Marine Corps Public Health Center: Sexual Health and Responsibility Program (SHARP), Military Sexual Health Indicators, available at <http://www-nehc.med.navy.mil/downloads/healthyliv/sexualhealth/planned_navy.pdf> (last visited May 10, 2010).

Klein D. A. Adelman W. P. , “Adolescent Pregnancy in the US Military: What We Know and What We Need to Know,” Military Medicine 173, no. 7 (2008): 658–665.

Dao J. , “At War: General Backs Of Court-Martial Threat for Pregnant Soldiers,” The New York Times, December 22, 2009, available at <http://atwar.blogs.nytimes.com/2009/12/22/general-backs-off-court-martial-threat-for-pregnant-soldiers/?emc=eta1> (last visited May 10, 2010).

See Government Accountability Office, supra note 4.

Hanna J. H. , “An Analysis of Gynecological Problems Presenting to an Evacuation Hospital During Operation Desert Storm,” Military Medicine 157, no. 5 (1992): 222–224.

See Government Accountability Office, supra note 4.

Battista R. M. Creedon J. F. Salyor S. W. , “Knowledge and Use of Birth Control Methods in Active Duty Army Enlisted Medical Trainees,” Military Medicine 164, no. 6 (1999): 407–409.

See Clark Finer Henshaw Robbins , supra note 9.

See Office of the Deputy Under Secretary of Defense, supra note 1.

U.S. Census Bureau, Annual Estimates of the Resident Population by Sex and Selected Age Groups for the United States: April 1, 2000 to July 1, 2008 (NC-EST2008–02), available at <http://www.census.gov/popest/national/asrh/NC-EST2008-sa.html> (last visited May 10, 2010).

See Office of the Deputy Under Secretary of Defense, supra note 1.

Office of the Deputy Under Secretary of Defense (Military Community and Family Policy), Department of Defense, Profile of the Military Community: 2006 Demographics, 2006, available at <http://cs.mhf.dod.mil/content/dav/mhf/QOL-Library/Project%20Documents/MilitaryHOMEFRONT/Reports/2006%20Demographics.pdf> (last visited May 10, 2010).; U.S. Census Bureau, Annual Estimates of the Resident Population by Sex and Selected Age Groups for the United States: April 1, 2000 to July 1, 2008 (NC-EST2008–02), available at <http://www.census.gov/popest/national/asrh/NC-EST2008-sa.html> (last visited May 10, 2010).

Id.

Id.

Id.

Id.

See Office of the Deputy Under Secretary of Defense, supra note 1.

Borsay-Trindle L. A. Pass C. M. Gilzean S. M. , “Unplanned Pregnancy among Active-Duty Army Females as a Readiness Issue,” Military Medicine 156, no. 2 (1991): 82–86.

Mosher W. D. Martinez G. M. Chandra A. Abma J. C. Wilson S. J. , “Use of Contraception and Use of Family Planning Services in the United States: 1982–2002,” National Center for Health Statistics, Vital Health Stat Series, no. 350 (2004).; Wu J. Meldrum S. Dozier A. Stanwood N. Fiscella K. , “Contraceptive Nonuse among US Women at Risk for Unplanned Pregnancy,” Contraception 78, no. 4 (2008): 284–289.

Bray R. M. Rae Olmsted K. L. Williams J. Sanchez R. P. Hartzell M. , “Progress Toward Healthy People 2000 Objectives among U.S. Military Personnel,” Preventive Medicine 42, no. 5 (2006): 390–396.

Thomson B. A. Nielsen P. E. , “Women's Health Care in Operation Iraqi Freedom: A Survey of Camps with Echelon I or II Facilities,” Military Medicine 171, no. 3 (2006): 216–219.

Id.

Brown D. , “Ban on Sex for Soldiers in Afghanistan Lifted…Sort Of,” Stars and Stripes, May 15, 2008, available at <http://www.military.com/features/0,15240,167950,00.html?ESRC=dod.nl> (last visited May 3, 2010); Yevich S. , “Preventive Medicine and the Operation Plan,” Military Preventive Medicine: Mobilization and Deployment, Vol.1, available at <http://www.bordeninstitute.army.mil/published_volumes/mpmvol1/pm1ch13.pdf> (last visited May 3, 2010); Abizaid J. P. , United States Central Command, Office of the Commander, Department of Defense, General Order Number 1B, March 13, 2006, available at <http://www.tac.usace.army.mil/deploymentcenter/tac_docs/GO-1B%20Policy.pdf> (last visited May 3, 2010).

Brown D. , “Ban on Sex for Soldiers in Afghanistan Lifted…Sort Of,” Stars and Stripes, May 15, 2008, available at <http://www.military.com/features/0,15240,167950,00.html?ESRC=dod.nl> (last visited May 3, 2010); Yevich S. , “Preventive Medicine and the Operation Plan,” Military Preventive Medicine: Mobilization and Deployment, Vol.1, available at <http://www.bordeninstitute.army.mil/published_volumes/mpmvol1/pm1ch13.pdf> (last visited May 3, 2010).

TRICARE Management Activity, Military Health System, available at <http://www.tricare.mil/mybenefit/home/Prescriptions/Medications> (last visited May 3, 2010).

Id.

Id.

See Thomson Nielsen , supra note 30.

Mosher W. D. Martinez G. M. Chandra A. Abma J. C. Wilson S. J. , “Use of Contraception and Use of Family Planning Services in the United States: 1982–2002,” National Center for Health Statistics, Vital Health Stat Series, no. 350 (2004); United Nations, World Contraceptive Use, 2003, April 2004, available at <http://www.un.org/esa/population/publications/contraceptive2003/wcu2003.htm> (last visited May 3, 2010).

United Nations, World Contraceptive Use, 2003, April 2004, available at <http://www.un.org/esa/population/publications/contraceptive2003/wcu2003.htm> (last visited May 3, 2010).

See TRICARE, supra note 34.

Duke M. R. Ames G. M. , “Challenges of Contraceptive Use and Pregnancy Prevention Among Women in the U.S. Navy,” Qualitative Health Research 18, no. 2 (2008): 244–253; Gehlbach D. , “Talks From the Forum on the Health of Women in the Military: Contraceptive Needs, Complications, and New Directions for Research,” Womens Health Issues 6, no. 6 (1996): 355–358.

See Thomson Nielsen , supra note 30.

See Battista , supra note 16.

Boatman J. M. Dorko J. J. , U.S. Army Maneuver Support Center and Fort Leonard Wood Department of the Army Headquarters, Department of Defense, FLW Regulation No. 350–13, Training: Trainee Conduct, August 15, 2002, available at <http://www.wood.army.mil/doimspt/FLW%20Publications/r350–13.pdf> (last visited May 3, 2010).

See Thomson Nielsen , supra note 30.

Id.

Thomson B. A. Nielsen P. E. , “Women's Health Care in Operation Iraqi Freedom: A Survey of Camps with Echelon I or II Facilities,” Military Medicine 171, no. 3 (2006): 216–219; Hawley-Bowland C. , “Selected Talks From the Forum on the Health of Women in the Military: Epidemiologic Overview of Common Gynecologic Disorders and First-Trimester Complications Among Active-Duty Women,” Womens Health Issues 6, no. 6 (1996): 353–355.

Duke M. R. Ames G. M. , “Challenges of Contraceptive Use and Pregnancy Prevention Among Women in the U.S. Navy,” Qualitative Health Research 18, no. 2 (2008): 244–253.

Christopher L. A. Miller L. , “Women in War: Operational Issues of Menstruation and Unintended Pregnancy,” Military Medicine 172, no. 1 (2007): 9–16; Hawley-Bowland C. , “Selected Talks From the Forum on the Health of Women in the Military: Epidemiologic Overview of Common Gynecologic Disorders and First-Trimester Complications Among Active-Duty Women,” Womens Health Issues 6, no. 6 (1996): 353–355; Luukkainen T. Toivonen J. , “Levonorgestrel-Releasing IUD as a Method of Contraception with Therapeutic Properties,” Contraception 52, no. 5 (1995): 269–276; Thomson B. A. Nielsen P. E. , “Women's Health Care in Operation Iraqi Freedom: A Survey of Camps with Echelon I or II Facilities,” Military Medicine 171, no. 3 (2006): 216–219.

Westhoff C. Jain J. K. Milsom I. Ray A. , “Changes in Weight with Depot Medroxyprogesterone Acetate Subcutaneous Injection 104 mg/0.65 mL,” Contraception 75, no. 4 (2007): 261–267.

See TRICARE, supra note 34.

Hefling K. , “All Bases Required to Offer Morning-After Pill,” Army Times, February 4, 2010, available at <http://www.armytimes.com/news/2010/02/ap_military_emergency_contraception_020410/> (last visited May 10, 2010).

See TRICARE, supra note 34.

Remund D. D. Egland T. , Minutes of the Department of Defense Pharmacy and Therapeutics Executive Council Meeting, May 2, 2002, available at <http://www.tricare.mil/Pharmacy/PT_Cmte/archives.htm> (last visited May 3, 2010).; Maze R. , “Emergency Contraception Still Available,” Marine Corps Times, 2007, available at <http://www.marinecorpstimes.com/news/2007/04/military_emergency_contraceptives_070430w/> (last visited May 3, 2010).

Text of H.R. 2064: Compassionate Care for Servicewomen Act, available through <http://www.govtrack.us/congress/billtext.xpd?bill=h110–206> (last visited May 3, 2010).

Mateczun J. M. , U.S. Navy Memorandum, Prescribing, Dispensing, and Distribution of PlanB (Levonorgestrol), February 27, 2007, available at <http://www.med.navy.mil/bumed/womenshealth/Training%20%20Resource%20Files/BUMED%20POLICY%20Plan%20B%20Feb07%20%282%29.pdf> (last visited May 10, 2010).

Id.

See Hefling , supra note 52.

See U.S. Army Center for Health Promotion and Preventive Medicine, supra note 5.

See Duke Ames , supra note 48; Christopher L. A. Miller L. , “Women in War: Operational Issues of Menstruation and Unintended Pregnancy,” Military Medicine 172, no. 1 (2007): 9–16; Chung-Park M. , “Emergency Contraception Knowledge, Attitudes, Practices, and Barriers Among Providers at a Military Treatment Facility,” Military Medicine 173, no. 3 (2008): 305–312.

See Duke Ames , supra note 48.

Id.

Id.

Vuic K. D. , “‘I'm Afraid We're Going to Have to Just Change Our Ways’: Marriage, Motherhood, and Pregnancy in the Army Nurse Corps during the Vietnam War,” Signs: Journal of Women in Culture and Society 32, no. 4 (2007): 997–1022.

Id., at 1016.

Roe v. Wade , 410 U.S.113 (1973), available at <http://laws.fndlaw.com/us/410/113.html> (last visited May 4, 2010); see Vuic , supra note 64.

Department of Defense Appropriation Act, 1979 § 863, Pub L No 95–457, 92 Stat 1231, 1254 (1978); Crawford A. E. , “Under Siege: Freedom of Choice and the Statutory Ban on Abortions on Military Bases,” University of Chicago Law Review 71, no. 4 (2004): 1549–1582.

Mayer W. , Department of Defense, Department of Defense Policy Regarding Providing Non-Funded Abortions in Outside the Continental United States Military Medical Treatment Facilities, Memorandum for Secretaries of the Military Departments, June 21, 1988, available at <http://www.tricare.mil/policy/memos/abortion.html> (last visited May 4, 2010); Maze R. , “Senate Votes to End Ban on Overseas Abortions,” Army Times, June 21, 2002, available at <http://www.armytimes.com/legacy/new/0-292925-976893.php> (last visited May 4, 2010).; see Crawford , supra note 67.

Maze R. , “Senate Votes to End Ban on Overseas Abortions,” Army Times, June 21, 2002, available at <http://www.armytimes.com/legacy/new/0-292925-976893.php> (last visited May 4, 2010); see Crawford , supra note 67.

National Defense Authorization Act for Fiscal Year 1996 § 738, Pub L No 104–106, 110 Stat 186, 384 (1996); see Maze , supra note 69; Crawford , supra note 67.

10 USC § 1093(b) (2000); see Crawford , supra note 67, at 1554.

See U.S. Army Center for Health Promotion and Preventive Medicine, supra note 5.

See Crawford , supra note 67.

Id.

Id., at 1571.

Department of Defense, Task Force Report on Care for Victims of Sexual Assault, 2004, available at <http://www.defense.gov/News/May2004/d20040513SATFReport.pdf> (last visited May 10, 2010).

Id.; Skiba V. Durham C. , “Challenges of Meeting New Department of Defense Sexual Assault Guidelines,” Military Medicine 172, no. 8 (2007): iv–vi; Valente S. Wight C. , “Military Sexual Trauma: Violence and Sexual Abuse,” Military Medicine 172, no. 3 (2007): 259–265; Mullen C. , Washington Coalition of Sexual Assault Programs, “Understanding Sexual Assault in the United States Military Culture,” Connections (Fall/Winter 2005): 10, available at <http://www.wcsap.org/pdf/Connections%20Military.pdf> (last visited May 4, 2010); Lumpkin J. J. , Washington Coalition of Sexual Assault Programs, “Military Sexual Assault Victims Faced Inconsistent System Treatment,” Connections (Fall/Winter 2005): 12, available at <http://www.wcsap.org/pdf/Connections%20Military.pdf> (last visited May 4, 2010).

See Roe v. Wade, supra note 66.

Casey, 505 US at 874.

See Crawford , supra note 67, at 1564.

Id., at 1570.

See Borsay-Trindle , supra note 27.

Finer L. B. Henshaw S. K. , “Disparities in Rates of Unintended Pregnancy in the United States, 1994 and 2001,” Perspectives on Sexual and Reproductive Health 28, no. 2 (2006): 90–96.

See Crawford , supra note 67, at 1571.

Speidel J. J. Harper C. C. Shields W. C. , “The Potential of Long-Acting Contraception to Decrease Unintended Pregnancy,” Contraception 78, no. 3 (2008): 197–200.

See Thomson Nielsen , supra note 30.

Christopher L. A. Miller L. , “Women in War: Operational Issues of Menstruation and Unintended Pregnancy,” Military Medicine 172, no. 1 (2007): 9–16.

Luukkainen T. Toivonen J. , “Levonorgestrel-Releasing IUD as a Method of Contraception with Therapeutic Properties,” Contraception 52, no. 5 (1995): 269–276.

See Thomson Nielsen , supra note 30.

Halpern V. Grimes D.A. Lopez L. M. Gallo M. F. , “Strategies to Improve Adherence and Acceptability of Hormonal Methods of Contraception,” Cochrane Database of Systematic Reviews, 2006(1): Art. No.:CD004317; Canto De Cetina T. E. Canto P. Luna M.O. , “Effect of Counseling to Improve Compliance in Mexican Women Receiving Depot-Medroxy-progesterone Acetate,” Contraception 63, no. 3 (2001): 143–146.

Moos M. Bartholomew N. E. Lohr K. N. , “Counseling in the Clinical Setting to Prevent Unintended Pregnancy: An Evidence-Based Research Agenda,” Contraception 67 (2003): 115–132; Lopez L. M. Steiner M. Grimes D. A. Schulz K. F. , “Strategies for Communicating Contraceptive Effectiveness,” Cochrane Database of Systematic Reviews 2008(2): Art. No.:CD006964; Kirby D. , “The Impact of Programs to Increase Contraceptive Use among Adult Women: A Review of Experimental and Quasi-Experimental Studies,” Perspectives on Sexual and Reproductive Health 40, no. 1 (2008): 34–41.

Hughes T. C. Staren-Doby D. , “Reducing Unintended Pregnancy in Young, Single Active Duty Women in an Overseas Environment,” Military Medicine 168, no. 1 (2003): 11–14.

Chung-Park M. S. , “Evaluation of a Pregnancy Prevention Programme Using the Contraceptive Behavior Change Model,” Journal of Advanced Nursing 61, no. 1 (2008): 81–91.

Raymond E. G. Trussell J. Polis C. B. , “Population Effect of Increased Access to Emergency Contraceptive Pills: A Systematic Review,” Obstetrics & Gynecology 109, no. 1 (2007): 181–188.

See Remund Egland Maze , supra note 54.

Act of Sept 30, 1976 § 209, Pub L No 94–439, 90 Stat 1418, 1434.

See Maze , supra note 69.

“Roll Call: House Nixes Military Abortions,” Human Events, 59, no. 21 (2003): 22.

See Office of the Deputy Under Secretary of Defense, supra note 1.

See Roll Call, supra note 99, at 1.