May 20, 2015 — Congressional lawmakers have advanced House and Senate versions of the annual defense bill (HR 1735) that include provisions designed to improve contraceptive access and the quality of contraceptive care for women in the military, the New York Times reports.
The Defense Advisory Committee on Women in the Services in a report last December found that servicewomen encountered "barriers, both informal and formal, to access family planning" and certain forms of contraception. According to the Times, the report recommended several of the changes being advanced in the congressional legislation.
The House on Friday approved a version of the defense bill that includes a provision requiring military clinics and hospitals to be able to dispense all FDA-approved methods of contraception. According to the Times, servicewomen have said they sometimes are not able to access their prescribed contraceptives, particularly when serving overseas.
Further, the bill would require that women, when possible, be able to access a supply of contraceptives that will last the duration of their deployment. Servicewomen deployed overseas have said they are sometimes not able to refill their contraceptives because military clinics run out of supplies and they occasionally face slow resupply shipments, the Times reports.
Rep. Jackie Speier (D-Calif.) said she pushed for the contraception provisions because of recent research showing that women in the military face higher rates of unplanned pregnancy than women in the general population. "Servicewomen deserve access to the same array of contraceptive methods available to civilians," she said, adding, "My amendment would ensure that military bases stock a broad range of contraceptive options, so a trip to the pharmacy isn't a game of chance."
Meanwhile, the Senate Armed Services Committee last week approved a companion bill with a provision that would improve the quality of contraceptive care for servicewomen and other individuals covered by military insurance programs.
According to the Times, the provision, proposed by Sen. Jeanne Shaheen (D-N.H.), would require DOD to provide women in the military with the most current "standard of care" for contraception and related counseling as defined by CDC, the American College of Obstetricians and Gynecologists, and similar organizations.
The proposal also calls for the secretary of defense to create "a uniform standard curriculum" for family planning education programs for all armed service members, both male and female. In addition, the proposal states that the Pentagon in its health surveys should collect data on family planning methods and the unintended pregnancy rate among active-duty military personnel.
Shaheen said, "Almost 15 percent of our military are now women. But the military has not developed a comprehensive program to make sure they have access to family planning, contraception and counseling."
However, Shaheen also noted that DOD has voiced opposition to elements of the proposal. Specifically, DOD has argued that Congress should not "mandate incorporation of specific questions into required surveys" and that it should not legislate education programs or guidance on clinical practice. The department said it needed "maximum flexibility" to adequately care for servicemembers.
According to the Times, women's health advocates have suggested that lawmakers look to Navy contraception policies. The Navy directs physicians to "screen female sailors for contraceptive needs" before women are sent to sea. However, according to the website of the Navy and Marine Corps' public health center, roughly 25% of servicewomen between ages 21 and 25 reported an unintended pregnancy over the last 12 months.
Meanwhile, Daniel Grossman, a physician and military care expert, said the government could better address female service members' contraceptive needs by ensuring access to long-acting reversible contraceptives, such as intrauterine devices and hormonal implants. He said doing so would reduce the need for contraceptive refills or switches in the type of contraception used while servicewomen are deployed.
Separately, Donna Barry, who co-authored a Center for American Progress report on servicewomen's reproductive health care, said, "We have had an incredible increase in women service members in recent years, but reproductive and sexual health care has not kept up" (Pear, New York Times, 5/19).