(CNN) -- Despite access to free contraceptives, unplanned
pregnancies are a rising problem for women in the U.S. military, according to a
Nearly 11% of more than 7,000
active-duty women surveyed by the Department of Defense in 2008 reported an
unplanned pregnancy during the previous year. That's 50% higher than the average
rate in the United States, the study authors say. The study, publishing next
month in the journal Obstetrics & Gynecology, also notes that the rate has
increased since 2005.
Authors Dr. Daniel Grossman and
Kate Grindlay analyzed data from the 2005 and 2008 Department of
Defense Survey of Health Related Behaviors, which they obtained through a
Freedom of Information Act request.
"It's alarming," Grossman said of
the increasing rate. "When you're in the military, that's actually one time
where you have access to free, good quality health care. ... It really
highlights the need to better address contraceptive care."
The military offers FDA-approved
contraceptives, including emergency contraception, at no cost in its medical
facilities, according to Shoshona Pilip-Florea, spokeswoman for the U.S. Navy
Bureau of Medicine and Surgery.
"It's important to note that
contrary to the study, Navy Medicine has consistently found that the number of
unintended pregnancies among female sailors and Marines is comparable to the
national rates in the general population," Pilip-Florea wrote in an e-mail.
Unplanned pregnancies can have a
significant impact on the health of military personnel and on troop readiness,
according to the study.
Servicewomen who become pregnant
unexpectedly while at home cannot be deployed, which may affect their career.
Servicewomen who become pregnant while overseas must be sent home, which can
cost the military around $10,000.
Research has shown approximately 43% of unplanned pregnancies
in the United States end in abortion. "For women in the military, that can
represent a huge challenge," Grossman said.
Federal law allows abortion to
be covered at military facilities only when the pregnancy is the result of rape
or incest, or threatens the life of the woman. And going off-base for medical
care in places like Afghanistan or Iraq can be extremely dangerous, Grossman
Sexual assault could be playing
a role in the military's high number of unplanned pregnancies, the study authors
Research shows an estimated 20% to
40% of servicewomen experience rape or attempted rape during their military
career. (Exact numbers are difficult to obtain; the Department of Defense
estimates more than 80% of incidents are never reported.)
A lack of sexual education and
fears about repercussions could also be contributing factors, the authors
In 2012, Grossman and Grindlay
results from a small online survey about the use of contraception in the
military. Close to 60% of the 281 servicewomen surveyed said that contraception
was easy or somewhat easy to obtain. The most common reason women cited for not
using birth control while deployed was not planning to have sex.
More than half of the
respondents said they did not speak to a military medical provider about
birth-control options before deploying. Some felt policies prohibiting or
discouraging sex during deployment prevented them and/or their doctors from
initiating a conversation about contraception, the study authors said.
Not being able to access their
preferred method of birth control was also cited as a reason for not using
contraception. Vaginal rings often cannot be used due to refrigeration needs and
refills of patches or pills may be delayed due to transportation issues.
Like many Americans, military
personnel most frequently choose the pill and condoms for contraception,
"These methods are much more
failure-prone than long-acting reversible contraceptives (LARC) such as
intrauterine devices and hormonal implants," she said. "Increasing the
acceptance and usage of LARCs may decrease the unplanned pregnancy rate."
Some branches of the military
have already begun to address these issues. The Navy and Marine Corps Public
Health Center created the Sexual Health and Responsibility Program (SHARP) in 1999 to
help reduce the occurrence of sexually transmitted infections and unplanned
"Policies and programs, like
SHARP, have been put in place to help minimize these barriers," Pilip-Florea
said. "As a result, we believe those mentioned by Dr. Grossman may exist in
isolated cases but do not represent a systemic problem."
In 2012, the Navy issued a
policy requiring all females to be offered contraception services immediately
after receiving orders to make sure they have time to find a contraception
method before being deployed, Pilip-Florea said.
Navy medical facilities also
have a film on the different kinds of contraceptives; the facilities will soon
receive another film on the consequences of unplanned pregnancies.
The Navy also plans to add a
"multi-hour, facilitated classroom lecture on family planning" to their
mandatory training after boot camp, according to Pilip-Florea.
Grossman acknowledged these
efforts, but said more needs to be done across all branches to provide education
and access to contraception for servicewomen.
"These findings highlight an
important public health problem within the military that has not been adequately
addressed," the study authors wrote.
Jacque Wilson, CNN