Unintended pregnancies among deployed women in the U.S. Armed Forces create not only a significant challenge for the mother-to-be but also can impact troop morale and readiness, according to the author of a new study who says that medical counseling and education can go a long way toward lessening the problem.

"Unintended pregnancy among women in the U.S. Armed Forces has implications, not only for women and their families, but also for the military operational effectiveness of servicemembers, potentially compromising troop readiness and deployment,” says the author of a paper published earlier this year in Contraception.¹

How significant is the problem? The author,  Laura Duberstein Lindberg, PhD, a senior research associate at The Guttmacher Institute in New York, estimated that, based on self-reports, 54% of pregnancies among women in the military are unintended — and even that figure did not paint a complete picture. When she took into account likely underreporting for abortion, she says that number would rise to 59%.

Master Sgt. Ruby Ann Murray, right, the head instructor of the Postpartum Physical Training Program, 1st Sustainment Command (Theater), calls cadences encouraging her soldiers to finish the group run. Photo courtesy of www.army.mil.

“We know from household data that women underreport, so we used a technique that has been employed for decades to fill in that gap,” Lindberg explains. “We had to assume that women in the military underreport; if anything, we’d expect more underreporting, so I consider our number to be conservative.” Lindberg also calculated that the “adjusted unintended pregnancy rate” was 117 per 1,000 women.    Data for this analysis was drawn from the 2005 DoD Survey of Health Related Behaviors Among Active Duty Military Personnel.² Members of all service branches was sampled, both within and outside the U.S.

For the purpose of the study, “unintended pregnancy” was defined as “A woman having a mistimed (wants to have a baby sometime, but not now) or unwanted (never wants to have another baby) pregnancy,” says Lindberg. “It results from non-use of contraception, as well as contraceptive failures.”  Although in the general population, most pregnancies to unmarried women are un-planned, she notes, “This is not the case for all.”

The issue takes on even greater significance when the woman’s overall health and military readiness are taken into consideration, she continues. “There is a body of literature on the consequences of unintended pregnancy on both mother and child,” notes Lindberg. “What’s even more important here is that we should focus on the individual woman’s career and her ability to engage in her job in the military — and what that does for the military; parenting comes with great challenges in the military and even more so if the pregnancy is unplanned. For example, if you have to have a plan of care for the child, women in the military with unplanned pregnancy may have less of a social network to lean on.”

All of this presents the military with a critical question: When should women servicemembers plan to have a child? “Is there a good time?” Lindberg poses? “If there is, it is something the military should address.” 

Education is a key variable

In terms of addressing the issue of unintended pregnancies and targeting key subgroups within the military, Lindberg notes that her findings are instructive. For example, younger, less-educated women had higher rates of unintended pregnancy. The same was true for enlisted women, compared with women officers. “I would absolutely say the issue here is their level of education,” she asserts.

What’s more, only two subgroups — women officers and women aged 30-44 — met the “Healthy People 2010”³ objective of reducing the proportion of servicewomen’s pregnancies that are unintended to no more than 30%, a goal adopted by the DoD.

“In general, both those groups are more educated,” says Lindberg. “Also, in the 30-44 age range, you are much more likely to have women using contraceptive sterilization; they may be done with child-bearing and have chosen tubal ligation or having a partner with a vasectomy.” In addition, she notes, officers choose to make a very strong commitment to their military careers and may be more proactive because of the potential career consequences of an unintended pregnancy.

The good news, says Lindberg, is that it should be fairly easy to target these key populations more aggressively.

“I would think it’s very possible, based on enlistment status,” she says. “Individuals in the military are grouped that way, so services such as classes, instruction and other information for specific groups should be very natural.”

It could be more difficult to target those servicewomen who did not graduate from college, says Lindberg, noting that it is complicated to target services based on criteria that don’t line up with the military's organizing framework.

“Enlisted women and those who are not officers need more support, and programs should be relatively easy to implement,” she notes. If such a targeted approach is not current being implemented, she adds, “I recommend that it take place.”
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