Serving Those Who Serve
“#ThxBirthControl for letting me control my period in Iraq (nobody wants to change tampons in a sandstorm!)” – Former Army Officer
Reading those words can change your perspective on contraception. Not many of us can imagine changing a tampon in a sandstorm but to some servicemembers it is a reality of active duty.
Women are serving at increasing rates, and comprise more than 17% of members of the Armed Forces. As of 2018, nearly 350,000 women served on active duty. Ninety-five percent of women serving in the Armed Forces are of reproductive age and as of 2017, more than 700,000 female spouses and dependents of members of the Armed Forces on active duty were of reproductive age.
Servicemembers and their families face unique challenges in nearly every aspect of their lives and work, and these circumstances make information, coverage, and access to birth control even more important throughout their service and as veterans. That’s why Power to Decide recently partnered with the Center for Reproductive Rights and Service Women’s Action Network on a new policy brief examining the critical role contraception plays for servicemembers, their dependents, and veterans. Serving Those Who Serve: Contraception Access for Servicemembers and Veterans examines the unique barriers facing servicemembers, their families, and veterans in accessing the birth control method they need, the progress being made to overcome these barriers, and the work still to be done.
Our brief shares how new guidance from the Defense Health Agency (DHA) is helping to address barriers in active-duty servicemembers’ information about and access to contraception, particularly access during deployment. For years servicemembers struggled with insufficient supplies of contraception for the duration of deployment, failures of the mail-order delivery system to replenish their supply, and providers who refused to prescribe the requested birth control because of general orders restricting sexual activity while deployed—missing the point that many servicemembers use contraception for non-contraceptive benefits such as menstrual suppression. The new DHA guidance requires that servicemembers “receive an adequate supply of short-acting reversible contraceptives for the entire length of deployment. If menstrual suppression is planned, extra supply of the chosen method will be ordered and dispensed as necessary to ensure the member has enough active medication for the entire length of deployment.”
The DHA guidance will also help to improve knowledge about sexual health and the full range of contraceptive methods for servicemembers. How can you avoid changing that tampon in a sandstorm if you don’t know there’s birth control methods that can help you not to get your period or to get it less often?
The Navy’s Sexual Health and Responsibility Program (SHARP) program has been doing a great job for over two decades providing high-quality information to all servicemembers in that branch, but education in other branches has largely focused solely on condoms and avoiding STIs. The new DHA guidance requires that all servicemembers receive “comprehensive evidence-based family planning and contraceptive education on all available contraceptive methods, including EC, menstrual suppression, and the prevention of common sexually transmitted infections.”
But when it comes to birth control, there’s still more work to do. Most of us in the civilian world can get our birth control without co-pays or other out-of-pocket costs. Active-duty servicemembers also have their birth control covered without co-pays, but non active-duty servicemembers and dependents—family members covered by TRICARE (the health insurance that covers servicemembers and dependents) —are charged co-pays for their birth control. These costs can be prohibitive for some, causing them to either forgo contraception entirely or to use a method not right for them, which can then lead to unplanned pregnancy. Everyone deserves the power to decide if, when, and under what circumstances to get pregnant and have a child, and this must include eliminating cost barriers for ALL those who serve and their families.
Another group we must do better by is veterans. Most veterans receiving their care through the Veterans Health Agency (VHA) must pay a copay for their contraception. Women are the fastest-growing population of veterans accessing care through the VHA, and female veterans are more likely to live in poverty than male veterans. Again, charging co-pays for birth control could make it cost-prohibitive—especially accessing the specific method a veteran needs.
Contraception makes so many things possible for people—educational attainment, economic security, and career achievements to name a few. Our military servicemembers, their families, and our veterans deserve to reap these benefits too. While progress has been made, there’s more work to do before we can say we’re truly serving all those who serve with the birth control they deserve so they can face any sandstorm!