Informatics, Decision Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah.
Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah.
Semin Reprod Med. 2018 Nov;36(6):361-370. doi: 10.1055/s-0039-1678749. Epub 2019 Apr 19.
Reproductive-age women are a fast-growing component of active-duty military personnel who experience deployment and combat more frequently than previous service-era women Veterans. With the expansion of the number of women and their roles, the United States Departments of Defense and Veterans Affairs have prioritized development and integration of reproductive services into their health systems. Thus, understanding associations between deployments or combat exposures and short- or long-term adverse reproductive health outcomes is imperative for policy and programmatic development. Servicewomen and women Veterans may access reproductive services across civilian and military or Veteran systems and providers, increasing the need for awareness and communication regarding deployment experiences with a broad array of providers. An example is the high prevalence of military sexual trauma reported by women Veterans and the associated mental health diagnoses that may lead to a lifetime of high risk-coping behaviors that increase reproductive health risks, such as sexually transmitted infections, unintended pregnancies, and others. Care coordination models that integrate reproductive healthcare needs, especially during vulnerable times such as at the time of military separation and in the immediate postdeployment phase, may identify risk factors for early intervention with the potential to mitigate lifelong risks.
生育年龄的女性是现役军人中增长迅速的一部分,她们比以前各兵役时期的女性退伍军人更频繁地经历部署和战斗。随着女性人数和角色的增加,美国国防部和退伍军人事务部已将生殖服务的发展和整合优先纳入其卫生系统。因此,了解部署或战斗暴露与短期或长期不良生殖健康结果之间的关联对于政策和方案制定至关重要。女兵和女性退伍军人可以在民用和军事或退伍军人系统和提供者之间获得生殖服务,这增加了对与广泛提供者的部署经历的认识和沟通的需求。一个例子是女性退伍军人报告的军事性创伤的高患病率以及相关的心理健康诊断,这可能导致终生高风险应对行为增加生殖健康风险,例如性传播感染、意外怀孕等。生殖保健需求的护理协调模式,特别是在军事分离和部署后立即等脆弱时期,可能会确定早期干预的风险因素,从而有可能减轻终生风险。