Increased Need for Support in Pregnancy for Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF)

Studies show that Veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) may experience significant stress during military service that can have lingering effects. Little is known about mental health problems or treatment among pregnant OEF/OIF veterans.

Pregnancy and mental health conditions were quantified according to ICD-9-CM codes and specifications. Mental healthcare use and prenatal care were assessed by analyzing VHA stop codes. During the study period, 2966 (7%) women received at least one episode of pregnancy-related care, and 32% of veterans with a pregnancy and 21% without a pregnancy received one or more mental health diagnoses.

Veterans with a pregnancy were twice as likely to have a diagnosis of depression, anxiety, posttraumatic stress disorder (PTSD), bipolar disorder, or schizophrenia as those without a pregnancy. little is known about ongoing concomitant prenatal and mental healthcare or about pregnancy outcomes among these women veterans because the VHA does not provide pregnancy care.

U.S. Senators Cory Booker (D-NJ) and Marsha Blackburn (R-TN) introduced a bipartisan bill, Delivering Optimally Urgent Labor Access for Veterans Affairs, or the DOULA Act, to establish a pilot program to encourage the use of doulas in the Veterans Health Administration to support pregnant veterans and improve maternal health outcomes. An increasing number of doula organizations and veteran stakeholders coming together to advocate for the placement of doulas in the Veterans Health Administration as a support for pregnant veterans.

Maternal mortality in the United States is a public health crisis that demands urgent action,” said Senator Booker. “Providing increased access to doula care for veterans—especially those who are survivors of military sexual trauma or experiencing a mental disorder—is a proven, effective way to improve health outcomes for mothers and children and support our veterans.”

Under the Delivering Optimally Urgent Labor Access for Veterans Affairs, or the DOULA Act, the Department of Veteran Affairs would be required to measure the impact that doula support services have on pregnant veterans birth and mental health outcomes. The pilot program would allow for six Veterans Integrated Service Networks (VISN), three with the highest percentage of female veterans, and three with the lowest rate of female veterans, to participate and compare results regarding barriers to care. If done successfully, it will lower childbirth complications and incentivize veterans to receive VA care during and after their pregnancy.

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