Abstract: Although researchers in civilian society have devoted a great deal of attention to often competing demands of work and family roles, research has only recently started to consider such issues in the context of the U.S. military. For a soldier, military and family institutions are uniquely interrelated, described by some as "total" (Gofrman, 1961, as cited in Bowen, 1989, p. 2) and "greedy" (Lewis Coser, 1974, as cited by Mady Segal, 1988, p. 79). For most soldiers, "[s]ervice...involves more than just an occupational choice; it is the selection of a lifestyle that permeates almost every aspect of a person's life" (Bowen, 1989, p. 1). This chapter documents the development of military family research. In order to review the literature on work-family research relevant to those interested in this phenomenon among those in the military, we first consider definitions and models that have come largely from the civilian literature on work-family conflict. Despite the obvious differences between military and civilian organizations, military researchers have drawn heavily from this literature to formulate military-specific models and develop research hypotheses. The chapter then shifts to a description of the framework researchers at the Walter Reed Army Institute of Research (WRAIR) have used to study work-family issues among military personnel. The chapter then includes a description of empirical work-family research that is relevant to the military. As readers will notice, much of the research reviewed was not conducted with military samples. However, at the end of each subsection we explain the relevance of findings to military personnel. The chapter concludes with a general summary and description of implications of this research for improving the quality of life for military personnel.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.