Increasing understanding of infants and young children in military families through focused research
Abstract: Until recently, the examination of the effects of combat deployment on military families have been largely limited to a small number of studies involving Vietnam veterans. While these studies help to demonstrate relationships between veterans’ psychological injuries and difficulties in child/family outcomes, much of this research was conducted years after the veteran’s return, potentially limiting the application of the studies to today’s sociopolitical landscape. In the past several years, additional studies have emerged that focus specifically on military families and children in the context of OEF/OIF. Although sparse, this emerging literature examines the reintegration experience of today’s military families struggling with the extraordinary stressors associated with combat deployment-related separation, physical injury, psychological injury, and uncertainty may place even the strongest families at risk for destabilization or compromised functioning.
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.