We sent them to war - now we have to treat them

It is no surprise that the military and the VA is lagging behind in the delivery of healthcare services to women - until the early 70's, women in the military could not have dependents. Women who got pregnant were dismissed from service. Back then, they used to say that if the Army wanted you to have a baby, it would have issued you one.

Now, 35 years later, women have made great strides toward equality that coincided with an all-volunteer military, and women now comprise 20% of the uniformed services. I never thought that we would see numbers like that in my lifetime, but here we are, and that number is quite real.

Well, we have come so far that we are now sending women to war - 180,000 have deployed to the wars in Afghanistan and Iraq - and one of the consequences of doing so is presenting itself in the VA health system, because when they come home, they want the benefits they earned. Last year the VA treated just over 250,000 female veterans, but that number is projected to double within five years.

VA officials say they're better prepared to handle female patients than they were several years ago. But they acknowledge "continual challenges" as they move to open the door to a man's world, where pap smears and mammograms could become as common as prostate exams.

And where "military sexual trauma" would be treated as a serious and growing mental health problem, rather than as a subject to be avoided.

"It's not your father's VA — it really isn't," said Patricia Hayes, the VA's national director of women's health care issues. "We have geared up and are gearing up. But there are places that may have gaps."

Others say the agency is far from prepared. And given the VA's chronic budget shortfalls and increasing demands from the rapidly growing number of male veterans, the task could be even harder than expected.

"They aren't ready," said Sen. Patty Murray, D-Wash., said of VA officials. "Absent a proactive, concerted effort and knowing their limited resources, they (VA officials) are struggling with so much this might get lost."

Murray, perhaps the leading VA critic on Capitol Hill, has introduced legislation that requires studying how serving in Iraq and Afghanistan has affected the physical, mental and reproductive health of women, and how the VA is dealing with their problems.

The legislation also would require the VA to start caring for newborn children of female veterans who are receiving maternity care. Currently the VA doesn't cover newborn costs. In addition, it would require increased training for VA personnel dealing with military sexual trauma and post-traumatic stress disorder, or PTSD, in women.

Murray's bill will receive a hearing in the Senate Veterans Affairs Committee tomorrow. "It's a hard issue, and pouring a huge light on this is a risk, as some will say women just shouldn't be in the military," Murray said. "But as more women transition home from the physical and mental wounds of war and step back into lives as mothers, wives and citizens, the VA must be there for them."

It is imperative that the VA be fully funded, and that the services that female veterans will need - and have earned - be implemented and available. To do less would surpass unconscionable and go right to betrayal.

Yet another way the soldiers in the field get screwed over

If women stop enlisting, the Army won't make their recruitment quotas. If more women decline to reenlist, the Army isn't going to be able to meet it's retention goals. But that's the direction that it's heading, and the Army's own policies are to blame.

Currently, women comprise 15% of the military, and 40% of all women serving on active duty have children. Since 2001, about half of all female service personnel have been deployed at least once to either Iraq or Afghanistan. Currently, there are about 25,000 female service members serving in war zones, and filling vital roles. (Current total force strength for both wars is less than 200,000.)

About 10% of all women serving become pregnant each year. It is estimated that there are 75,000 military dependents under one year old. The problem is exacerbated because in today's military, there are many dual-service couples.

When a female soldier has a child, she is given six weeks maternity leave, before she returns to her job. This is standard across all branches of service, and this is not the outrage. Where the Army deviates from the other branches is in how rapidly female soldiers who happen to be new mothers are deployed. The Navy and the Marine Corps do not deploy new mothers until the child is between six months (USMC) and one year old (Navy). The Air Force has a four-month deployment exemption as well, but Air Force deployments are between four and six months, versus fifteen months for the Army. In short, Army moms get the shortest shrift of all - the shortest time between giving birth and being deployed, and the longest deployments of all the services.

When Specialist Amy Shaw, who serves as a Medic with the First Infantry Division, rotated back to Iraq for her second tour, she left behind her three-month-old son Connor who is staying with her parents in Wisconsin while she is deployed, this time for 15 months. Connor's father, a military policeman, is also deployed, so both of his parents are missing out on the crucial bonding that takes place throughout the first year, and both child and mother are denied the very real health benefits of breastfeeding for the first year.

"Without women we would not make our volunteer numbers, so if we destroy the interest of women to volunteer it puts us in a particularly bad place, because the nation does not want a draft," said Maj. Gen. Gale Pollock, deputy Army surgeon general for force management.

"We need to look at the fact that many women want to serve but they also want to be mothers," Pollock said. "It's a medical issue, it's a mental health issue. Your ability to bond with your children is . . . very important."

Pollock said last summer that she had proposed that the Army double the time women are exempt from deployment from four to eight months, noting that she would prefer 12 months. "That addresses the need for breast-feeding that is important for health, and also allows for optimal bonding time," she said.

But, alas, the top brass has not budged. Even though social science researchers have found that the number of women aged 18 to 21 willing to consider military service has dropped from 10% to 4% since 2003, and there is a direct tie between the declining willingness of women to serve and the difficulties that a life in service present for families.

If anyone were to ask me (and no one has) I would suggest that the services all voluntarily enact regs that would keep moms and babies together for the first year; but then I would go one step further and adopt a regulation like the British have that prohibits both parents of small children being deployed simultaneously.

And if the services don't do it voluntarily, Congress should attach those rules to all funding requests.