Results

Understanding the Effect of Military Stress on Postpartum Outcomes in Active Duty Women

Nakeisha Seymore and Rebecca YarbroughUniversity of California, San Diego ∙ BSPH Candidates ‘18

• Exempt approval was obtained by the Institutional Review Board at UC San Diego

• All active duty and veteran women who experienced their first pregnancy in the military and continued service for at least six months after giving birth were invited to participate

• Participants completed two measures:•Demographic questionnaire•Postpartum Depression Predictors

Inventory-Revised (PDPI-R)• Data was collected anonymously online by

promoting survey link through•Social media outlets•Personal contacts•Posting flyers at the Student Veteran

Resource Center at UCSD• Responses to questionnaires were

systematically organized by Google Forms statistical software

Methods

Factors identified that may contribute to PPD outcomes:• General lack of support from command• Barriers to breastfeeding• Inadequate time to heal and prepare for physical

fitness assessment• Difficulties acquiring child care• Insufficient length of maternity leave time

Other findings:

• Higher rates of PPD were reported among enlisted women (67.8%) than officers (48.7%)

• Results show no difference in PPD outcomes when comparing those who received 12 weeks or more maternity leave to those who received less than 12 weeks (59% vs. 58.5%)

Allow additional time for

postpartum service-

members to prepare for a

physical fitness

assessment in every branch

(one year)

Further modify

instructions and require all service-members to

attend mandatory

training sessions

regarding breastfeeding

instruction

Open additional military-operated childcare facilities and/or

provide subsidies toward civilian

childcare

Research on this topic is

largely understudied.

Further research and replication of

results is needed to confirm findings

Figure 1. Perceived social support from peers in the military after having a baby

Figure 2. Breastfeeding support and facilities as reported by participants

Figure 3. Preparing for the military physical fitness test

References1. Department of Defense. (2016). 2015 Demographics profile of the military community. Retrieved from: http://download.militaryonesource.mil/12038/MOS/Reports/2015-Demographics-Report.pdf2. Appolonio, K. K., & Fingerhut, R. (2008). Postpartum depression in a military sample. Military Medicine, 173(11), 1085-1091.3. Lawrence-Wood, E., Kumar, S., Crompvoets, S., Fosh, B. G., Rahmanian, H., Jones, L., & Neuhaus, S. (2016). A systematic review of the impacts of active military service on sexual and reproductive health outcomes among servicewomen and female veterans of armed forces. Journal Of Military & Veterans' Health, 24(3), 34-55.4. Martin, S. E., Drake, E., Yoder, L., Gibson, M., & Litke, C. A. (2015). Active duty women's perceptions of breast-feeding support in the military setting. Military Medicine, 180(11), 1154-1160.

Discussion

Policy Implications

AbstractINTRODUCTION: With the expansion of women’s role in the military, it is important to understand how the added stressors unique to military life affect their health as new mothers and to maintain the physical readiness of female soldiers, sailors, and airwomen.

OBJECTIVES: The primary objective of this study was to identify stressors unique to women in the military that may contribute to adverse postpartum outcomes.

METHODS: All active duty and veteran women who experienced their first pregnancy and gave birth while in the military within the past ten years were invited to participate in the study. Participants completed a modified Postpartum Depression Predictors Inventory-Revised (PDPI-R) and demographic questionnaire. Data was collected through anonymous surveys administered online via social media channels associated with the Student Veteran Resource Center at UCSD and various support groups for female servicemembers on Facebook. Our primary outcome was to examine the unique risk factors related to military service that may have contributed to increased rates of PPD in a military sample.

RESULTS: A total of 260 active duty women and women veterans participated in the study. Of the 260 participants, 66.9% reported experiencing depression during their pregnancy and 50.8% experienced anxiety. Over half (58.5%), experienced depression and 61.2% experienced anxiety after pregnancy. Most were not treated for postpartum depression (89.2%). Themes identified in open-ended responses potentially contributing to PPD included: dual-military challenges, childcare hardships, military physical fitness difficulties, negative consequences for advancement opportunities, lack of command support, issues with healthcare providers/facilities, deployment stressors, lack of breastfeeding support and/or facilities, and maternity leaveconcerns.

CONCLUSIONS: An elevated prevalence of PPD was apparent among study participants. Major risk factors included lack of support from military peers, lack of breastfeeding support, and inadequate time to prepare for physical fitness assessments.

• A recent DOD demographic report showed that women make up 15% of all active-duty military personnel1

• 39,638 active duty members gave birth to their first child while in the military in 2015 alone1

• In an active duty sample, one study found an elevated percentage of PPD cases compared to civilians2

• Research shows military weight requirements for new mothers may be viewed as unrealistic3

• Long, inflexible working hours and frequent separations from baby may make it difficult for mothers on active duty to continue to breastfeed4

Introduction