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Military Health System

Walk-in Contraceptive Services Required at Hospitals and Clinics

Image of Five people wearing masks look at the camera. Staff assigned to Naval Hospital Bremerton's OB-GYN clinic display a number of the instruments and devices associated with patient-centered care during the walk-in contraceptive clinic, an essential part of women's health services provided at NHB. The Defense Health Agency recently issued an Administrative Instruction for access to walk-in contraception services across the Military Health System, letting beneficiaries discuss and receive their preferred and medically appropriate care. (Photo: Douglas Stutz, Public Affairs Officer, NHB/Navy Medicine Readiness and Training Command (NMRTC), Bremerton)

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The Defense Health Agency is expanding walk-in contraceptive care services to improve reproductive health services.

These services include same-day access with no appointment or referral needed.

Walk-in contraception services let the patient discuss and receive their preferred and medically appropriate care to support family planning, menstrual health, pregnancy prevention, and for our active-duty personnel, readiness. This also will bring readily available contraceptive care to the increasing active-duty force who are female or who are able to get pregnant.

On Sept. 27, the DHA issued an Administrative Instruction outlining the requirements at military hospitals and clinics for these full-scope contraceptive services.

By January 2023, all DHA markets will define the location and hours of operation of walk-in services. The instruction aims to ensure active-duty service members and beneficiaries have access to important reproductive health care in the form of contraception at military hospitals and clinics.

These services “give time back to active-duty service members and promote autonomy in making a decision with the capacity for all types of contraception,” said Theresa Hart, senior nurse consultant at the DHA Women and Infant Clinical Community, Special Medical Programs.

Active-duty service members and other Military Health System beneficiaries will receive the full scope, to include oral, patches, rings, shots, rods, natural family planning, and IUDs in a single visit. This service eliminates the need for a referral to have an intrauterine device or birth control implant placed. Ensuring the providers have the skills, equipment, and team to provide the care on a walk-in basis is a leading practice to empower women to make timely decisions for their reproductive health.

“This is not just based on what a provider is comfortable with,’” Hart said, “and there is no need for a follow-up specialty appointment if the patient wants a long-acting contraceptive,” such as an intrauterine device or Depo-Provera injections.

Supporting Overall Well-being and Readiness

Contraceptive care walk-in services support the overall well-being of the force and optimize personal warrior readiness and family planning throughout their reproductive years, Hart said.

These services offer both beneficiaries and warriors the option of menstrual suppression, stopping monthly bleeding to improve hygiene, ability to deploy, and comfort for warfighters and beneficiaries alike.

Active-duty service members and beneficiaries have found there are benefits in decreasing menstrual periods, along with the physical symptoms and hormonal changes, Hart explained.

For one, it’s beneficial in deployed environments and to stay force fit.

“For the active-duty service members, not having menstrual periods during deployment means not having to carry months of feminine hygiene supplies and having to make do with austere environments where hygiene, washing, and privacy is in short supply,” she said.

“By preventing unplanned pregnancies, we're ensuring that we're not eliminating somebody from the fighting force for 18 months or more,” said U.S. Navy Cmdr. (Dr.) Jacqueline Lamme, who heads the OB-GYN services at Naval Hospital Bremerton in Washington.

Access to contraceptive care will also help beneficiaries with family planning.

“Because this access exists for our patients, no matter where they're stationed, we're both improving our patient's ability to plan their pregnancies and meet their family planning goals personally, as well as to positively impact unit readiness,” Lamme said.

The Benefits of Readily Available Contraceptive Care

Naval Hospital Bremerton has been meeting all the requirements of the Administrative Instruction since its walk-in services were opened in 2021, Lamme said. The U.S. Navy pioneered the concept, opening its first walk-in contraceptive services clinic in 2016.

“One of our clinic’s biggest successes is that we truly integrated the combination of specialties to provide this care within the OB-GYN clinic,” Lamme said. “We're staffed and patients are seen by a combination of the OB-GYN physicians, the clinic nurse-midwives, and both physicians and nurse practitioners from family medicine.”

The Administrative Instruction will also improve provider accessibility and productivity and improve patient satisfaction.

“Bremerton has the ability for some of the general medical officers that are local who need more practice with IUD placement, and other contraceptives, to come and work in our clinic,” Lamme said.

“By shadowing in a supervisory role, they become more comfortable so they can then take those skills out to their units in the fleet and maintain those skills while they're deployed. That collaboration also has been one of our largest successes,” she said.

Darnall-Hood Army Medical Center at Fort Hood, Texas, is also extending its services to walk-in availability.

“The walk-in services offer another avenue to break down any barriers that patients might have to obtaining their contraception of choice and receiving pregnancy planning education,” said U.S. Army Col. Amanda Forristal, chief nursing officer for the hospital and the DHA’s Central Texas Market.

Currently, Darnall’s Family Medicine Residency Clinic offers walk-in services for women seeking contraception options that can be prescribed and picked up at the pharmacy the same day, such as oral contraception, patches, rings, and injections.

“We will run our pilot of the walk-in contraception clinic on November 17,” Forristal said, adding the monthly walk-in services will begin in January.

“This is also an opportunity for (service members) to receive care from a provider that is not also in their unit, whom they see on a more regular basis outside of the clinical setting and can be awkward for some,” Forristal added.

In the coming months, military hospitals and clinics across the Military Health System will offer these expanded services.

Resources

TRICARE has readily available information on contraceptive care.

Here's how to find out more about reproductive health, including the DHA Administrative Instruction.

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