Women's Health Care in Operation Iraqi Freedom: A Survey of Camps with Echelon I or II Facilities

Abstract
Objective: To assess women’s perceptions of health care delivery in Operation Iraqi Freedom. Methods: An anonymous questionnaire was distributed through command channels to female soldiers stationed in camps receiving echelon I or II care. Questions covered predeployment screening, contraceptive method availability and side effects, accessibility of gynecologic care, field hygiene counseling, and smoking status. Results: Two hundred fifty-one (91%) of 275 surveys were returned. Twenty-two percent of respondents had received no annual gynecologic examination including the Papanicolaou test/cervical cytologic study in the past year. Irregular bleeding was the most common gynecologic side effect. Ortho Evra patches fell off in 58% of cases; 23% of soldiers changed contraceptive methods because of unavailability, 21% experienced gynecologic problems, and 44% could not access gynecologic care. Twenty-six percent received predeployment menstrual hygiene counseling, and 77% attempting cycle control succeeded. Conclusions: Gynecologic screening, contraceptive options, and cycle control counseling must occur before deployments. Specialty gynecologic care and medications for cycle control should be readily accessible to all female soldiers during deployments.