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      U.S. Marine Cpl. Mary E. Walls (right), an ammunition technician, and linguist Sahar, both with a female engagement team, patrol with 1st Battalion, 2nd Marine Regiment in Musa Qa'leh, Afghanistan, on Aug. 6, 2010.  Walls and other female engagement team members patrolled local compounds around the district center to establish relationships with local people and talk with the women of the area in support of the International Security Assistance Force.  DoD photo by Cpl. Lindsay L. Sayres, U.S. Marine Corps.  (Released)

Cautious optimism on “No Exceptions” with important caveats

As pleased and excited as I am, by Ash Carter’s announcement, that women will be allowed in all military occupational specialties, I am also concerned that we do it right. Otherwise we may have public failures that cause people to question the decision.

The media and public discussion is preoccupied with the strength of military women: Can they make it through Ranger training? Can they drag their wounded comrades to safety?

While these issues are important I am more concerned with other medical issues which may cause problems with the unit fighting strength, cohesion, and morale. These have to do problems which may cause women to under-perform or leave military service early. However all of these problems can be remedied by relatively simple steps, if the military leadership and the public are willing to grapple with them.

The following subjects are uncomfortable. They focus on reproductive and genito-urinary issues, often avoided in public discourse. But they need to be discussed, as the vast majority of military women are in their childbearing years.

Women in combat in Southern Israel by Israel Defense Forces. CC BY 2.0 via Wikimedia Commons.
“November 13, 2007. The Karakal Battalion during its first winter training session, held in an open area in Southern Israel.” by Israel Defense Forces. CC BY 2.0 via Wikimedia Commons.

One of the biggest problems for active women in the military is unintended pregnancy. Enlisted single service women have double the rate of unintended pregnancy as their civilian counterparts. This is not because women in the service are more promiscuous than their counterparts, I believe, but because birth control is often less available. In the theater of war, until recently in Iraq and still in Afghanistan, birth control may be hard or impossible to obtain in a discreet manner. The same is true on ships.

So if a service woman gets pregnant, and chooses to carry her baby to term, she is not able to deploy. After giving birth, she has six to twelve months (depending on the service) before she can deploy again. This leads to wide spread resentment that she is “getting pregnant to avoid deployment.”

If she chooses to have an abortion, the Military Health System does not pay for the abortion, except in the case of rape or incest. Many women are stationed in foreign countries, such as Korea or Japan, where abortion is illegal. Thus they face the choice of having an illegal abortion, or asking their commanding officer for leave to go back to the US and have an abortion, which can be a very embarrassing situation for these women.

Another health issue for women in the field is the difficulty of finding clean safe bathrooms. I wrote about this in 1990 after being in the field for extended periods in Korea on the DMZ, where porto-potties were often filthy. A women has to take off her “battle rattle” in order to urinate. There was no place to put your gear down that was not a mess. In Somalia, often there were very long lines for the few porto-potties.

In Kosovo, Bosnia, Afghanistan, and Iraq, if on a convoy, it was too dangerous to stop. Men can urinate in a bottle; it is almost impossible for a woman to do that. Unfortunately, in 2011 in Afghanistan, female soldiers had to wear diapers while on the road.

Thus many female service members restrict fluids, so as to avoid the need to get outside the vehicle to urinate, and potentially be shot or step on an IED. This leads to urinary tract infections (UTIs), and dehydration. If a female service member is experiencing the intense pain from an UTI, she may not be an effective member of the fighting force.

The Female Urinary Diversion Device (FUDD) is a potential solution. While it takes some practice, it is a relatively simple way to be able to urinate without stopping.

Having your menstrual period in the deployed environment is another potential distractor. Another simple strategy is to have women go on commonly prescribed contraceptives to suppress their cycle when in the field. This is not only safe, but covers birth control as well.

Some people reading this blog will say that I am emphasizing all the reasons women should not be in the military, I would counter that argument with stressing how essential women have been to the forces fighting in the “Long War.” Recognition of their different biology will further enhance their success.

Featured image credit: “U.S. Marine Cpl. Mary E. Walls (right), an ammunition technician, and linguist Sahar, both with a female engagement team, patrol with 1st Battalion, 2nd Marine Regiment in Musa Qa’leh, Afghanistan, on Aug. 6, 2010” by Cpl. Lindsay L. Sayres, U.S. Marine Corps. Public domain via Wikimedia Commons

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