Voluntary and involuntary childlessness in female veterans: associations with sexual assault.

Abstract:

OBJECTIVE:To assess associations between lifetime sexual assault and childlessness in female veterans. DESIGN:Cross-sectional, computer-assisted telephone interview study. SETTING:Two Midwestern Veterans Administration (VA) medical centers. PATIENT(S):A total of 1,004 women aged ≤52 years, VA-enrolled between 2000 and 2008. INTERVENTION(S):None. MAIN OUTCOME MEASURE(S):Sociodemographic variables, reproductive history and care utilization, and mental health. RESULT(S):A total of 620 veterans (62%) reported at least one attempted or completed sexual assault in their lifetime (LSA). Veterans with LSA more often self-reported a history of pregnancy termination (31% vs. 19%) and infertility (23% vs. 12%), as well as sexually transmitted infection (42% vs. 27%), posttraumatic stress disorder (32% vs. 10%), and postpartum dysphoria (62% vs. 44%). Lifetime sexual assault was independently associated with termination and infertility in multivariate models; sexually transmitted infection, posttraumatic stress disorder, and postpartum dysphoria were not. The LSA by period of life was as follows: 41% of participants in childhood, 15% in adulthood before the military, 33% in military, and 13% after the military (not mutually exclusive). Among the 511 who experienced a completed LSA, 23% self-reported delaying or foregoing pregnancy because of their assault. CONCLUSION(S):This study demonstrated associations between sexual assault history and pregnancy termination, delay or avoidance (voluntary childlessness), and infertility (involuntary childlessness) among female veterans. Improved gender-specific veteran medical care must attend to these reproductive complexities.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Ryan GL,Mengeling MA,Booth BM,Torner JC,Syrop CH,Sadler AG

doi

10.1016/j.fertnstert.2014.04.042

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

539-47

issue

2

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(14)00402-6

journal_volume

102

pub_type

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