Prenatal Care for Women Veterans Who Use Department of Veterans Affairs Health Care.
OBJECTIVE
The number of women Veterans of childbearing age enrolling in Department of Veterans Affairs (VA) health care is increasing. Our objective was to describe characteristics of women veterans and resumption of VA care after delivery by use of VA prenatal benefits.


METHODS
We used data from the National Survey of Women Veterans, a population-based survey. VA-eligible women veterans with at least one live birth who had ever used VA and were younger than 45 years when VA prenatal benefits became available were categorized based on self-reported receipt of VA prenatal benefits. Characteristics of by use of VA prenatal benefits were compared using χ2 tests with Rao-Scott adjustment. All analyses used sampling weights.


RESULTS
In our analytic sample, of those who potentially had the opportunity to use VA prenatal benefits, 25% used these benefits and 75% did not. Compared with women veterans not using VA prenatal benefits, those who did were more likely to be 18 to 24 years old (39.9% vs. 3.7%; p=.03), and more likely to have self-reported diagnosed depression (62.5% vs. 24.5%; p=.02) and current depression or posttraumatic stress disorder (PTSD) symptoms (depression, 46.1% vs. 8% [p=.02]; PTSD, 52.5% vs. 14.8% [p=.02]). Compared with women veterans not using VA prenatal benefits, those who did were more likely to resume VA use after delivery (p<.001).


CONCLUSIONS
Pregnant women veterans who use VA prenatal benefits are a high-risk group. Among those who opt not to use these benefits, pregnancy is an important point of attrition from VA health care, raising concerns regarding retention of women veterans within VA and continuity of care.
Health Services Research and Development (HSR&D), Department of Veterans Affairs (VA) Puget Sound Health Care System, VA Medical Center, Seattle, Washington; Women's Veterans Health Services, Office of Patient Services, VA Central Office, Washington, DC; Department of Health Services, University of Washington School of Public Health, Seattle, Washington. Electronic address: jkaton@u.washington.edu.
Jodie G
JG
Katon
VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, North Hills, California; Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California.
Donna L
DL
Washington
VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, North Hills, California; Department of Medicine, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California.
Kristina M
KM
Cordasco
Health Services Research and Development (HSR&D), Department of Veterans Affairs (VA) Puget Sound Health Care System, VA Medical Center, Seattle, Washington; Department of Health Services, University of Washington School of Public Health, Seattle, Washington; Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington.
Gayle E
GE
Reiber
VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, North Hills, California; Department of Health Policy and Management, University of California Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, California.
Elizabeth M
EM
Yano
Women's Veterans Health Services, Office of Patient Services, VA Central Office, Washington, DC; Department of Obstetrics and Gynecology, New York University Langone School of Medicine, New York, New York.
Laurie C
LC
Zephyrin
D000328:Adult; D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D011159:Population Surveillance / Q000379:methods; D037841:Pregnant People; D011295:Prenatal Care; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D058014:Veterans Health; D014932:Women's Health Services / Q000706:statistics & numerical data; D055815:Young Adult