Babies At The VA: Lessons Learned From Maternity Care For Veterans

Historically,  and with rare exception, the U.S. Department of Veterans Affairs provides care for veterans only , not their families.  So, if a woman veteran gave birth, the VA covered the mom’s medical bills, but not her baby’s.

It took a lot of lobbying and an Act of Congress, but a few years ago newborns with veteran moms became eligible for up to seven days of hospital care.

Alexandria Reid is a Navy veteran and an aircraft mechanic, now serving in the Air Force Reserves. She’s come to the VA in Leeds, Massachusetts, for a doctor’s appointment. The weekend before at drills she had a severe asthma attack.

Reid is also a new mom. It’s hot and humid as Reid hauls a baby carriage out of her trunk. Once she’s got her little boy Wyatt strapped in, she heads in. Reid checks into the tiny waiting room using an ATM-like machine.

Wyatt Alton Joseph Martin had up to seven days of hospital coverage from the VA when he was born, though Reid says he was healthy and didn’t need much more than routine care.

As it was planning for this coverage, the VA wanted to know how many babies were — like Wyatt — born to veteran moms. Dr. Kristin Mattocks, assistant chief of staff for research and education at the VA in central Massachusetts, conducted a study of these babies born between 2008 through 2012.

“What we found was the during that five-year period there were nearly 10,000 babies,” Mattocks says. “With the exception of a few facilities scattered across the country — maybe three or four, there’s no VA that provides on-site maternity care.”

And that, says Mattocks, makes sense. The percentage of women in the U.S. military has grown to nearly 15 percent on active duty and about 18 percent in the national guard or reserves. But despite the increase, Mattocks says the number of vets who become pregnant remains relatively small.

So the VA pays for women’s maternity care, but doesn’t actually provide the care on site. But first, Mattock’s says, “She comes to her VA provider and she gets a confirmatory pregnancy test just like you would in the private sector.”

Keep in mind that most primary care providers at the VA don’t see a lot of women, which was certainly the case when Joni Porus, a patriot missile operator in the Army for two years, got pregnant and went to see her regular VA doctor.

“He is a crusty older gentleman. Who has I think like four women patients, right?” Porus says. “But he’s very sensitive to that and he’s wonderful. So, no, the VA itself isn’t conducive to pregnancy, but it was very helpful in getting me where I needed to go.”

Taking care of women veterans has forced the institution to change. That includes hiring, for the first time, a director of reproductive health.

Dr. Laurie Zephyrin says when she came on board, she immediately saw the need to think widely about women’s health.

“So that it’s not being developed within a silo and build bridges and collaborate with other aspects of the VA health care system,” Zephyrin says.

Particularly, Zephyrin says, because about 30 percent of women veterans have mental health or chronic health conditions. So in 2013, the VA released the first national policy on maternity care and coordination. Zephyrin says all this is good, but only as good as the follow up.

“And so the policy actually designated that there should be maternity care coordinators at each site that are working toward keeping the veteran connected with the health care system during their pregnancy,” she says.

And veteran Alexandria Reid says she talks to her maternity coordinator all the time. It’s what she likes best about the whole experience. That and the attention her baby gets when she brings him to her own doctors appointments at the VA. Like the one on the day we visited together. We’re squeezed pretty tightly into the waiting room. Reid suggests moving the baby carriage out into the hall, where people walking down the hallway stop to wave and say, “Hi,” to the baby.

“That right there is the epitome of every visit here with a baby,” Reid says. “They don’t care. ‘Oh, you brought a baby? Awesome.’ And they just make it work no matter what you’re doing.”

Offering maternity care at the Veterans Administration has been a sea change. This is only the story of a few vet’s experiences, but given the daunting challenge now facing an institution buckling under the weight of an overwhelming number of Iraq and Afghanistan veterans, maternity care might just be a good example of how to make changes. Dr. Kristin Mattocks expects the growing number of women enlisting to mean a growing number of pregnant veterans and their babies.