A bipartisan group of lawmakers is pushing to ensure a proposed pilot program to give pregnant service members and dependents specialized mental health[1] care comes to fruition amid a quiet opposition campaign from the Defense Department.
The proposal was included in the House-passed version of the annual defense policy bill, but not the Senate version of the bill. As negotiators hash out a compromise version of the bill that Congress is expected to approve before the end of the year, supporters of the proposal sent a letter to negotiators urging them to include it in the final version.
“Pregnancy is a life changing event, as is postpartum recovery,” Reps. Chrissy Houlahan, D-Pa., and Don Bacon, R-Neb., and Sens. Jeanne Shaheen, D-N.H., and Deb Fischer, R-Neb., wrote to the chairmen and ranking members of the House and Senate Armed Services committees in a letter sent last week that was obtained by Military.com. "We know that you will ensure our servicewomen, and their families, receive the resources that enable them, and therefore our country, to thrive."
Spokespeople for the committees, which typically do not comment on negotiations while they are ongoing, did not respond to emailed requests for comment on the letter Monday.
The provision in question in the House-passed National Defense Authorization Act, or NDAA, would create a pilot program that would integrate perinatal mental health care into existing obstetric and postpartum care programs at military medical treatment facilities.
The proposal aims to tackle an issue brought to light in a 2022 report from the Government Accountability Office. That report found service members face mental health conditions during the perinatal period, which is the period right before and after giving birth, at a higher rate than civilians. While one in five civilian women will experience depression during or within a year of pregnancy, about one in three service members receive a new mental health diagnosis during or shortly after pregnancy, according to the GAO report[4].
Under the measure included in the House-passed NDAA, the Pentagon would have until 2028 to assess whether the pilot program "was effective in preventing the onset, or reducing the symptoms, of perinatal mental health conditions of pregnant and postpartum members of the armed forces[5] and covered beneficiaries," according to the bill text. The pilot would be available in at least two military medical treatment facilities per Defense Health Agency market.
Despite the proposal garnering bipartisan support, the Pentagon is quietly opposing the provision, a congressional aide familiar with the situation told Military.com on condition of anonymity to discuss behind-the-scenes talks.
The provision was not among the ones highlighted by the White House in a June statement on language it opposes in the House NDAA, nor was it part of the so-called "heartburn letter" that Defense Secretary Lloyd Austin recently sent to the Armed Services committees outlining the department's top concerns with the House and Senate NDAAs. But, the congressional aide said, the department is telling lawmakers that a perinatal mental health pilot program is unnecessary since it is already running a pilot program on providing doulas[6] to service members.
The doula pilot program is only available to service members and dependents going to civilian medical facilities, while the proposed perinatal program would be at military medical facilities. And while doulas can provide emotional support to their clients, they are non-medical professionals whose training focuses on providing guidance about the birthing process.
The proposed pilot program in the House NDAA, by contrast, would focus on “evidence-based activity that ... has been proven to avert the onset, or decrease the symptoms, of a perinatal mental health condition,” according to the bill text.
A Pentagon spokesperson declined to comment Monday on the department's position on the provision.
In their letter to the leaders of Armed Services committees, Houlahan, Bacon, Shaheen and Fischer said the goal of their proposal is to help overall retention of service members and their families. Houlahan and Bacon are both Air Force[7] veterans who led the House Armed Services Committee's military quality-of-life subpanel[8], while Bacon and Fischer are both in tight reelection races.
"With a 20% increase since 2005 in women serving in the military coupled with a 6% decrease in recruitment[9] since 2012, it is imperative that the Department of Defense (DoD) take steps to support the health, readiness and careers of the growing number of women serving in the military as well as fathers impacted by their spouses[10]' maternal mental health," the lawmakers wrote in the letter. "Existing evidence-based prevention programs provide a cost-effective means to improve the health, readiness and lives of our members of the armed forces and their families."
