Welcoming a new baby to your family should be one of the happiest times in your life. Some pregnant military spouses are feeling extra stress as they face delivering their babies away from their partners.
Under new guidelines from the Tricare Overseas Program contractor, SOS Government Services, some mothers-to-be may be forced to leave certain overseas locations due to high-risk pregnancies. For expectant mothers getting ready to PCS, their travel may be delayed until after their baby arrives. Tricare has stated that this is not a new policy but reflects the ongoing assessment of the local health care facilities by the contractor.
Mothers-to-be who become high-risk pregnancies while already at an OCONUS duty station have options.
Several OCONUS duty stations, like Bahrain and El Salvador, have been included in this guidance. SOS Government Services has determined that the local standard of care is not equivalent to the United States. There is not on-base maternity care available at these locations.
Other duty stations include New Delhi; Madagascar; Jakarta, Indonesia; La Paz, Bolivia; Kosovo; Qatar; Georgia; Suriname; and Chad. Other locations may be added or removed based on the changing status of health care standards in a particular place.
What is “high-risk?”
High-risk pregnancies are determined based on many factors. Often maternal age plays a role in moving a pregnancy into the high-risk category. Other factors could include gestational diabetes, other pregnancy complications, expected delivery complications or anticipated needs of the newborn based on prenatal screenings.
Military spouses who are determined to be at high-risk before they arrive in an identified duty station may stay behind until after the baby is born. Once mother and child are both medically cleared, the family can be reunited. Active duty military members could possibly have accompanied orders converted to shorter unaccompanied orders on a case-by-case basis.
Mothers-to-be who become high-risk while already at a duty station also have options. One option is “stork nesting” at a military facility of Tricare’s choosing. This could be a medical facility in the United States or one at an approved OCONUS location.
Another option would be returning to the U.S. to be near family until the baby arrives. In both cases, the travel and other expenses would be paid for.
Women who become high-risk after they are no longer able to travel will be relocated with a civilian air ambulance.
Active duty military who are identified as high-risk should consult with their command and medical practitioner. All parties should work together to determine what is best for mother and baby. Options could include expanded medical leave or an early permanent change of station.
Complications and confusion
While the policy is intended to facilitate a healthy delivery, pregnancy is not always predictable. Many textbook pregnancies end in complicated deliveries. Some newborns have unexpected health needs that must be immediately addressed. The guidance is less clear about what would happen in those cases. There is no official document that charts these possibilities or provides guidance for mothers-to-be about their options.
This becomes especially confusing when considering the guidance about seeking care in the local community. Some clinics on-base in the identified locations do refer mothers-to-be to providers in the local community.
However, Tricare has issued guidance that this care will not be covered under Tricare Prime, Tricare Prime Remote Overseas or Tricate Prime Overseas. No guidance about billing or Tricare eligibility has been issued should a normal pregnancy end with a complex birth or a baby with health concerns.
There is also no official documentation about spouses joining their pregnant partners at the selected birthing location.
This has left many military spouses confused and uncertain about their options and possible outcomes. While the health of mother and baby is always most important, pregnancy can and does change minute to minute.
I think this is an incredibly personal decision which should be decided by and controlled by the parents and should never be regulated by any government agency.