@article{ref1,
title="Voluntary and involuntary childlessness in female veterans: associations with sexual assault",
journal="Fertility and sterility",
year="2014",
author="Ryan, Ginny L. and Mengeling, Michelle A. and Booth, Brenda M. and Torner, James C. and Syrop, Craig H. and Sadler, Anne G.",
volume="102",
number="2",
pages="539-547",
abstract="OBJECTIVE: To assess associations between lifetime sexual assault and childlessness in female veterans. <br><br>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. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="0015-0282",
doi="10.1016/j.fertnstert.2014.04.042",
url="http://dx.doi.org/10.1016/j.fertnstert.2014.04.042"
}