Overview

This is a mixed-method study aimed at gathering new evidence on reproductive health among female service members in the Canadian Armed Forces (CAF). Reproductive health includes four primary domains: contraception; undesired reproductive outcomes (including unintended pregnancy, adverse pregnancy outcomes, and infertility); assisted reproductive care; and pelvic floor dysfunctions. Additional factors that may influence reproductive outcomes will also be explored, including gynecological health (including but not limited to menstrual health, menopause, breast injury, sexually transmitted and blood-borne infections) as well as physical and psychological health (including but not limited to repetitive strain injuries, depression, and post-traumatic stress disorder). Evidence gathered on reproductive health issues will include, but not limited to, the lived experiences (occurrence), associated risk factors, access to care, including barriers and facilitators, service utilization, and career-related impacts among actively serving members and Veterans of the CAF. These will inform the development of recommendations and support services aimed at improving reproductive health care within the CAF. This project is divided into 3 convergent parts:

Part 1: An online pan-Canadian survey that will achieve a minimum total sample of 1067 participants.

Part 2: Semi-structured individual interviews (open-ended questions) will be conducted with female CAF members and Veterans who have experienced at least one reproductive health issues. A total of 30 participants are estimated to be required to achieve data saturation across the four primary domains.

Part 3: Semi-structured group discussion (open-ended questions) will be conducted with healthcare providers, who have experience with treating female reproductive health issues in CAF members, as well as stakeholders and policymakers involved in supporting female members of the CAF/Veterans. A total of 24 healthcare providers/stakeholders/policymakers will form 3 group discussion (8 participants/group).

For all 3 parts, efforts in recruitment will be made to ensure representation across CAF elements, minority groups, and native language (French and English).

Eligibility

Inclusion Criteria (part 1):

• Female (biological sex)
• Aged at least 18 years old
• Completed Basic Military Qualification (including Regular Forces, Reserve Forces (Class A, B, or C), Canadian Rangers, COATS instructors, and survivors of the LGBT Purge whose official records of service have been changed to reflect the nature of their discharge)

Inclusion Criteria (part 2):

• Female (biological sex)
• Aged at least 18 years old
• Completed Basic Military Qualification (including Regular Forces, Reserve Forces (Class A, B, or C), Canadian Rangers, COATS instructors, and survivors of the LGBT Purge whose official records of service have been changed to reflect the nature of their discharge)
• Have experienced a reproductive health issue while serving in the CAF

Inclusion Criteria (part 3):

• Healthcare providers (CAF Health Services, public servant, civilian) who has treated female patients who are actively serving and/or Veterans of the CAF in the past 5 years.
• Stakeholders who are involved in supporting reproductive health of female members of the CAF and/or Veterans.
• Policymakers who are involved in supporting reproductive health of female members of the CAF and/or Veterans.