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Abstract
The goal of this study was to investigate the lived experience of pregnant active duty service members (ADSMs). In-depth interviews with 30 women ADSMs in the US Air Force were conducted and the bioecological framework was used to examine emerging individual and institutional factors that influenced well-being and retention of women during pregnancy. Ten themes were identified as significantly effecting the physical and psychological health, social interactions, future career goals, and desire to remain in the military among pregnant ADSMs. Pervasive, negative stereotypes and bias surrounding pregnancy within the Air Force; the effect of leadership style; changes in job tasks; and mistrust of military medical doctors were the most common. In accordance with the bioecological framework, complex, bi-directional relationships between these factors were identified. Specifically, changes in job tasks during pregnancy simultaneously protected the physical health and well-being of both women and their unborn children while exacerbating women’s experiences of negative stereotype and bias in the workplace. Organizational factors such as career field and leadership style also influenced the degree to which stigma and bias were experienced and effected women’s health, career goals, and desire to remain in the military. Airmen in career fields such as Security Forces, Aircraft Maintenance, and Pilots were more likely to experience greater changes in job tasks during pregnancy and reported greater amounts of negative stereotypes and bias, which ultimately affected both their physical and psychological health. A traditional authoritarian leadership style was associated with reports of adverse physical, psychological, and career goal ramifications. Furthermore, effective use of pregnancy accommodations among pregnant ADSMs was complicated by current organizational practices which leave medical recommendations to the discretion of operational commanders to enact/enforce. This, in turn, left pregnant ADSMs vulnerable to negative stereotypes and bias, in particular, among those with authoritarian leaders. Finally, findings illuminated widespread mistrust of military medical doctors among pregnant ADSMs. This stemmed from experiences in which women’s physical concerns were dismissed or went unnoticed, or their personal preferences for medical care and medical providers were not heeded within the military medical system. These processes exist within the larger culture of the military in which a hierarchical power structure and efficient processes are emphasized over individualization, and physical limitations are viewed as weakness. Given these findings, recommendations for improving processes were provided. Most notably, ways for targeting the negative organizational culture around pregnancy within the military are discussed, with the goal of fostering safe and effective ways for ADSMs to remain active, productive, integral parts of their units during pregnancy.