{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:32:38Z","timestamp":1787239958486,"version":"build-2736575974"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"5-6","funder":[{"name":"Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development","award":["IIR 13-294"],"award-info":[{"award-number":["IIR 13-294"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Military service represents a unique life transition occurring during early adulthood. Limited existing work suggests that military service delays childbearing for service members compared to civilians at a similar point in the life course and that this effect is stronger for women. The Cognitive-Social Model of Fertility Intentions posits that women form clearly defined fertility intentions when encountering situations across the life course that motivate cognitive attention toward childbearing enough that women form a conscious, actionable family-building plan. We aimed to qualitatively investigate factors influencing U.S. military veterans\u2019 fertility planning before and after military service using the Cognitive-Social Model of Fertility Intentions. To our knowledge, no previous study has qualitatively investigated U.S. military veterans\u2019 fertility intentions, nor those of men generally, using this model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Among participants who had previously completed computer-assisted telephone interviews as part of a national U.S. study investigating infertility and trauma experiences in this population, a total of 60 U.S. military veterans who had been diagnosed with combat-related Post-Traumatic Stress Disorder (PTSD) or who had experienced attempted or completed military sexual assault; a toxin exposure; or a combat injury including pelvic, head, or spinal cord injury were recruited by fertility status: infertile (n\u2009=\u200920), not infertile has biological children (n\u2009=\u200920), not infertile and no biological children (n\u2009=\u200920). We performed thematic analysis of 60 semi-structured interviews with these U.S. military veteran women and men in relation to Cognitive-Social Model of Fertility Intentions constructs. Interviews assessed socio-structural factors veterans considered important when planning their families before, during, and after military service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Before military service, veterans expressed expectations of forming a future nuclear family or expressed no childbearing expectations. Several situations emerging during and after military service motivated attention to childbearing plans, including suitable partnership, fears of deployment, age benchmarks to conclude childbearing, and military trauma. Veteran women and men reported similar fertility-relevant factors motivating attention to childbearing unique to military service, including service-related demands and military trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our qualitative findings can help support Veterans Health Administration (VHA)\u2019s efforts to anticipate reproductive healthcare services needed for both men and women. A better understanding of the contextual factors impacting post-military fertility intentions can support VHA\u2019s Whole Health approach\u2014understanding what matters to the person, not what\u2019s the matter with the person\u2014and potentially improve clinician-veteran communication and inform reproductive healthcare policy development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaf547","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T18:09:57Z","timestamp":1763230197000},"page":"e1270-e1277","source":"Crossref","is-referenced-by-count":1,"title":["Assessing United States Military Veterans\u2019 Fertility Intentions Before and After Military Service Using a Cognitive-Social Model"],"prefix":"10.1093","volume":"191","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5751-5422","authenticated-orcid":false,"given":"A M","family":"Racila","sequence":"first","affiliation":[{"name":"Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Medical Center , Iowa City, IA 52246,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0518-0461","authenticated-orcid":false,"given":"Kenda R","family":"Stewart Steffensmeier","sequence":"additional","affiliation":[{"name":"Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Medical Center , Iowa City, IA 52246,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7339-3886","authenticated-orcid":false,"given":"Monica B","family":"Paez","sequence":"additional","affiliation":[{"name":"Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Medical Center , Iowa City, IA 52246,","place":["United 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City, IA 52242,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1680-1334","authenticated-orcid":false,"given":"Aaron T","family":"Seaman","sequence":"additional","affiliation":[{"name":"Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affairs Medical Center , Iowa City, IA 52246,","place":["United States"]},{"name":"Department of Internal Medicine, Division of General Internal Medicine, University of Iowa Carver College of Medicine , Iowa City, IA 52242,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2819-3249","authenticated-orcid":false,"given":"Ginny L","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Washington School of Medicine , Seattle, WA 98195,","place":["United States"]},{"name":"Veterans Affairs Puget Sound Health Care 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