PREGNANCY NOTIFICATION POLICY

[Tony]

CLASSIFICATION: UNCLASSIFIED//
ROUTINE
R 271542Z FEB 23 MID200080757062U
FM SECNAV WASHINGTON DC
TO ALNAV
INFO SECNAV WASHINGTON DC
CNO WASHINGTON DC
CMC WASHINGTON DC
BT
UNCLAS
 
ALNAV 017/23

MSGID/GENADMIN/SECNAV WASHINGTON DC/-/FEB//

SUBJ/PREGNANCY NOTIFICATION POLICY//

REF/A/SECDEF MEMORANDUM/20OCT22//
REF/B/ALNAV 071/22//
REF/C/USD-PR MEMORANDUM/16FEB23//
REF/D/NMCPHC TM-6260.01D/MAY2019//
REF/E/DODI 6025.19/13JUL22//
REF/F/SECNAVINST 1000.10B/16JAN19//
REF/G/OPNAVINST 1300.20/25SEP18//
REF/H/OPNAVINST 6000.1D/12MAR18//
REF/I/MCO 5000.12F CH-1/10MAR21//
REF/J/DODI 1332.45/30JUL18//
REF/K/CNAF M-3710.7/15MAY22//
REF/L/BUMEDINST 6200.15A/28JUL16//
REF/M/MANMED, NAVMED P-117/06FEB23//

NARR/REF A IS GUIDANCE FROM THE SECRETARY OF DEFENSE ENTITLED, "ENSURING 
ACCESS TO REPRODUCTIVE HEALTH CARE."   
REF B IS ALNAV ENTITLED "REPRODUCTIVE HEALTH SERVICES AND SUPPORT".   
REF C IS UNDER SECRETARY OF DEFENSE FOR PERSONNEL AND READINESS GUIDANCE 
ENTITLED "CHANGES TO COMMAND NOTIFICATION OF PREGNANCY POLICY."   
REF D IS NAVY AND MARINE CORPS PUBLIC HEALTH CENTER TECHNICAL MANUAL 6260.01D 
- REPRODUCTIVE AND DEVELOPMENTAL HAZARDS:  A GUIDE FOR OCCUPATIONAL HEALTH 
PROFESSIONS.   
REF E IS DOD ISSUANCE ENTITLED "INDIVIDUAL MEDICAL READINESS."   
REF F IS SECNAV INSTRUCTION ENTITLED "DEPARTMENT OF THE NAVY POLICY ON 
PARENTHOOD AND PREGNANCY."   
REF G IS OPNAV INSTRUCTION ENTITLED "DEPLOYABILITY ASSESSMENT AND ASSIGNMENT 
PROGRAM."   
REF H IS OPNAV INSTRUCTION ENTITLED "NAVY GUIDELINES CONCERNING PREGNANCY AND 
PARENTHOOD."   
REF I IS MARINE CORPS ORDER ENTITLED "MARINE CORPS POLICY CONCERNING 
PARENTHOOD AND PREGNANCY."   
REF J IS DOD ISSUANCE ENTITLED "RETENTION DETERMINATIONS FOR NON -DEPLOYABLE 
SERVICE MEMBERS."   
REF K IS CHIEF OF NAVAL AIR FORCES MANUAL ENTITLED "NAVAL AIR TRAINING AND 
OPERATING PROCEDURES STANDARDIZATION GENERAL FLIGHT AND OPERATING 
INSTRUCTIONS."   
REF L IS ENTITLED "SUSPENSION OF DIVING DUTY DURING PREGNANCY."   
REF M IS ENTITLED "MANUAL OF THE MEDICAL DEPARTMENT."//

RMKS/1.  The Department of the Navy (DON) is committed to ensuring the 
health, safety, and well-being of those who serve our country, and their 
families in an environment of safety, privacy, and respect.  References (a) 
and (b) announced the intent to establish additional privacy protections for 
reproductive health care information, including standardizing and extending 
the time Service Members have to fulfill their obligation to notify 
commanding officers (CO) of a pregnancy to no later than 20 weeks unless 
specific requirements to report sooner, such as those necessitated by 
occupational health hazards, are set forth in policy.  Reference (c) is 
newly-released policy that provides those privacy protections and associated 
procedures.

2.  Policy
    a.  Service Members shall be provided the time and flexibility to make 
private health care decisions in a manner consistent with the responsibility 
of CO to meet operational requirements and protect the health and safety of 
those Service Members in their care.
    b.  To provide Service Members with appropriate privacy protections in 
the early months of pregnancy, in accordance with reference (c), DON health 
care providers shall follow a presumption that they are not to disclose to a 
Service Member's command authorities a Service Member's pregnancy status 
prior to 20 weeks gestation unless this presumption is overcome by one of the 
notification standards listed below.  In making a disclosure pursuant to the 
notification standards established below, Department of Defense (DoD) health 
care providers shall provide the minimum amount of information required to 
satisfy the purpose of the disclosure, consistent with applicable policy.
    c.  Any DON personnel required to make mandatory notifications, such as 
related to domestic abuse or sexual assault, in accordance with applicable 
DoD, DON, or Service regulations, will do so without disclosing the Service 
Member's pregnancy status.
    d.  Consistent with existing law and Department policy, CO will protect 
the privacy of protected health information they receive under this policy, 
as they should with any other protected health information.  Such health care 
information shall be restricted to personnel with a specific need to know; 
that is, access to the information must be necessary for the conduct of 
official duties.  Personnel shall also be accountable for safeguarding this 
health care information consistent with existing law and Department policy.

3.  Confirmation of Pregnancy, Procedures for Pregnancy Notification, and 
Assessment of Duties.
    a.  A Service Member believing they are pregnant should confirm the 
pregnancy as soon as possible through testing and counseling by a DoD health 
care provider, or through a licensed non-DoD health care provider from whom 
the Service Member is receiving care, to receive the benefits of prenatal 
care and occupational health counseling.
    b.  Pregnancy Notification.  A Service Member who has confirmed pregnancy 
and intends to carry the pregnancy to term must make every effort to meet 
with a DoD health care provider at a military medical treatment facility, 
reserve medical unit, or with a TRICARE authorized provider, no later than 12 
weeks gestation.  The provider will assess whether the Service Member's 
duties could adversely impact their health, their pregnancy, or whether the 
pregnancy impacts the Service Member's ability to safely accomplish their 
mission using reference (d).  The Service Member should also consult with 
appropriate public health officials, if available.  While not all pregnancies 
will require significant alteration of the work environment, modification of 
job tasks may be required, based on medical advice and operational 
requirements, resulting in the need for light duty status.
        (1) Notification to CO Upon Confirmation.  A Service Member intending 
to carry the pregnancy to term is encouraged to notify appropriate command 
authorities upon confirmation of pregnancy, validated through a DoD health 
care provider or licensed non-DoD health care provider from whom the Service 
Member is receiving care.  This notification should include the DoD health 
care provider's assessment of whether the pregnancy impacts the Service 
Member's ability to safely accomplish their mission, the potential impact of 
their duties on their pregnancy, and any limitations recommended by the 
provider.  A Service Member receiving care from a licensed non-DoD health 
care provider is required to submit any limitations recommended by the 
provider to appropriate command authorities.
        (2) Delayed Notification to CO.  A Service Member who has confirmed 
their pregnancy and chooses to delay pregnancy notification to appropriate 
command authorities will notify the appropriate command authorities no later 
than 20 weeks gestation, unless notification must be made prior to 20 weeks 
gestation in the circumstances detailed in paragraph 4.
            (a) When a Service Member chooses to delay notification, the DoD 
health care provider will - after consultation with the Service Member - 
place the pregnant Service Member in a medical temporary non-deployable 
status and light duty status without making any reference to the Service 
Member's pregnancy status for up to 20 weeks gestation.  A Service Member 
choosing to delay notification will be advised by their health care provider 
that such delay could result in delayed access to non-medical resources or 
assessments, related to their pregnancy or health, which may benefit the 
Service Member.
            (b) No later than 20 weeks gestation, the Service Member will be 
placed on a medical temporary non-deployable status with limitations specific 
for pregnancy in accordance with references (e) through (i).
    c.  Pregnancy Termination.  A Service Member considering terminating the 
pregnancy is encouraged to consult with a DoD health care provider or a 
licensed non-DoD health care provider from whom the Service Member is 
receiving care.  The DoD health care provider will place the Service Member 
considering pregnancy termination in a medical temporary non-deployable 
status without reference to the Service Member's pregnancy status, until 
appropriate medical care and the necessary recovery period are complete.
    d.  Resources for Service Members.  Service Members may access Military 
OneSource and chaplain resources, if desired, to understand the reproductive 
health care and other resources available to them.
    e.  Guidance for Remote Locations.  Service Members assigned to remote 
locations, away from a military installation, and who receive care from a 
licensed non-DoD health care provider, are responsible for coordinating their 
individual medical readiness status with a DoD health care provider at the 
Navy Medicine Readiness and Training Command with medical cognizance, or 
reserve medical unit.

4.  Special Circumstances Affecting Notification to a CO.
    a.  Duties, Hazards, and Conditions.  There are military duties, 
occupational health hazards, and medical conditions where the proper 
execution of the military mission outweighs the interests served by delaying 
CO notification.  In these situations, DoD health care providers will 
recommend the Service Member be placed in a light duty status, to include 
temporary non -deployable status, with limitations specific to a medically-
confirmed pregnancy in accordance with references (e) and (j).  These 
situations are:
        (1) Special Personnel.  Many occupations in the DON are subject to 
occupational hazards that pose a risk to the Service Member and pregnancy.  
Service Members should consult their relevant occupational guidelines for 
pregnancy.  The DON has identified the following personnel as having mission 
responsibilities or being subject to occupational health hazards that would 
significantly risk mission accomplishment should notification to a CO of the 
Service Member's pregnancy be delayed.
            (a) Naval Aviators, Naval Flight Officers, and Aircrew assigned 
to duty involving flight operations.  These personnel shall adhere to the 
pregnancy regulations in accordance with reference (k).
            (b) Sailors or Marines assigned to diving duty must immediately 
report presumptive pregnancy to a diving medicine representative as outlined 
in reference (l).
            (c) Sailors on submarine duty must adhere to the guidelines 
outlined in reference (m), chapter 15-106.
            (d) Sailors or Marines assigned or selected to other special duty 
assignments requiring completion of a Special Duty Assignment physical exam 
must adhere to the regulations governing those programs.
        (2) Acute Medical Conditions Interfering with Duty.  The treating DoD 
health care provider has determined that there are special medical 
circumstances related to the Service Member's pregnancy that would interfere 
with their ability to safely accomplish their military mission.
        (3) Other Special Circumstances.  The notification is based on other 
special circumstances in which proper execution of the military mission 
outweighs the interests served by delaying notification, as determined on a 
case-by-case basis by a DoD health care provider (or other authorized 
official of the military medical treatment facility involved) at the grade of 
O-6 or higher, or civilian employee equivalent level.  The DON has identified 
the following special circumstances as requiring earlier notification:
            (a) Sailors and Marines who intend to carry the pregnancy to term 
and are in receipt of orders to an officer accession program, to include the 
United States Naval Academy, Naval Reserve Officers Training Corps, or 
Officer Candidate School, must inform the program offices no later than 90 
days prior to the report date for the program.  Commands will coordinate with 
the accession program to determine whether the orders can be executed or need 
to be deferred.
            (b) Sailors and Marines who intend to carry the pregnancy to term 
and are in receipt of orders to a training or educational program that will 
not be completed prior to the expected delivery date must inform their 
commands no later than 90 days prior to the report date for the program.  
Commands will coordinate with Service assignment offices and the schoolhouses 
to determine whether the training orders can be executed or need to be 
deferred.
    b.  Required Pregnancy Testing.  When pregnancy testing is included as 
part of health screenings for pre-deployment, specific job training, theater 
entry requirements, or other authorized reasons, test results will first be 
reviewed by the DoD health care provider, and will not be automatically sent 
to the appropriate command authorities.  In the event of a positive pregnancy 
test, the DoD health care provider will consult with the Service Member to 
determine their preferred course of action, in accordance with this guidance.
        (1) If the Service Member intends to carry their pregnancy to term, 
the Service Member must notify appropriate command authorities immediately.  
The Service Member will immediately be placed on a medical temporary non-
deployable status with limitations specific for pregnancy in accordance with 
reference (e), applicable Department and Service specific policy and 
procedures, and this
        guidance.
        (2) If the Service Member informs the DoD health care provider that 
they intend to or are considering pregnancy termination, the Service Member 
will be placed in a medical temporary non-deployable status without reference 
to pregnancy status, until appropriate medical care and the necessary 
recovery period are complete.  Neither the Service Member nor the DoD health 
care provider shall be required to notify the appropriate command authorities 
that pregnancy is the basis for the restricted duty status, in accordance 
with this guidance.
    c.  Deployed or Underway.  If a Service Member is confirmed to be 
pregnant while deployed or underway, the treating DoD health care provider 
will consult with the Service Member to determine their preferred course of 
action.
        (1) If the Service Member intends to carry their pregnancy to term, 
the DoD health care provider will place the Service Member on a temporary non 
-deployable status with limitations consistent with reference (d).  The 
Service Member will redeploy to their permanent duty station in accordance 
with references (h) and (i), and/or theater-level policy.
        (2) If the Service Member informs the DoD health care provider that 
they intend to or are considering pregnancy termination, the DoD health care 
provider will place the Service Member in a medical temporary non-deployable 
status without reference to the Service Member's pregnancy status.  The 
Service Member will be redeployed to their permanent duty station if required 
by theater-level policy or based on the recommendation from the DoD health 
care provider.  When the appropriate medical care and the necessary recovery 
period are complete, the Service Member may be eligible to return to the 
theater based on mission requirements and applicable theater-level policy.
    d.  Provider Notification to the Service Member.  For notifications made 
pursuant to sections 4.a., 4.b(1), and 4.c(1), DoD health care providers must 
provide the Service Member reasonable notice of no less than 1 business day, 
unless exigent mission requirements necessitate notification more quickly, 
prior to placing the Service Member on a medical temporary non-deployable 
status or light duty status with limitations specific to a medically-
confirmed pregnancy.

5.  References (f), (h), and (i) will be updated to conform with this policy.  
The Navy and Marine Corps will ensure regulations governing special duty 
assignments that trigger notification earlier than 20 weeks under paragraph 
4.a.(1)(d) do so only when non-disclosure prior to 20 weeks would 
significantly risk mission accomplishment.

6.  I encourage you to visit the Navy and Marine Corps Public Health 
Center's, "Women's Health Toolbox," at https://www.med.navy.mil/Navy-Marine-
Corps-Public-Health-Center/Womens-Health/  
for additional information and resources on myriad women's health issues.  
More information about the DoD policies can be found at 
https://www.health.mil/EnsuringAccesstoReproductiveHealth.

7.  Rest assured that the DON's work to implement the DoD's new policy is a 
priority.  I expect cooperation from leaders across the Navy and Marine Corps 
to ensure appropriate input and efficient implementation of this new policy.

8.  Released by the Honorable Carlos Del Toro, Secretary of the Navy.//

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CLASSIFICATION: UNCLASSIFIED//