Review of Veterans Health Administration Reproductive Health Services

The VA Office of Inspector General (OIG) conducted a national review of Veterans Health Administration’s (VHA) reproductive health services. The need for VHA to ensure ample capacity of reproductive health services is highlighted by women being the fastest growing veteran demographic; recent court decisions and subsequent changes in state legislation that may affect access to reproductive health services through community care; and the recent expansion of reproductive health services covered in VA’s medical benefits package. The OIG found facilities were generally able to provide reproductive health services. For the most part, the concerns reported were not unique to the provision of reproductive health care and were consistent with recognized broader challenges for health care. These concerns included provision of rural health care, community care provider availability and coordination, and shortages in VHA staffing. Challenges were more frequently reported regarding implementation of services newly authorized under VA’s 2022 interim final rule related to reproductive health services, which include pregnancy options counseling and abortion services. Despite federal protections, facility leaders described concerns that providing abortion services in states with laws more restrictive than VA would place providers and staff at risk for civil or criminal liability, or disciplinary action by state licensing boards. Leaders also identified lack of community-based abortion resources in some localities and the need for ongoing national guidance and trainings as challenges for implementing these services. Given the identified challenges, the need for further national guidance and training, and the evolving legal landscape related to abortion services across the country, facility leaders will need continuing national and Veterans Integrated Service Network support while VHA’s Office of Women’s Health continues to develop and disseminate guidance to facilities. This was a descriptive review, intended for informational purposes, and the OIG made no recommendations.