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Policy Revision Supports Expectant Mothers at Naval Support Activity Bahrain

By Mass Communication Specialist 2nd Class Victoria Kinney, U.S. Naval Forces Central Command Public Affairs | August 07, 2017

The Regional Tricare Office, Navy Medicine, International SOS (ISOS) and the Defense Health Agency have come together to update a health care policy that affected some expectant mothers  stationed at Naval Support Activity Bahrain.

The policy update is designed to provide personal and specific prenatal care to service members and authorized beneficiaries by evaluating patients on a case-by-case basis instead of assigning them to a high-risk pregnancy group based on a set group of categories.

The previous obstetric policy International SOS (ISOS), the contract insurance company that manages service members in the U.S. Central Command (CENTCOM) area of operations, handled pregnancies with very little leniency in regards to categorization. If a pregnant woman was over the age of 35, had abnormal pap smear, or fetal malposition (potential breech), she was labeled “at risk,” and as a result, transferred to the nearest U.S. facility for treatment or given the option of “Storknesting,” which relocates the patient to Landstuhl Army Medical Center in Germany for treatment until delivery.

“We anticipate most pregnancies to be ‘low risk’,” said Lt. Cmdr. Greg Pirkl, family medicine physician, Naval Branch Health Clinic (NBHC) Bahrain. “Now we have the added benefit that these more moderate pregnancies can stay on island which will keep families together, service members on station, and allow for us to stay mission oriented.”

The key focus is mission efficiency and readiness, and the process of identifying how to safely manage treatment using the hospitals in Bahrain was streamlined with that in mind. The use of non-DoD medical facilities can include some additional financial obstacles, which require approval by the Tricare area office to ensure minimal financial impact on military families.  Before this change to the obstetric policy, some families chose to switch to Tricare Standard, which allowed the mother to deliver on the island, however this option required a $5,000 copay.  The policy change eliminates this potential burden.

“The biggest takeaway from this change of policy is that the medical teams heard the concern surrounding the policy, listened, and worked together to change the policy to better serve our patients,” said Capt. Christopher Quarles, force surgeon, U.S. Naval Forces Central Command.

Naval Branch Health Clinic (NBHC) Bahrain handles an average of 40 pregnancies per year. Under the previous policy, 41percent of current pregnancies that are receiving care at NBHC would have been considered as high risk. After the update, only four percent will need to change from routine care and the others can choose to remain in Bahrain with little to no changes to their current care plan.

NBHC Bahrain is a forward deployed clinic of U.S. Naval Hospital Sigonella, Italy. The clinic is responsible for the primary care of service members assigned to Naval Support Activity Bahrain, NAVCENT, and 91 tenant commands, as well as over 3,800 beneficiaries.