https://armypubs.army.mil/epubs/DR_pubs/DR_a/ARN37643-ARMY_DIR_2023-04-000-WEB-1.pdf
MEMORANDUM FOR SEE DISTRIBUTION
SUBJECT: Army Directive 2023-04 (Command Notification of Pregnancy)
1. References. See enclosure.
2. Purpose. This directive implements changes to Department of the Army policy for
command notification of pregnancy to ensure Soldiers have the time and flexibility to
make private healthcare decisions, commanders can meet the responsibilities of
operational requirements, and protected health information is adequately safeguarded.
3. Applicability. This policy applies to the Regular Army, Army National Guard/Army
National Guard of the United States, and U.S. Army Reserve.
4. Policy. Where this directive conflicts with any other Army policy or procedural
guidance, this directive is controlling.
a. Definitions. For the purposes of this policy, the term “Soldier” includes U.S.
Military Academy cadets. “Reproductive health care” addresses the reproductive
processes, functions, and systems at all stages of life, including, but not limited to:
sexual health, treatment of sexually transmitted infections, contraception, menstrual
suppression, treatment of urogenital conditions, maternal health, pregnancy, and
abortion.
b. Privacy Protection. Pursuant to reference 1c, any Army personnel required to
make mandatory notifications, such as those related to domestic abuse or sexual
assault, to comply with Department of Defense (DoD) and Department of the Army
policy will do so without disclosing the Soldier’s pregnancy status.
c. Confirmation of Pregnancy. Soldiers who believe they are pregnant should
confirm their pregnancy as soon as possible through testing and consultation with a
healthcare provider from whom they are receiving care to receive the benefits of
prenatal care and occupational health counseling.
d. Pregnancy Notification. Soldiers who have confirmed their pregnancy must make
every effort to meet with a healthcare provider at a military medical treatment facility,
Reserve medical unit, or Guard medical unit or with a TRICARE-authorized provider no
later than 12 weeks gestation. The Soldier should also consult with appropriate public
health officials, if available, especially if the Soldier is not under the care of a healthcare
provider with direct access to an occupational health clinic.
S E C R E T A R Y O F T H E A R M Y
W A S H I N G T O N
SUBJECT: Army Directive 2023-04 (Command Notification of Pregnancy)
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(1) Pregnancy Profiles. Credentialed healthcare providers are authorized to
issue standard pregnancy e-Profiles for the duration of the pregnancy in accordance
with reference 1f. The profiling provider, in conjunction with occupational health as
needed, will determine whether any additional restrictions should be specified on the
standard pregnancy e-Profile to restrict exposure from workplace hazards. The provider
will make this determination through an occupational health interview to assess whether
the Soldier’s duties could adversely impact the Soldier’s health or pregnancy, or
whether the pregnancy impacts the Soldier’s ability to safely accomplish the mission.
Although 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 limited or light duty status.
(2) Notification to Commanders. Soldiers are encouraged to notify appropriate
command authorities on confirmation of pregnancy, validated through a healthcare
provider from whom the Soldier is receiving care. This notification should include the
healthcare provider’s assessment of whether the pregnancy impacts the Soldier’s ability
to safely accomplish the mission, the potential impact of official duties on the
pregnancy, and any limitations recommended by the healthcare provider. A Soldier
receiving care from a licensed non-DoD healthcare provider is required to submit any
limitations recommended by the healthcare provider to appropriate command
authorities.
(3) Delayed Notification to Commanders. Soldiers who have confirmed their
pregnancy and choose 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 4h.
(a) When a Soldier chooses to delay notification, the healthcare provider will,
after consultation with the Soldier, place the pregnant Soldier in a medical temporary
non-deployable status and limited duty or light duty status without making any reference
to the Soldier’s pregnancy status for up to 20 weeks gestation. Soldiers choosing to
delay notification will be advised by their healthcare provider that such delay could
result in delayed access to non-medical resources or assessments that may benefit
their pregnancy or health.
(b) No later than 20 weeks gestation, the Soldier will be placed on a medical
temporary non-deployable status with limitations specific to pregnancy in accordance
with references 1d, 1e, and 1i.
e. Pregnancy Termination. A Soldier considering pregnancy termination is
encouraged to consult with a healthcare provider or a licensed non-DoD healthcare
SUBJECT: Army Directive 2023-04 (Command Notification of Pregnancy)
3
provider from whom the Soldier is receiving care. The profiling healthcare provider
will place the Soldier considering pregnancy termination in a medical temporary
non-deployable status without reference to the Soldier’s pregnancy status until
appropriate medical care and the necessary recovery period are complete.
f. Resources for Soldiers. In addition to healthcare resources, Soldiers may access
Military OneSource and chaplain resources, if desired, to understand the reproductive
healthcare and other resources available to them.
g. Guidance for Remote Locations. Soldiers assigned to remote locations, away
from a military installation, and who receive care from a licensed non-DoD healthcare
provider, are responsible for coordinating their individual medical readiness status with
their nearest healthcare provider or Reserve or Guard medical unit in accordance with
reference 1f.
h. Special Circumstances Affecting Notification to a Commander.
(1) Duties, Hazards, and Conditions. In certain military duties, occupational
health hazards, and medical conditions, the proper execution of the military mission
outweighs the interests served by delaying commander notification. Healthcare
providers will place pregnant Soldiers in the following situations on a pregnancy profile
in accordance with references 1a, 1b, 1e, 1f, and 1i:
(a) Special Personnel. These Soldiers are assigned positions with mission
responsibilities or subject to occupational health hazards that would significantly risk
mission accomplishment should notification to a commander of the Soldier’s pregnancy
be delayed. Regulations addressing healthcare provider notification by those in special
duty status, including flight status and personnel reliability programs, remain in place
pursuant to references 1d and 1e.
(b) Acute Medical Conditions Interfering With Duty. The treating healthcare
provider has determined that special medical circumstances related to the Soldier’s
pregnancy would interfere with the Soldier’s ability to safely accomplish the military
mission.
(c) Other Special Circumstances. A healthcare provider or other authorized
official at the grade of O-6/GS-15 or above assigned to the military medical treatment
facility involved has determined that proper execution of the military mission outweighs
the interests served by delaying notification.
(2) Required Pregnancy Testing. When pregnancy testing is included as part of
health screenings for pre-deployment, specific job training, theater entry requirements,
SUBJECT: Army Directive 2023-04 (Command Notification of Pregnancy)
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or other authorized reasons, test results will first be reviewed by the healthcare provider
and will not automatically be sent to the appropriate command authorities. Healthcare
providers will consult with Soldiers who test positive for pregnancy to determine the
Soldier’s preferred course of action in accordance with this policy.
(a) Soldiers who intend to carry their pregnancy to term must notify appropriate
command authorities immediately. The Soldier will immediately be placed on a medical
temporary non-deployable status with limitations specific to pregnancy in accordance
with references 1b, 1e, 1f, and 1i.
(b) Soldiers who inform their healthcare provider that they intend to or are
considering pregnancy termination 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. Pursuant to this directive, neither the Soldier
nor the healthcare provider will be required to notify the appropriate command
authorities that pregnancy is the basis for the restricted duty status.
i. Pregnancy Confirmed During Deployment. Treating healthcare providers who
confirm a Soldier is pregnant while deployed will consult with the Soldier to determine
the preferred course of action.
(1) When Soldiers indicate they intend to carry their pregnancy to term, the
healthcare provider will place them on a temporary non-deployable status with
limitations as defined by reference 1i. Soldiers in this status will redeploy to their
permanent duty station in accordance with references 1f and 1i.
(2) When Soldiers indicate they intend to or are considering pregnancy
termination, the healthcare provider will place the Soldier in a medical temporary
non-deployable status without reference to the Soldier’s pregnancy status. Soldiers in
this status will be redeployed to their permanent duty station if required by reference 1i
or theater-level policy or based on the recommendation of the healthcare provider.
When the appropriate medical care and the necessary recovery period are complete,
the Soldier may be eligible to return to the theater based on mission requirements and
references 1f and 1i.
j. Provider Notification to the Soldier. For notifications made pursuant to
paragraphs 4h(1), 4h(2)(a), and 4i(1) of this directive, healthcare providers must provide
the Soldier reasonable notice of no less than one business day, unless exigent mission
requirements necessitate notification more quickly, before placing the Soldier on a
medical temporary non-deployable status, limited duty status, or light duty status with
limitations specific to a medically confirmed pregnancy.
SUBJECT: Army Directive 2023-04 (Command Notification of Pregnancy)
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5. Proponent. The Assistant Secretary of the Army (Manpower and Reserve Affairs) is
the proponent for this policy. The Office of the Surgeon General will incorporate its
provisions into AR 40–8, AR 40–501, and AR 40–502; and the Deputy Chief of
Staff, G-1 will incorporate its provisions into AR 600–20; within 2 years of the date of
this directive.
6. Duration. This directive is rescinded on publication of the revised regulations.
Encl Christine E. Wormuth
DISTRIBUTION:
Principal Officials of Headquarters, Department of the Army
Commander
U.S. Army Forces Command
U.S. Army Training and Doctrine Command
U.S. Army Materiel Command
U.S. Army Futures Command
U.S. Army Pacific
U.S. Army Europe and Africa
U.S. Army Central
U.S. Army North
U.S. Army South
U.S. Army Special Operations Command
Military Surface Deployment and Distribution Command
U.S. Army Space and Missile Defense Command/Army Strategic Command
U.S. Army Cyber Command
U.S. Army Medical Command
U.S. Army Intelligence and Security Command
U.S. Army Corps of Engineers
U.S. Army Military District of Washington
U.S. Army Test and Evaluation Command
U.S. Army Human Resources Command
Superintendent, U.S. Military Academy
Commandant, U.S. Army War College
Director, U.S. Army Civilian Human Resources Agency
Executive Director, Military Postal Service Agency
Director, U.S. Army Criminal Investigation Division
Superintendent, Arlington National Cemetery
(CONT)
SUBJECT: Army Directive 2023-04 (Command Notification of Pregnancy)
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DISTRIBUTION: (CONT)
Director, U.S. Army Acquisition Support Center
CF:
Principal Cyber Advisor
Director of Business Transformation
Commander, Eighth Army
Enclosure
REFERENCES
a. Department of Defense (DoD) Instruction 1332.45 (Retention Determinations for
Non-Deployable Soldiers), 30 July 2018, incorporating Change 1, effective
27 April 2021
b. DoD Instruction 6025.19 (Individual Medical Readiness Program), 13 July 2022
c. Under Secretary of Defense (Personnel and Readiness) memorandum (Changes to
Command Notification of Pregnancy Policy), 16 February 2023
d. Army Regulation (AR) 40–8 (Temporary Flying Restriction Due to Exogenous
Factors Affecting Aircrew Efficiency), 2 February 2022
e. AR 40–501 (Standards of Medical Fitness), 27 June 2019
f. AR 40–502 (Medical Readiness), 27 June 2019
g. AR 600–20 (Army Command Policy), 24 July 2020
h. Army Directive (AD) 2022-06 (Parenthood, Pregnancy, and Postpartum),
19 April 2022
i. Department of the Army Pamphlet 40–502 (Medical Readiness Procedures),
27 June 2019