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NEWS | April 22, 2022

AR-MEDCOM nurse integral in consulting on new Army Parenthood, Pregnancy, and Postpartum Directive

By Master Sgt. Alexandra Hays Army Reserve Medical Command

Leaving a lasting mark on the organization they serve is a dream for many, but for one nurse, through her career in the Army Reserve, she’s been able to do just that.

Lt. Col. Kelly Bell, commander of the 7203rd Medical Support Unit in Hobart, Indiana, successfully advocated for accommodations of pregnant Soldiers and new parents, resulting in Army policy change at the highest level.

Announced and released on April 21, 2022, Bell was an integral contributor and author of the new Parenthood, Pregnancy, and Postpartum Army directive. The directive features 12 distinct policy changes that pertain to pregnant and postpartum Soldiers as well as new parents. Changes touch on areas ranging from deployment deferments, an extended timeline to take the Army Combat Fitness Test after giving birth, and attending professional military education while pregnant, to convalescent leave after pregnancy loss or miscarriage or stillbirth, and more.

“I just wanted to take care of my pregnant Soldiers the way I wanted to be taken care of,” she said of her collaboration on policy change.

“It’s a change I never thought I’d see in my career, and it’s been needed for many, many years,” said Capt. Jennifer DeMaio, a mobilization officer with Army Reserve Medical Command, who gave birth to her fourth child on April 20, 2022, the day before the directive was published.

DeMaio, who has had all four of her children while serving in the Army, said the attitude towards pregnancy is different now than it was 18 years ago when she had her first child. For example, she only received a four-month deployment deferment after having her first child.

DeMaio also praised the new one-year timeline to prepare and train for the Army Combat Fitness Test after childbirth, mentioning the level of athleticism and healing that is necessary.

“The events are completely different,” DeMaio said of the new test. “And they are harder. This one-year prep time for the ACFT is completely needed.”

DeMaio experienced a complicated pregnancy this time around and delivered a baby girl, Jessah, via C-section at 26 weeks after several weeks of bedrest. DeMaio said she is grateful for her command’s reaction to and support of her pregnancy—a hint that culture change towards the normalization of parenthood has already begun.

“This unit is the most accepting of any unit I’ve been in,” DeMaio said of her pregnancy. “I was scared to tell my leadership because I didn’t have the best reactions (to her pregnancies) in the past. But I can’t imagine it going any better—nothing but positivity.”

Maj. Quentin F. Stewart, a plans officer at Army Reserve Medical Command and father of a newborn, said he believes the policy changes align with the Chief of Staff of the Army’s “People First” initiative and will have an impact on retention.

“This is a really great change for the health and welfare of our Soldiers and Families,” Stewart, currently on paternity leave, said. “The foundation of everything we do in the Army begins with people and I believe the parent and postpartum changes brings the Army on par with the other services when it comes to supporting the important early years of new family additions.”

For Bell, advocating for new parents and helping foster change to Army policy isn’t new; she’s been fostering accommodations around this topic for a while.

Bell commissioned into the Army Reserve in 1999 through Marquette University’s Reserve Officer Training Corps program after earning a bachelor’s degree in nursing. Since then, she has worked as a nurse both in the Army, which included a deployment to Afghanistan and a stateside mobilization during the COVID-19 pandemic, and in her civilian career. In her civilian capacity, she now works at a Des Moines, Iowa Veterans Affairs primary care clinic.

With the bulk of her experience in emergency room nursing, Bell has loved taking care of others as a career. She explained that becoming pregnant with her first child while serving as a commander of a medical unit was eye-opening to the challenges faced by military mothers and new parents.

Bell encountered vague guidance on the postpartum period for new Army mothers, including in the area of accommodating a time and place for pumping breastmilk for their new infants.

“It’s a huge mental stress on a lactating Soldier if they aren’t provided the services to pump and store breastmilk for their children,” she explained.

And her first foray into advocacy touched on this issue. In 2018, Bell wrote an email to the sergeant major of uniforms branch, asking for provisions be made for lactating Soldiers to wear an alternate nursing t-shirt that would make pumping breastmilk more easily accessible: her request was approved.

This led to a revision to AR 670-1 in 2021 which includes the undershirt authorization and notes that Soldiers are permitted to breastfeed their nursing child anywhere the Soldier and child are authorized to be. Additionally, the updated uniform regulation does not require breastfeeding Soldiers to cover themselves with additional items while doing so.

“I think the most significant thing this time around is the time I’ll have to get back to the standards,” said Spc. Kellie N. Steele from Midland, Michigan, a dental specialist in the 7203rd Medical Support Unit. Steele, who is now pregnant with her fourth child (her second while serving in the Army Reserve), said she is grateful that the new Army directive will give her a year after having her child to take a record Army Combat Fitness Test.

Steele explained that after having her last child in December 2020, she experienced hip and pelvic pain, and it wasn’t safe for her to lift weights until she had fully recovered from childbirth.

“Every woman’s body is different,” Steele said. “The fact that they are extending and accommodating things means a lot.”

Steele said she is also grateful for the lactation accommodations in the new directive, as breastfeeding her children is important to her. The directive clarified and expanded Army Regulation 600-20, Army Command Policy, and now dictates where, how long, and under what conditions commanders will provide lactating Soldiers opportunity to express breastmilk and discusses its storage.

Bell was instrumental in facilitating the passing of a waiver to Tri-Service Bulletin Medical 530, which discusses food codes. The waiver allows for storage and management of breastmilk in field food establishment refrigerators, making it an option to store breastmilk for nursing Soldiers.

Steele explained that she was able to use this waiver firsthand while on annual training at Fort McCoy, Wisconsin and away from her then eight-month-old daughter for two weeks: she successfully stored her breastmilk and was able to transport it home after her temporary duty, rather than throwing it away.

Bell did not stop her advocacy there, and became active in moderating two popular Facebook groups aimed at giving Army mothers an outlet for discussing pregnancy and childbirth topics.

She found in the groups that Soldiers of all ranks and components pointed out further gaps in policy, education, and empathy on behalf of command teams. Concerns that continued to come up from new mothers included maternity and paternity leave, postpartum body composition testing, being excluded from attending professional military education while pregnant, and leadership education, among others.

Bell, along with 10 other authors, wrote a white paper published in 2021 that addressed these topics and stood as recommended revisions to the Army’s pregnancy and postpartum policies. Bell’s particular area of concentration for the paper was looking at the Army’s current operational and deployment deferment for new parents. Through research, the author group concluded that a one-year deployment deferment is necessary for both the development of the child and the child’s bond to its parent.

“We wanted to keep at least one parent at home with the infant during the child’s first 12 months,” Bell explained.

The white paper had the desired effect: senior leaders listened. Just a year after the white paper was published, policy has been issued—a speed of action which suggests how seriously the recommendations were taken by Army leadership.

“The Sergeant Major of the Army was an integral part of reading this … and working with us to get the words right from a very early stage,” said Amy Kramer, lead action officer for the policy during a Pentagon press briefing.

Kramer noted that becoming a parent is a healthy, natural part of life, and the Army is committed de-stigmatizing it.

“I think culture shift takes a lot longer than just writing a directive, but we hope that the directive will give the tools to begin the normalization of parenthood that’s necessary,” Kramer said.

For Bell, she’s leaving behind a legacy of perhaps enabling pregnant Soldiers and new parents to be both phenomenal troops and caregivers at the same time—to be able to better balance both worlds without having to choose to compromise one.

“None of these policies are now going to help me personally, but they will give me the tools needed to be a better leader,” Bell explained, and said she won’t be having any more children herself, but wanted to help usher change to help future generations of Soldiers.

“Be the change,” she said. “Advocate for your Soldiers.”

And Bell has done just that.

To access the full directive, visit: https://armypubs.army.mil/ProductMaps/PubForm/Details.aspx?PUB_ID=1024798