A sign apparently posted by a nurse practitioner at the women’s health clinic at Whiteman Air Force Base in Missouri that told patients she would not provide them with contraception has been removed, officials told Air Force Times.

The sign — a photograph of which was posted Wednesday on the unofficial Facebook page Air Force amn/nco/snco ― read “For religious reasons and the health of women, I do not prescribe or counsel on contraceptive methods. I will be happy to find you a provider that can accommodate your needs.”

The sign continued: “If you would like to discuss natural family planning or fertility awareness based methods, I am more than willing to do so. Thank you for your patience and understanding.”

It was signed, Maj. Aimee Alviar, WHNP-BC ― women’s health nurse practitioner. Alviar did not respond to a Facebook message requesting comment.

Lt. Allen Palmer, a spokesman for Whiteman, confirmed Thursday morning that such a sign was posted on base and has since been taken down. Palmer declined to answer any further questions and referred all other questions to the Pentagon.

Air Force spokeswoman Brooke Brzozowske said that under Air Force regulation AFI 44-102, medical personnel are allowed to decline to provide family planning services, including contraceptives, sterilization, and emergency contraception, if they have moral, ethical, religious or professional objections.

But the AFI also states that objecting personnel are obligated to “facilitate timely identification of a willing provider” who can provide such services.

The regulation also says they should register their objections to the chief of the medical staff or department chairman when they arrive at a medical treatment facility, to allow enough time to make alternative arrangements for providing family planning services.

“The Air Force places a high value on the rights of its members to observe the tenets of their respective religion or to observe no religion at all,” Brzozowske said. “We are dedicated to maintaining an environment in which people can realize their highest potential.”

It is unclear whether Alviar notified Whiteman’s leadership about her contraceptive objections before the sign was posted, or when the sign was posted.

Officials at Whiteman refused to provide any additional information apart from confirming that the sign had been removed.

But one wife of an airman at Whiteman, who asked to not be named, said the situation put women “between a rock and a hard place.”

“She is our only women’s health doctor,” the wife told Air Force Times in a message. “Some women have been refused a referral to see someone else because they didn’t want to see her first, because she can’t assist in their problems. It was a ‘see her or you get no referral situation.’”

“We’re a small base, and we are placed in a position where the next providers may not be super accessible,” the wife continued. “There are reputations for certain clinics, and reasons why women don’t want to go certain places, and that puts them being referred to farther places. I know some women aren’t comfortable with the male [primary care manager] being involved in their matters, which is normal, but the female PCM is said to be leaving.”

The wife stressed that people at Whiteman aren’t mad at the nurse for exercising her religious freedoms, and that “she’s been nothing but nice and friendly to patients.”

“It’s more so not having another option on base ... that is really ruffling feathers,” the wife said.

Teri Prochaska, whose active-duty husband is stationed at Whiteman, said in an interview with Air Force Times that PCMs there can prescribe contraceptives.

But, Prochaska said, Alviar’s decision to not prescribe contraception complicated and frustrated her effort to obtain medical treatment for her teenage daughter last November.

Prochaska said her daughter needed treatment for medical issues that were uncommon for her age, causing her pain and concerns about her reproductive health, and affecting her day-to-day life. She wanted a thorough examination of her daughter by a women’s health provider to find the cause of and a solution to her problems, including medication ― not simply a birth control prescription from a PCM for pregnancy prevention.

When Prochaska made the appointment for her daughter, she said she was clear with the person on the phone about what she was looking for. However, nobody told her that Alviar had objections to providing birth control medication.

Prochaska said she only realized that would be a problem when she and her daughter were taken back into the clinic and saw the sign. At that point, Prochaska said she stopped the appointment because she felt Alviar couldn’t help her daughter with her issues.

She and her daughter were frustrated because her daughter missed school for an appointment that wasn’t going to be useful, Prochaska said.

After stopping the appointment, Prochaska said another nurse told her the medical center would request an appointment with another women’s health specialist off-base and let them know within 48 hours.

But Prochaska never received another call, so two days later, she called the clinic and was told the request to see someone besides a PCM was denied, because PCMs prefer to give out birth control prescriptions rather than make a referral.

Prochaska said getting just a birth control prescription from a PCM without a thorough examination was out of the question. Her older daughter previously had medical issues of her own, which were misdiagnosed by a PCM who put her on birth control, she said. Prochaska’s older daughter ended up losing most of her hair and 20 pounds because of that misdiagnosis, she said.

She filed a complaint with the Defense Department’s online Interactive Customer Evaluation, or ICE, system about a week after the appointment. That same morning, Prochaska was told that her daughter’s referral to a women’s health clinic at a hospital in Warrensburg, Missouri, about 10 miles away, had been approved. Her daughter had her appointment three weeks later ― roughly a month after the initial appointment she hoped would start solving her medical problems.

“If the AFI states she’s able to not prescribe birth control, that’s fine,” Prochaska said. “If they are able to accommodate her religious beliefs, I think that’s great. We’re mostly frustrated with the clinic staff’s inability to relay this information for people when they call to make appointments, and refusal to give people referrals off-base if they are uncomfortable with a family practitioner handling specialty issues. If I’m having issues with my joints or any other organ in my body, they’re going to refer me to a specialist, and I see this as no different.”

Stephen Losey is the air warfare reporter for Defense News. He previously covered leadership and personnel issues at Air Force Times, and the Pentagon, special operations and air warfare at Military.com. He has traveled to the Middle East to cover U.S. Air Force operations.

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