updated 7/22/2009 9:04:32 PM ET 2009-07-23T01:04:32

Veterans Affairs Department hospitals and clinics aren't always making sure women veterans have privacy when they bathe and receive exams, government auditors said Tuesday.

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As thousands of women veterans return from Iraq and Afghanistan and enter the VA's health system, the Government Accountability Office reported that no VA hospital or outpatient clinic under review is complying fully with federal privacy requirements.

GAO investigators found that many VA facilities had gynecological tables that faced the door — including one door that opened to a waiting room. It also found instances where women had to walk through a waiting area to use the restroom, instead of it being next to an exam room as required by VA policy.

At four hospitals investigators visited, women were not guaranteed access to a private bathing facility. In two of those cases, there wasn't a lock on the door.

Female veterans told the Senate Veterans' Affairs committee that VA workers need to be better educated about combat situations that women face in the two ongoing wars. Beyond privacy concerns, there are other issues as well, they said, such as a lack of child care at VA hospitals and difficulty in finding diaper-changing tables.

"Many VA facilities are not prepared to accommodate the presence of children," said Kayla Williams, an Iraq veteran and author. "Several friends have described having to change babies' diapers on the floors of VA hospitals."

A majority of the women veterans who have turned up at VA facilities are between the ages of 20 and 29, and on average are much younger than the average male veteran, the GAO survey found. Nearly 20 percent have been diagnosed with post-traumatic stress disorder, and many experienced sexual trauma while serving. Yet, a smaller percentage of eligible women than men use VA care.

Randall Williamson, director of health care issues at GAO, said while top VA officials are committed to improvements in women's care, hospitals and clinics weren't always taking simple steps to make women more comfortable — such as moving the direction of exam tables.

"Part of it comes down to commitment at the local level," Williamson said. The GAO is the investigative arm of Congress.

Patricia Hayes, chief consultant of the veterans strategic health care group at the VA, said the VA recognizes the care given to women isn't as good as what's offered to men, but it's made changes and will continue to do so.

She said space constraints and the layout of buildings pose challenges, but the VA is putting together long-term plans for construction improvements. Changes under way "will build the system that will provide care equal to the health care needs of all America's veterans, regardless of gender," Hayes said.

In 2008, the VA provided health care to more than 281,000 women veterans, a 12 percent increase from 2006. Over the next two decades, the number of women veterans is expected to increase by 17 percent.

Congress is considering legislation by Sen. Patty Murray, D-Wash., that would mandate a review of barriers keeping women veterans from getting care from the VA and require the VA to start a pilot program to provide child care to women seeking mental health care.

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