Elsevier

Women's Health Issues

Volume 21, Issue 4, July–August 2011, Pages 259-264
Women's Health Issues

Policy matters
Abortion Restrictions in the U.S. Military: Voices from Women Deployed Overseas

https://doi.org/10.1016/j.whi.2011.04.014Get rights and content

Abstract

Purpose

U.S. military women and dependents have few options for abortion when facing an unintended pregnancy overseas. Federal law prohibits the use of Department of Defense facilities and funds for abortion except when the woman’s life is at risk, and privately funded abortions are permitted at military facilities only if a pregnancy is the result of rape or incest. The purpose of this study was to explore military women’s experiences seeking abortion care during overseas deployment.

Methods

We reviewed routine consultation data and user queries from an online service providing information about medication abortion. Information received between September 2005 and December 2009 from U.S. military women and dependents overseas was included. All women gave consent for anonymous use of their data, which were analyzed qualitatively for themes related to experiences seeking abortion.

Findings

Data were analyzed for 130 women, including 128 women in the U.S. military and 2 military dependents. Women reported facing numerous challenges accessing abortion overseas, including legal and logistical barriers to care in-country, and real or perceived difficulties accessing abortion elsewhere owing to confidentiality concerns, fear of military reprimand for the pregnancy, and the narrow timeframe for early abortion. With no perceived alternatives, some women considered unsafe methods to terminate the pregnancy themselves.

Conclusion

U.S. servicewomen overseas lack access to safe abortion services, which may place their health and careers in jeopardy. These women should have the same rights to abortion care as women living in the United States.

Section snippets

Introduction and Background

Women make up 14% of the U.S. military’s active duty (AD) forces, and 97% are of reproductive age (Defense Manpower Data Center, 2010, Office of the Undersecretary of Defense, 2008). The most comprehensive data on unintended pregnancy in the military, conducted among a representative sample of AD women age 18 to 44 years participating in the 2005 Department of Defense Survey of Health Related Behaviors among AD Military Personnel, found an unintended pregnancy rate of 97 per 1,000 women in the

Methods

We conducted a retrospective, qualitative study analyzing data from women seeking information on medication abortion from an online service. These data came from two distinct sources: 1) de-identified e-mail queries from women looking for information on how to access medication abortion services, and 2) responses to standardized questions that were part of the online consultation to determine eligibility for early abortion. We reviewed all e-mail communication and consultation data received by

Results

Data were analyzed for 130 women, including 128 women in the U.S. military and 2 military dependents (one military spouse and one daughter). Background characteristics of participants are shown in Table 1. Eighty-eight women provided information on age and number of children. The median age was 26 years and median number of children was one; just under half of women (44%) had no children, half (49%) had one or two children, and 7% had three or four children. Among all 130 women, the majority

Discussion

This study provides a glimpse into some of the challenges faced by U.S. military women seeking abortion during an overseas deployment, while at the same time highlighting their motivations for choosing pregnancy termination. Although their reasons for seeking abortion are not unique, it is striking that some were specifically motivated by a desire to complete their tour of duty or continue their military career. The cases of women who were raped are particularly concerning, because these women

Kate Grindlay, MSPH, is a Project Manager at Ibis Reproductive Health. Her research focuses on expanding the availability and accessibility of reproductive health services for women in the United States and internationally.

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    Kate Grindlay, MSPH, is a Project Manager at Ibis Reproductive Health. Her research focuses on expanding the availability and accessibility of reproductive health services for women in the United States and internationally.

    Susan Yanow, MSW, is a consultant to several domestic and international organizations. Her projects focus on expanding access to abortion care through advocacy, training, and organizing strategies.

    Kinga Jelinska, MA, is a Project Manager at Women’s Wallet. Her research focuses on telemedicine and access to safe abortion.

    Rebecca Gomperts, MD, is the founder Women on Waves, an organization that focuses on creating access to safe medical abortion around the world.

    Daniel Grossman, MD, is a Senior Associate at Ibis Reproductive Health. His research focuses on improving access to contraception and safe abortion in the United States, Latin America, and sub-Saharan Africa, as well as improving links between reproductive health and HIV services.

    Supported by a grant from The Wallace A. Gerbode Foundation.

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