Kelsey Holt and Kate Grindlay, Ibis Reproductive Health
At the end of last year the Senate blocked the Shaheen Amendment to the 2012 National Defense Authorization Act, which would have restored insurance coverage of abortion for women serving in the military who are raped—giving military women the same benefits that federal employees, women enrolled in Medicaid, and women in federal prison receive.
The lack of support for this bill is shocking given the high rates of sexual assault and rape in the military that put the nearly 300,000 women serving in the US military (97 percent of whom are of reproductive age) at increased risk for unintended pregnancy. While the Shaheen Amendment would have been an important step forward in ensuring comprehensive health care for servicewomen, our research at Ibis Reproductive Health has documented a number of other gaps in access to reproductive health care that also need to be addressed. We urge policymakers in 2012 to put politics aside and support the women serving our country through policies that meet their needs and promote their health and well-being.
Servicewomen need access to abortion in military medical facilities to ensure safe, confidential, and timely access to care
In addition to military insurance not covering abortions except in cases where the servicewoman’s life is in danger, current federal policy also prohibits abortions from being performed in military facilities overseas even if a woman pays for it herself, with narrow exceptions for life endangerment, rape, and incest.
In a recent study we conducted with military women and dependents seeking abortion during overseas deployment, women with an unintended pregnancy overwhelmingly wanted to complete their tour of duty and continue serving their country, and did not want to interrupt their service by returning home because of the pregnancy. The majority, however, were stationed in countries where abortion is prohibited, such as Iraq and Afghanistan, where abortion is banned except to save the life of the woman.
Women furthermore reported difficulties leaving their military bases due to combat operations and other unsafe conditions that limited their mobility. In the face of these obstacles to in-country abortion care, they had to leave to return to the US for an abortion. These circumstances adversely affect the ability of the woman’s unit to accomplish its mission, and a soldier’s travel to the United States for an abortion also delays access to this time-sensitive procedure, creates confidentiality concerns, and can negatively affect the soldier’s career.
We found that even in circumstances of rape, when women should, under current law, be entitled to abortion services at military facilities (if they pay for it themselves), many servicewomen were still seeking to terminate their pregnancy outside of the military system because they feared their account of the rape would not be believed and that the pregnancy could negatively affect their careers. More efforts are needed to ensure that servicewomen who experience military sexual trauma receive the timely care and support that they need and deserve. Moreover, military policies prohibiting or discouraging sexual activity during deployment create an environment of fear for some women, and the military should instead emphasize making reproductive health services, including the full range of contraceptive methods and abortion care, available rather than punishing the women (and men) who have unintended pregnancies.
Servicewomen need access to the full range of contraceptive methods for deployment
According to a literature review we recently published, U.S. military women experience higher rates of unintended pregnancy than women of reproductive age in the US overall, and though this may in part be due to disproportionate numbers of young women serving in the military, these rates signal health care needs that are not being met. Our research on the experiences of US military women seeking health care during deployment has found that women face a number of challenges to accessing contraceptives during deployment. Preliminary results from an online survey and telephone interviews with servicewomen show that women do not get routine counseling about contraceptive options as part of pre-deployment preparations; they do not always have access to the full range of contraceptive methods—in particular IUDs—for deployment; and they face challenges getting refills and consistently using their method during tours of duty.
Servicewomen should be able to access the full range of reproductive health care services so that they can decide if and when to have children, and can lead safe, healthy reproductive lives during and after their military service. All women in the military need to know about and have access to the full range of contraceptive methods and abortion services during overseas deployment, when they may have no other source of health care than military medical facilities. Allowing abortions to be provided in military medical facilities (and ideally be covered by military insurance to prevent financial barriers) would ensure safe, timely access to abortion care—either in-country or on a military base in the United States.
Improved reproductive health care access during deployment would not only meet the needs of servicewomen, but also help promote troop readiness, ensuring women who serve their country can do their jobs and that their units do not suffer their absences any longer than necessary. Finally, it is critical that sexual assault in the military continues to be addressed and that sexual assault survivors have access to high-quality prevention and treatment services.
Women in the military serve their country with distinction and protect our rights. We should support their rights and health, and ensure they have access to the reproductive health information, services, and products they need.