Pregnancy and abortion: Experiences and attitudes of deployed US servicewomen

Introduction: More US servicewomen than civilian women experience unintended pregnancies, which can impact their health, well-being, and careers. Despite this, federal policy limits abortion access and coverage for military personnel to cases of rape, incest, and life endangerment. This study aimed to document servicewomen’s experiences with unintended pregnancy and abortion during deployment, and their knowledge and opinions of military policies related to sexual activity, pregnancy, and abortion.

Material and Methods: Between June 2016 and July 2017, we conducted a cross-sectional online survey among a convenience sample of current and former U.S. Military, National Guard, and Reserves members whose last deployment ended in 2010 or later. We asked open- and closed-ended questions about demographics, experiences with pregnancy and abortion during deployment, and knowledge and opinions of military policies related to sexual activity, pregnancy, and abortion. We ran descriptive statistics on closed-ended questions and inductively coded open-ended question responses. This study was approved by the Allendale Investigational Review Board.

Results: A total of 319 participants were included. The majority said that servicewomen are reprimanded for sexual activity and becoming pregnant during deployment in all or some circumstances. Among these respondents, one-third said that fear of reprimand for sexual activity affects deployed servicewomen’s use of contraception. Twenty respondents became pregnant or discovered that they were pregnant during deployment; twelve were unable to access the pregnancy- and/or abortion-related services they wanted or needed. Among those whose last deployment ended in 2013 or later (n = 141), when federal policy expanded abortion coverage for servicemembers to include cases of rape and incest, the minority knew the correct coverage or provision policies for abortion in cases of rape and incest or life endangerment. The majority believed that the military should cover and provide abortion in cases of rape, incest, or life endangerment and for unwanted pregnancies.

Conclusion: Among this convenience sample of current and former servicewomen with an overseas deployment that ended in 2010 or later, 6% became pregnant or discovered that they were pregnant during deployment, and most of these respondents reported being unable to access the pregnancy- and/or abortion-related services they wanted or needed. The majority reported lack of knowledge of military abortion policies and that servicewomen are reprimanded for pregnancy and/or sexual activity in some or all circumstances, with many noting this reprimand as a barrier to contraceptive use for some servicewomen. Predeployment health visits may be one intervention point for disseminating the military’s abortion policies; commanding officers should also be well versed in these policies so that they are able to provide effective leadership to junior military members.