Study: Female Active Duty Soldiers Face Many Barriers to Care

Much of the discussion surrounding the yet-unapproved National Defense Authorization Act for 2011 has focused on the future of “Don’t Ask, Don’t Tell.”  But the Senate version of this bill contains another controversial provision that would reverse the prohibition on use of military facilities for elective abortions, though women would have to pay for the services themselves.  Although a small step, this would be an important advance toward recognizing the significant contribution that women bring to our armed forces. 

Women make up approximately 14 percent of active duty forces, and 97 percent are of reproductive age.  Like the general U.S. population, unintended pregnancy is common among women in the military, despite policies aimed at restricting sexual contact.  The unfortunate reality is that not all sexual activity is consensual, with as many as one-third of female soldiers reporting being a victim of sexual assault.

Ibis Reproductive Health is conducting several studies aimed at understanding the experiences of women in the U.S. military seeking reproductive health care, and our research has uncovered many barriers faced by active duty soldiers.  In an online survey, about one-quarter of women who had been deployed overseas reported difficulties obtaining a birth control method at military facilities.  Women complained of problems making an appointment with a clinician to obtain contraception, the lack of availability of certain methods, an inability to get enough supplies at one time, as well as concerns about the confidentiality of services.  Those who wanted an IUD before deployment found it particularly hard to access due to restrictions about who was eligible for the method—restrictions that are not based on the most up-to-date clinical evidence.

But the biggest challenge is faced by military women deployed abroad who find themselves with an unintended pregnancy.  Federal policy under U.S. Code 1093 states that no Department of Defense facility or funds may be used for abortion except when the life of the pregnant woman is at risk.  If a pregnancy is the result of rape or incest, the abortion may be performed at a military facility, but the woman must pay for it out of pocket.  Despite these latter exceptions, and the known high rates of sexual assault against servicewomen, very few abortions take place at military facilities. 

Why do women in the military decide to seek abortion?  In our research, women with an unintended pregnancy had a strong desire to complete their tour of duty and continue serving their country, and they did not want to disrupt their service by returning home because of the pregnancy.  Beyond this, their reasons were similar to those of most women who make this difficult choice:  because it’s the wrong time in their life to have a child, because they don’t have the financial resources to support a child, because they’re worried the pregnancy will adversely affect their career, or because they were raped, among others. 

The ban on abortion care at military facilities is particularly difficult for women deployed in active combat zones, where their mobility is severely limited.  In addition, abortion is illegal in Iraq and Afghanistan except to save the life of the pregnant woman, meaning most women can’t access care off base.  Indeed, a woman’s only option to access safe abortion care may be to take personal leave to return home and pay for the service herself.  Such a requirement makes it difficult for a woman to keep her decision confidential and can delay accessing services.  It also takes her away from the job she enlisted to do.

So what’s the solution?  Military policy needs to catch up with the recently issued U.S. Medical Eligibility Criteria for Contraceptive Use and make the full range of birth control options easily available to everyone—especially long-term methods like the IUD or implants that would be most convenient during deployment.  The recent decision to make emergency contraception a required medication on the military’s basic core formulary is an encouraging step, but more work is needed to ensure widespread access to all birth control methods. 

And when a woman in the military is faced with an unintended pregnancy, she should have the same access to care and support as American women not in the military, regardless of whether she decides to continue the pregnancy or not.  Supporting the troops means supporting their reproductive rights as well.

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  • saltyc

    Because the whole situation, of women being asked to sacrifice their lives for the rest of us, and the rest of us can’t even allow her to have an abortion because we are “morally” offended by it is so screamingly wrong, I just can’t get through this very important and must-read article right now, it will ruin the rest of my day.

    Another issue, are the non-soldier wives of army men, they have a hard time accessing services because they’re not covered by insurance, live in an army town with no providers, etc. It’s sickening that I get calls from military wives needing abortion funds when they should qualify due to fetal complications, health risks, etc but these exceptions are rarely granted.

  • forced-birth-rape

    ~ I just read in my September 2010 US vogue an infuriating article titled Bye-Bye Baby. Yearlong deployments for mothers of young children By Elizabeth Rubin. Quote from the article, “What astounded me is that in the past decade, 100,000 mothers have been deployed to Afghanistan and Iraq. Not even the Soviets, the Israelis, or the Iraqi Baathists have sent mothers of infants or toddlers to the front lines.” ~

  • arekushieru

    Well, what about the fathers of infants and/or toddlers?  The article just sounded like it was still contributing to sexism towards women, but in a different way.  Sorry!  ><;

  • forced-birth-rape

    ~ One of the women in the article was a single mother, she had no one to keep her ten month old son, so she did not go in for deployment and they arrested her.~

  • colleen

    We live in a culture where zealots strive for a culture in which motherhood is obligatory and a punishment for having agreed to have sex and fatherhood, even in the simplest form …financial support, is optional. Indeed we’re rapidly approaching a time when the majority of infants will be born to single mothers.

  • arekushieru

    I’m just thinking (maybe like Colleen suggested in her comment below…?) that even single fathers seem to be given a special pass over single mothers…?

  • colleen

    I didn’t  mean to imply that the military wouldn’t deploy single fathers. These days they will deploy anyone.

  • arekushieru

    No, I’m saying that single fathers are less likely to be perceived by the public as committing a dereliction of duty by going on a mission from the military than single mothers would be.

  • crowepps

    Keep in mind, these people are not just outraged by the idea that women are having sex without religious sanction, not just horrified by the ‘promiscuity’ of having a sexual relationship with more than one man in a lifetime, but worried about the ‘disastrous’ outcome of single women raising children at all.


    I cannot find the quote right now, but in a discussion of gays adopting, one Christian insists that children ‘had’ to have a man and women as parents, and if that could not be provided, then it was BETTER for the child to be put in an orphanage than to be adopted by a gay OR A SINGLE WOMAN.  It doesn’t make any difference to their opinion if the single woman is the biological mother, either — if she raises the child herself without a ‘male influence’ to ‘demonstrate masculinity’ then we all KNOW what’s going to happen!


    Conservative Christians strongly discourage even religiously devout, single Christian women who remain virgins as they approach middle age from adopting difficult to place older girls because their assumption is that without a man in the house to ‘supervise’ the parenting, the child’s character will be ruined.  No single woman can ever be faithful enough, even obsessively devoted to, compliance to their rigid religious strictures to ‘earn’ the right to be a mother without the male seal of approval conferred by a marriage.

  • crowepps

    And it is particularly ironic when the conservatives ALSO say that the ‘father is an absolutely vital part of the home and must be present to raise the children’ simultaneously with their ‘support the troops’ message that there’s no problem with father, married OR single, being gone for a year or so.  It’s hard to understand just what that vital thing is that he contributes if it can be done in absentia.


    If having children and their healthy upbringing are THE most important issue for society, and children REQUIRE both biological parents in the home to be healthy adults, then parenthood should disqualify ANY soldier from being deployed.