UPDATE, May 6, 4:50 p.m.: The Peace Corps Equity Act was officially reintroduced in both the House and Senate on Monday, with 27 bipartisan co-sponsors in the Senate and four co-sponsors in the House so far.
Peace Corps volunteers receive no coverage for abortion care under any circumstance, including rape, incest, and life endangerment, which is a restriction that no other federal employees face. A new report released Monday, coordinated with a lobbying effort on Capitol Hill, says that returning volunteers see this policy as “punitive and unfair” and think it needs to be changed.
The report, No Exceptions: Documenting the Abortion Experiences of U.S. Peace Corps Volunteers, is a large-scale qualitative study drawing on interviews with 433 returned Peace Corps volunteers, conducted by researchers with the University of Ottawa, Cambridge Reproductive Health Consultants, and the Office of Population Research at Princeton University.
Eighteen of the 362 women interviewed for the study (5 percent of female respondents) had a personal experience with abortion while volunteering, and 32 women (9 percent) had been sexually assaulted during their time of service. The majority of women who had abortions only learned about the no-exceptions policy after they became pregnant, and 97 percent of respondents strongly disagreed with the policy as it currently stands.
Christine Carcano shared her experience with becoming pregnant from rape during her Peace Corps service in Peru with RH Reality Check via email. She didn’t want to tell her parents about the attack, she said, because “I did not want my service tarnished by this experience in anyone’s eyes.” So she turned to a fellow volunteer, who told his mother. The mother sent Carcano a $500 check with a note saying, “Money should be the last thing you have to worry about right now.”
Carcano, like many Peace Corps volunteers, subsisted on a meager stipend. She only made $300 per month, and the procedure would cost at least $500. The check from her friend’s mother allowed Carcano to have the procedure, she said, but it limited her options medically—she could only afford the smallest amount of anesthesia possible. Her doctors said it would be OK, but she said no injury she’s had in life compares to the “searing pain” of that procedure.
“I felt it in every part of my body,” she said. “What was already a traumatic experience was made all the more painful due directly to my financial limitations.” The entire ordeal was “blow after blow after blow,” she said, from being raped, to not wanting to tell anyone about it, to being forced to do so after testing positive for a sexually transmitted disease, to finding out she was pregnant, and finally being told that her medical coverage would include travel and other costs, but not an abortion itself.
“The current policy in the simplest terms is unjust,” Carcano said.
She said she doesn’t blame the Peace Corps because their hands were tied, but she urges the U.S. government to do the right thing by its volunteers. “By allowing a Peace Corps Volunteer’s employer to aid financially in these drastic and traumatizing experiences, the government would be proving how much they value our lives and our future.”
The problems Carcano had—not making enough to cover the abortion out of pocket, losing more confidentiality than she bargained for, compounding an existing trauma—are similar to those experienced by other returning volunteers who were interviewed for the new report. Women also reported being given no information other than a phone book when they asked about where they could obtain an abortion.
Because of the Peace Corps’ policy requiring women to be medically evacuated to Washington, D.C., after they are determined to be pregnant, many volunteers also reported concerns with confidentiality or with finishing their projects. Once evacuated to D.C., if the volunteer chooses to have an abortion, she has to pay for the procedure herself and remain in D.C. for about a month before being medically cleared to go back to her host country.
“If somebody leaves for, you know, a month or two, and goes to DC and comes back … it just doesn’t take much of a stretch of the imagination to kind of figure out what it was that happened to that Volunteer,” one participant noted in the study.
Given these hurdles, some volunteers seek an often-illegal abortion in their host country. Most volunteers who’d had an abortion also reported going through the procedure alone, either because they didn’t want to tell family members or because people in their support networks could not come to D.C.
Almost all of the study participants disagreed with the current policy, and a majority think it should be expanded to cover all abortions, not just those needed for dangerous or rape-induced pregnancies. The study includes a word cloud showing the most common responses volunteers had to the current policy; those words included “shocking,” “unfair,” “wrong,” “appalling,” and “bullshit.”
To make matters worse, according to the report, no other group that receives health care from the federal government—like Medicaid recipients, federal employees and their dependents, women in federal prisons, and even employees of the Peace Corps—faces the same restrictions on abortion coverage that Peace Corps volunteers do.
To remedy what is seen as a wrong-headed policy, returned volunteers and survivors of sexual assault are lobbying Congress this week to pass the Peace Corps Equity Act, slated to be introduced by Sen. Jeanne Shaheen (D-NH) and Rep. Nita Lowey (D-NY). President Obama has also included a fix to include coverage for cases of rape, incest, and life endangerment for Peace Corps volunteers in his annual budget proposal for the 2015 fiscal year.
The study’s authors also recommended better informing volunteers about the policy ahead of time and about available abortion providers; letting volunteers draw from their $7,500 readjustment allowance that they get upon return to the United States in order to pay for an abortion; finding ways to expand volunteers’ access to safe abortion care in their host countries, either with or without Peace Corps participation; and ensuring reliable access to contraceptive care.
“Extending basic reproductive health care services to female Peace Corps volunteers is long overdue,” said Sen. Shaheen in a statement. “Peace Corps Volunteers face inherent risks living and working abroad. There’s no reason they should be denied standard health care services offered to most women with federal health care coverage.”