In the months since the Supreme Court overturned a federal right to abortion access, the Defense Department has been doing some soul searching on how to respond. A Pentagon-funded report released Wednesday shows there’s little policy recourse under existing laws, concluding that better education about birth control might stem female service members’ demand for abortions.
Roughly 80,000 active duty female service members are stationed in states with restrictions on abortions in the first and second trimesters, according to Rand Corp., though that number fluctuates with constant permanent change-of-station moves and does not include civilian spouses of service members, of which there are 450,000 total in restricted states.
“Using data from the DoD Women’s Reproductive Health Survey, a DoD-wide representative survey of active-duty service women that was fielded in 2020, we estimate that between 2,573 and 4,136 active-duty service women have an abortion annually,” per the report.
Just a few dozen of those are done at military treatment facilities each year, as federal law prohibits military health insurance from covering abortions unless they are done to save the life of the mother or because the pregnancy is the result of rape or incest, in addition to preventing MTFs from performing any uncovered abortions at all.
The Dobbs v. Jackson ruling now requires some female service members to take personal leave to travel out of state to get safe abortions, or risk prosecution if they choose to undergo a medication abortion at home.
There’s little data yet about how this change will affect the military overall, but the report makes some educated guesses.
“For the past several years, the military services have been deliberately recruiting women, both to fulfill specialized positions and discrete operational needs and because they represent a higher percentage of the recruitable population than their male counterparts,” according to the report, meaning that young American women are generally better educated, more fit and have less misconduct on their records than their male counterparts.
Then there is the issue of retention.
“Service women are already more likely to leave service than their male peers,” according to the report. “Frustration with family planning in the context of a military career and gender bias and discrimination often are cited as reasons for their separation.”
While not discussed in the report, restricted access to abortion care is also an issue for women with military health insurance who very much want to be pregnant and have children.
Federal law prohibits military health insurance from covering abortions in cases where severe genetic or physical fetal abnormalities condemn a pregnancy to miscarriage or death shortly after delivery, meaning that female service members or female partners of a service member in restricted states will have to travel to end those pregnancies.
Then there is the issue of states where “life of the mother” is an exception to abortion restrictions. State laws are not clear about how sick a pregnant woman has to be to legally end her pregnancy, opening the door for doctors concerned about prosecution to spend time consulting with lawyers while their patients get worse.
“If none of these options is viable to active-duty service women, they will carry their pregnancies to term in an environment where pregnancy is perceived to be stigmatized, child care is often difficult to obtain, and having a child at the wrong time could have serious implications for career trajectories,” according to the report.
The report’s best recommendation is for the services to increase education and access to birth control, in an effort to reduce potential need for abortions.
“The WRHS found that among active-duty service women who experienced a prior-year unintended pregnancy, 28.8 percent had a birth control method that failed, 24.2 percent were not properly using their birth control method, and 56.2 percent were not using any birth control just before the pregnancy occurred,” researchers found.
And in 2018, the DoD Health-Related Behaviors Survey found that 63.3% of unintended pregnancies were the result of no contraceptive use, with another 33% using birth control “not considered to be highly effective,” which is to say methods other than hormonal contraceptives and condoms.
Meghann Myers is the Pentagon bureau chief at Military Times. She covers operations, policy, personnel, leadership and other issues affecting service members.