US servicewomen’s experiences obtaining abortion care
Awarded 2014
Large Research Grants
Kate Grindlay, MSPH
Ibis Reproductive Health

Objectives: The unintended pregnancy rate among active-duty women is 72/1,000 women compared to 52/1,000 women in the general population. Despite this, there is little information about servicewomen’s contraceptive and abortion decision making, use, and access. We sought to understand servicewomen’s experiences accessing contraceptives and abortion care and perspectives on military abortion policy. Methods: Servicewomen who had an abortion in the prior two years were recruited from clinics and via social media. Respondents participated in interviews, which asked about experiences with and attitudes toward abortion and contraceptive access and military policies. Interviews were analyzed using modified grounded theory. Results: Twenty-one servicewomen participated. Women were satisfied with the convenience and low cost of accessing contraception through the military. However, many identified barriers, including inadequate counseling, time constraints, lack of appointment availability, poor continuity of care, concerns about stigma, and inability to access their preferred method. Pregnancy timing and military responsibilities were the main reasons women chose abortion. Few received a referral for an abortion from a military provider and many wished they had received more support. Women had little knowledge about military abortion policy and once they learned about it were supportive of changes to reduce barriers. Conclusion: These results highlight policy and practice changes necessary to increase access to abortion and contraception. Routine contraceptive counseling and abortion referral and support guidelines should be implemented and access to the full range of contraceptive methods ensured. Furthermore, servicewomen favor comprehensive abortion provision and coverage. Future research should target strategies to remove identified barriers.