Experiences of abortion in the UK Armed Forces: a cross-sectional survey

Abortion is a common pregnancy outcome; in the UK one in three women will have an abortion by age 45 years. Despite women making up 11.7% of the UK Armed Forces (UKAF), anecdotal voices from patient groups and clinicians highlight their gender-specific health needs not being addressed by the UKAF. There is a worldwide absence of literature and policy on abortion care in the AF, including rates and experiences. This survey addresses the paucity of data on abortion experiences in UK servicewomen to ensure the UKAF is providing the best possible care for them.

A REDCap survey was circulated among UK servicewomen via email and social media networks, and snowball distribution was utilised to widen participation. Quantitative data were used for descriptive statistics and qualitative data were analysed iteratively by the authors, with regular meetings to agree on themes.

A total of 427 servicewomen responded: 124 (29%) declared they previously had an abortion, with 102 (23.9%) being in service. Twelve (11.8%) of these abortions were required when on deployment. Four key themes emerged: 'Trust in information holders', 'Influencers, barriers and access', 'Systemic lack of awareness' and 'Life in the military'.

This is the first study to collect data on UK servicewomen's experience around abortion care, and highlights a complex interplay of factors which may influence abortion care decisions. Stigma and judgement were pervasive threads running through all themes, negatively impacting UKAF women. Evidence-based policies and information on abortion are recommended for both servicepeople and healthcare professionals to facilitate access to abortion and begin to destigmatise it in the AF.