Policy Knowledge and Abortion Access for US Active-Duty Servicewomen: A Mixed-Methods Study.

Area of Science:

• Reproductive Health Policy
• Military Medicine
• Public Health

Background:

• Over 80,000 US military servicewomen serve in states with abortion bans.
• Department of Defense (DOD) policies are constrained by the Hyde Amendment, limiting abortion coverage.
• Limited research exists on active-duty servicewomen's (ADSW) knowledge of reproductive health policies and abortion care access.

Purpose of the Study:

• To examine ADSW's knowledge of reproductive health policies.
• To explore the lived experiences of ADSW who have accessed abortion care.
• To identify barriers and facilitators to abortion care access within the military healthcare system.

Main Methods:

• A convergent mixed-methods design was employed.
• A 24-item questionnaire assessed policy knowledge and reproductive health experiences.
• Secondary analysis included 178 participants who self-reported obtaining an abortion while on active duty.

Main Results:

• A majority of participants lacked knowledge regarding TRICARE coverage for abortion (rape/incest), leadership permission requirements, and entitlement to convalescent leave.
• Many ADSW used personal leave, traveled long distances, and experienced financial difficulties and negative professional repercussions when accessing abortion care.
• Most participants were not offered mental health counseling post-abortion, though many felt it would have been beneficial.

Conclusions:

• Systemic lack of DOD abortion policy knowledge necessitates standardized training for healthcare professionals, leadership, and service members.
• Uniform policies ensuring equitable access to abortion care should be adopted and implemented across all military branches.
• Addressing financial burdens, stigma, and mental health support is crucial for improving abortion care access for ADSW.