Abortion in a military population: A review of the literature

Abortion is recognized by the World Health Organization as a fundamental part of good reproductive care, and worldwide three of 10 pregnancies will end in abortion. In a military context, the number of women in the armed forces (AF) worldwide increases each year, with an average of 12.5% across North Atlantic Treaty Organization member states in 2021. Despite the increasing number of women in the AF, little is known about their abortion experiences, or even the prevalence.

This systematic search of the literature was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. MEDLINE, CINAHL, and Google Scholar were searched for relevant articles, and bibliographies were screened. Qualitative themes were determined by two authors using iterative thematic analysis.

Twenty-three articles were identified; eight met the inclusion criteria. All but one focused on a U.S. population. Three themes emerged: rates of unintended pregnancy and abortion, accessibility to abortion care, and reasons for abortion. In the majority of studies, service women (SW) had an increased rate of unintended pregnancies but a lower abortion rate. SW face policy, logistical, and institutional barriers to accessing abortion, in addition to those faced by the civilian population.

Overall, there is a paucity of information on abortion in the AF worldwide. This review highlights the need for nation-specific research into SW's experience of abortion and provides guidance on how to do so to enhance understanding and lead to evidence-based national policy on abortion for AF personnel.