Ellen Haring was a 22-year-old Army lieutenant when she got pregnant and made the decision to have an abortion. She went to the military clinic where she was stationed in West Germany and was shocked to be told, Sorry, we can’t do anything for you.
More than 30 years later, Haring — now a retired Army colonel and director of research and programs with the Service Women’s Action Network — says that when it comes to service women’s access to abortion, virtually nothing has changed.
TRICARE, the military’s health care plan, currently covers the procedure only in cases of rape, incest or if a woman’s life is at risk — and that actually represents a broadening of the policy. Before 2013, women could only get coverage for abortions if their lives were at stake.
Similarly, Department of Defense policy holds that abortions can only be performed at military facilities in cases of rape, incest or life endangerment.
Those kind of barriers can lead to economic hardship no matter where a woman is stationed, but in foreign countries where the procedure is illegal, military women may be forced to carry to term or turn to unsafe methods to end their pregnancy.
“Nobody even talks about it,” said Haring, adding that she is helping a woman stationed in South Korea, where abortion is illegal, determine her options right now. That woman will have to alert her chain of command to her desire to get an abortion in order to take the leave that she needs to travel out of country, Haring said.
“The military has done no studies on it,” she said. “Where are women getting abortions? How is it impacting their health care?”
A small, qualitative study published Wednesday in the journal Perspectives on Sexual and Reproductive Health is one of the first to take a stab at some of those questions. Researchers spoke with 21 women who had abortions during active-duty service about how they obtained those abortions and how much they had understood about the military’s abortion policies beforehand.
Their answers suggest that abortion in the military is shrouded in stigma and secrecy — and that just like Haring was 30 years ago, the service women who terminate pregnancies are angered by the lack of support available to them.
Service women are more likely to face an unwanted pregnancy
Women now make up 15 percent of active-duty military forces, and at least one previous study suggests the rate of unintended pregnancy among those women is higher that among other women — 72 per 1,000 service women compared to 45 per 1,000 women among the general population. No one knows why that is, but some evidence indicates that service women face significant obstacles obtaining the pill and IUDs.
What’s more, many women who enlist in the military are unaware of its strict abortion policies until they are seeking care for themselves, the new study found. Only 11 of the 21 women interviewed had any knowledge of what the policies said, and all of the women said they were doubtful that other women they served with were aware of the rules. What’s more, they doubted male colleagues would care even if they did know about the policies.
“The military in general is obviously a male-based job,” one study participant told researchers. “And I don’t think any of the males care.”
As women take on an increasing role in active-duty and reserve forces, there may be pressure to change. Once they learned about the military’s policies regarding abortion, 15 of the 21 women surveyed said they disagreed with them.
Some thought the procedure should be covered by TRICARE, although they said they personally preferred the idea of seeing a non-military physician for privacy reasons. Others said the military should both cover abortion and offer the procedure at its medical facilities, not “pick and choose” which medical procedures it performs and covers.
“We pay for TRICARE. It’s not like it’s free,” one service woman said. “We pay for it, so the medical insurance that we pay for, we should be able to use it when we need to use it.”
What it’s like to seek an abortion on duty
After learning they could not get the procedure done with military health care providers and using military insurance, many of the women in the study had scrambled to find care.
One Navy service woman said a military health care provider offered “unofficial” advice about clinics that performed abortions, but the rest of the women said they did not get any kind of referral. Instead, the women — all but one of whom were in the United States at the time of their abortions — went online to find a clinic. They drove an average of an hour each way to the clinic, sometimes on multiple occasions if they were based in states with mandatory waiting periods. Many said it was challenging to find the time off.
“Many U.S. military bases are located in states that have restrictive policies, so you have the dual impact of both the military restrictions and local obstacles to care,” Kate Grindlay, a researcher with Ibis Reproductive Health and lead author of the study, told HuffPost. Women deployed overseas can similarly face logistical and legal barriers to care, as well as fear of military reprimand.
The women interviewed paid between $320 and $800 out of pocket, and at least one said she had to go back to work while still recovering. She had to use tampons so she could fulfill her duties, even though women who have surgical abortions are generally advised not to use tampons for at least a week.
Forcing women to effectively go it alone when dealing with an unintended pregnancy takes an emotional toll as well. The women feared being stigmatized for either continuing the pregnancy or getting an abortion, contributing to a cycle of secrecy and shame. Although the new study did not delve into the circumstances in which the women became pregnant, sexual assault is a problem that continues to plague the military.
“I did not tell my chain of command at all,” one said. “Part of that was because I’m only one of the very few females that works within my department. ... There’s a lot of like negative stigma that kind of goes along with that.”
“Here’s what kills me about it,” echoed Haring. “That’s a constitutional right guaranteed by the United States, but it’s not guaranteed to service women.”
This article originally appeared on HuffPost.