As more states adopt policies restricting or banning abortion, it could put abortion out of reach for some military women, according to one research group.

By law, abortions are not performed in military medical facilities, nor are they covered under Tricare, unless the pregnancy is the result of an act of rape or incest, or the life of the mother is at risk. Thus military women must seek abortions in the civilian community.

“If a servicewoman now has to travel out of state for abortion care, the financial and logistical demands escalate and can put abortion care out of reach for many, especially more junior military personnel who may not have the financial resources to cover the costs or the perceived ability to request the even longer time off,” said Kate Grindlay Kelly, associate at Ibis Reproductive Health, a global research organization describing itself as dedicated to “advancing sexual and reproductive autonomy, choices, and health worldwide.”

She has conducted research into military women’s access to contraception, and experiences related to abortion.

Efforts to seek comment from officials at National Right to Life were unsuccessful.

This year, 17 bans have been enacted across 10 states. A law passed in Alabama would ban nearly all abortions, including those for pregnancies resulting from rape or incest, according to the Guttmacher Institute, a research and policy organization which tracks such legislation. One trend is new laws that would ban abortion at six weeks, once a fetal heartbeat is detected. As the Guttmacher Institute notes, none of the 6-week abortion bans or Alabama’s near-total ban, have taken effect yet, either because of litigation, or later effective dates. Abortion is still legal in all states. However, currently 43 states prohibit abortion at some specified point during pregnancy, generally except when necessary to protect the woman’s life or health, according to the Guttmacher Institute.

As of March, there are 217,602 active-duty women. According to the results of the 2015 Department of Defense Health Related Behaviors Survey, the latest survey available, 4.8 percent of the military women who responded said they had an unintended pregnancy in the past year, compared to 4.5 percent of women of reproductive age in the civilian population. The survey does not ask questions about the results of unintended pregnancy, or whether there was an abortion.

According to an online-based survey conducted by the Service Women’s Action Network, released in late 2018, 13 percent of the active-duty women who responded — 36 women — had experienced an unintended pregnancy, and of those, eight had abortions. They paid between $300 to $600 for abortion services off base, and none received follow-up care from military health providers. Overall, 799 active duty, retired and veteran women responded to the online survey, which was not a scientific sampling.

Grindlay Kelly said the research that Ibis Reproductive Health has conducted has found that service women already face many obstacles getting abortions on their own. “These barriers ranged from financial and logistical challenges to paying for and accessing care off base, to concerns about maintaining confidentiality owing to the need to disclose their pregnancy to their chain of command in order to get time off for abortion services,” she said.

If states become more restrictive and women have to travel farther, there’s greater likelihood they’d have to let their command know in order to request time off, if mission and duty requirements and timing of the abortion conflict.

DoD officials had no comment on whether they are tracking states’ legislative activity on this issue, or whether there is a DoD policy regarding requests from military women who need to take leave for an abortion.

In one study that Grindlay Kelly co-authored, published in the journal Perspectives on Sexual and Reproductive Health in December 2017, researchers interviewed 21 military women in depth who had had an abortion in the previous two years. Concerns were raised about confidentiality, stigma and possible negative effects on their careers. They described a range of consequences of not disclosing their abortions to their commands, because of their desire for confidentiality, including inability to follow medical guidelines after the abortion, adverse health effects of unsafe care, and negative impacts to their career because of an unexplained work absence.

Because of the restrictions on abortions through the military health care system, 11 of the women stated they thought it could lead more service women to carry unwanted pregnancies. These pregnancies could affect troop readiness and personnel, seven of those interviewed said.

The study was limited, qualitative research, focusing in depth to provide insight into these women’s experiences. Researchers called for more study on abortion in the military, and consequences for women who aren’t able to get an abortion while in the military.

Most traveled about an hour each way to the clinic. Six mentioned the logistical burden of traveling off base, and two said their abortion appointments were delayed because of inflexible work schedules or logistical difficulties.

And many US military bases are located in states that have restrictive abortion policies, Grindlay Kelly said. “In these contexts of additional state restrictions to abortion, servicewomen face even greater hurdles.”

In just one example of a hypothetical soldier stationed at Fort Rucker, in southeastern Alabama: If the new ban on most abortions survives a lawsuit challenging it, and that soldier needs an abortion, the closest states would be Georgia and Florida. Georgia has enacted a ban at six weeks, which is also being challenged in court, and Florida currently bans abortions after 24 weeks. On the other side of Alabama, Mississippi bans abortions after 20 weeks, but a law has been enacted that would ban abortion after six weeks. That law is also being challenged in court.

Aside from the financial issues and logistical challenges, Grindlay Kelly said, “confidentiality also becomes harder to maintain when a woman has to travel long distances and take even more time off from her military responsibilities.

“Together, these barriers can compromise women’s privacy, finances, and health.”

Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book "A Battle Plan for Supporting Military Families." She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.

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