Why Women in the Military Need Access to Abortion: Stories from Physicians

My patient Erica* was stationed in the Middle East and working as an Arabic translator when she was raped by her commanding officer. She became pregnant as a result and wanted an abortion. Erica couldn’t end her pregnancy at her base’s medical facility unless she reported the rape, which she refused to do. She feared that her rapist would physically assault her if she turned him in. She also worried that he would go out of his way to hurt her career. Erica had no choice but to fly home to have an abortion.

Erica knew she was pregnant at four weeks, but she had to wait another ten weeks before she could go home. In addition to increasing the medical risk of her abortion, this ten-week delay complicated Erica’s emotional recovery from the rape. Her pregnancy was a constant reminder of the attack. -- Morris Wortman, MD; Rochester, NY

I was stationed in Iceland for a year and encountered several unintended, undesired pregnancies among American servicewomen and the wives of servicemen. In Iceland, a termination is relatively easy to obtain up to 12 weeks, but between 12 and 16 weeks, a committee must approve the procedure. After 16 weeks, abortions are illegal except for medical emergencies. And on our base, abortions were prohibited except in cases of reported rape, incest, and life endangerment.

One of my patients, Brittany* was 21 years old and had been in the military for three years. She had a history of irregular periods, and by the time she realized she was pregnant, she was 16 weeks along. She had to take leave and go to the United States in order to have a safe, legal abortion. This travel added significant delay and potential risk to her procedure. Brittany also had to pay for her airfare and all other expenses herself, which was a considerable strain on the budget of a junior enlisted service person.

Fortunately, Brittany had her abortion without complications. She returned to service at the end of her leave. -- A doctor currently serving in the U.S. military who chooses to remain anonymous

My patient Carol* was excited to give birth to her first child. Her husband was a Marine serving in Afghanistan. Sadly, in her second trimester, Carol learned that her baby had a lethal anomaly. She and her husband made the difficult decision to have an abortion. That’s when they learned that the military health insurance they relied on wouldn’t cover the abortion unless Carol’s life was in danger. Her husband was outraged. He had just flown back from Afghanistan to be with her, and he angrily asked me, “I’m over there defending my country, and they won’t even take care of my family?” -- Nancy Stanwood, MD, MPH; Rochester, NY

Gail* is a 22-year-old U.S. Army private who was raped at a military base in Afghanistan. She became pregnant and wanted an abortion, but military insurance covers termination only if the woman’s life is in danger—rape doesn’t count. Gail had no choice but to come home for the procedure, interrupting her service and her career. I met her at my Rochester office in November. Although she knew she was pregnant at two weeks gestation, Gail didn’t have her abortion for another 12 weeks. She faced “red-tape” delays in coming home plus the difficulty of raising the money for her procedure. Her sole source of financial support was her mother who was living on a fixed, low income. The man who raped Gail was court-martialed and awaits trial. His punishment is uncertain while hers is all too clear. -- Morris Wortman, MD; Rochester, NY

I treated a woman last year named Olivia.* Her husband was in the military and they and their young daughter were covered through his insurance. Olivia was 17 weeks pregnant and had found out that her fetus at Trisomy 18. Trisomy 18 is a condition that affects the brain and other organs and is generally lethal. Most babies with this condition die utero or shortly after birth. Olivia was devastated. I remember she came in with her sister; her husband was then stationed in Iraq. Olivia felt that she could not continue her pregnancy. However, military health insurance will only cover abortion when the woman’s life is in danger. Tricare considered an abortion I this heartbreaking situation to be “elective” and could not be convinced to pay for the abortion. Olivia paid $3,000 out of pocket for her care. Coming up with the funds was a tremendous hardship on her and her one-year-old daughter. The harsh restrictions in Olivia’s insurance coverage made an already tragic situation that more difficult. -- Amy Bryant, MD; Carrboro, NC

*Names changed to protect patient privacy.