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Editor’s Note: The possible overturning of Roe v. Wade has profound implications for women in the military. Kyleanne Hunter, a senior political scientist at the RAND Corporation and former chair of the Employment and Integration Subcommittee of the Defense Advisory Committee on Women in the Services, details how pregnancy, both wanted and unwanted, poses challenges for women in the military and explains why the lack of easy access to legal abortion will prove a heavy additional burden.
The news that Roe v. Wade is likely to be overturned has sent shockwaves throughout women’s and human rights advocate communities. While the end of the protections that Roe has historically afforded will affect women throughout the United States, military service women will be uniquely impacted. Texas, Missouri, Kentucky, Louisiana, and Oklahoma—all homes to major military instillations—have “trigger laws” that will go into place immediately upon Roe being overturned, effectively banning abortion for women in those states. And bills currently working their way through the legislatures of states such as Florida and Arizona in anticipation of the Supreme Court decision will restrict access to abortion in those states.
With the repeal of Roe, women stationed in states that either have a trigger law or are poised to enact more stringent abortion bans will be faced with sharp reductions in their health care options. While Title 10 of the U.S. Code restricts the Department of Defense from funding abortions except in cases of rape, incest, or risk to the mother’s life, access to safe and legal abortion is a health care option that has been an essential part of military service women’s lives. Women in the military are more likely to experience an unintended pregnancy, miscarriage, or ectopic pregnancy than their civilian counterparts. Additionally, women in the military are more likely to be sexually assaulted and victims of intimate partner violence than their civilian counterparts, factors that increase the risk of unintended pregnancy. Restricting access to abortion may therefore have an outsized effect on women in the military.
Lawmakers have pressed the Defense Department to ensure that service members have access to safe and legal abortion even if Roe is overturned. The department and the military services have been deliberating as to how to best respond. The policy options being discussed will likely address practical challenges associated with the loss of Roe protections, but they may also create additional concerns.
While the overturn of Roe and the introduction of more restrictive state-level abortion laws will have impacts on individual service women seeking abortion as part of their health care needs, there is also the potential for a cultural backlash against women in the military in general. Moreover, policies aimed at improving conditions for service women have suffered in implementation due to poor communication about them and the continued prevalence of outdated gender norms.
Challenges Service Women Currently Face When Seeking Abortion Care
Data on the prevalence of military women seeking abortion is scarce. Because Title 10 restricts when abortions can be provided by Tricare, the Defense Department’s health care plan, the majority of abortions sought by service women are furnished by private providers. This has prevented the systematic collection of data regarding service women who have sought abortion care. However, interview and focus groups reveal that, even with Roe protections, service women do not feel they are receiving support or receiving full information about their options for health care or abortion services.
While commanders cannot prevent women from seeking an abortion, service women still report barriers to seeking care. A lack of financial resources to cover the cost of travel or non-Tricare-covered medical expenses is one such barrier—especially for young service members. There is also a fear of negative career impacts, including missed deployments or training exercises.
Even before the draft Supreme Court opinion became public, service women were discussing how their lack of choice of duty location exacerbated many of the barriers to abortion care. Since the draft opinion was leaked, this discussion has intensified, and women are concerned about access not only to abortion care but also to care after miscarriages.
The repeal of Roe may add more stress and barriers to what is already a difficult process for service women. Financial burdens and time away from one’s unit may increase if women are required to travel out of state to receive care. Additionally, the need to travel may remove women from their support network, which may heighten feelings of isolation and separate them from their primary care providers, which may complicate follow-up care.
Cultural Impacts of a Repeal of Roe
The repeal of Roe may have effects on military culture in general and on women’s integration in particular. Women’s integration into the military has been a fraught battle—in terms of both winning policy expansions and addressing cultural concerns that have hindered women’s progress. Even though all military occupations are now open to women, attitudes and beliefs about women’s service have continued to hinder women’s advancement.
To explore the potential impact of repealing Roe on service women, this essay draws on focus groups that explored perceptions of women in the military as part of the Defense Advisory Committee on Women in the Services (DACOWITS). Topics covered in these discussions included pregnancy, child care, physical fitness, and gender bias in recruitment. The focus groups were conducted between 2016 and 2019, and included 2,142 participants across 27 military installations. Focus group protocols were approved by ICF’s Institutional Review Board and received concurrence from the Defense Department’s Office of the Under Secretary of Defense for Personnel and Readiness to ensure human subjects protection.
It is not known how the overturn of Roe would impact military culture, but evidence from other policy shifts may offer some insights. Based on what was learned from the DACOWITS focus groups, three areas of concern warrant consideration: A lack of privacy and the presence of stigma could facilitate potential retaliation, abiding by new policies may reinforce harmful gender stereotypes, and misinformation about the Defense Department’s policies may circulate and create false impressions about a service woman’s health care options.
Privacy Concerns and Stigma
The DACOWITS focus groups conducted on pregnancy, postpartum reintegration, and child care issues highlight women’s concerns about privacy and their health care choices. Women recounted feeling pressure about how and when to disclose pregnancies, and that they felt a loss of control and their sense of self when it was revealed that they were pregnant.
Several women participating in the focus groups felt pressured to hide pregnancies because of the negative stigma associated with being pregnant. As one enlisted woman noted:
When I [was pregnant], it was an expectation out there that I was going to become lazy and try to get out of work and not pull my part.
Male participants confirmed this stigma. As a male officer noted:
When a female comes to me to say she is pregnant I advise her to not tell anyone. There are legal things I need to do to make sure she is protected, but once the guys find out her life will be miserable. They will either think she’s trying to get out of work, or will all have opinions about what she should do.
Participants also noted that the military’s policies around reporting pregnancy increased feelings of anxiety and otherness among service women. As a female officer noted:
For a pregnant service woman, the first thing that comes to mind being a frustration is the early notification of your commander. As soon as you find out you are pregnant, you only have two weeks to notify your [commanding officer] that you are pregnant. This can be difficult in the case of a miscarriage. It’s supposed to be confidential, but everyone knows that you are pregnant. You can be six weeks and lose the child, and now you are in a very awkward situation at work.
Losing access to safe and legal abortions following the repeal of Roe may intensify the negative experiences highlighted in these focus groups. Two weeks is a short window for mandatory notification. For women who may be considering abortion care, and who may need to travel out of state to receive that care, two weeks may not be enough time, especially considering the growing backlog in appointments. The Texas Policy Evaluation Project found that even before the September 2021 enactment of Texas’s Heartbeat Act, the average wait time for an abortion appointment was 20 days—nearly a week longer than the mandatory reporting period for military service women. While current policy does not require women to disclose to their commanders that they are choosing abortion care, the backlog of appointments coupled with the short reporting window may force women into disclosing a pregnancy before they even have an option to receive abortion care.
The need to travel out of state for an abortion may further increase women’s fear of the negative stigma associated with pregnancy, especially as it means additional time away from their units. Women who take time away from their units for pregnancy and childbirth already face stigma. As a male officer noted:
I guess it can be perceived by the unit, not necessarily rightfully or wrongly, that the female has chosen to be pregnant instead of working.
Negative perceptions around pregnancy and the resulting time away from the unit feed into gendered stereotypes about women and the degree to which they belong in military service. Stereotypes about women—from being caregivers who are ill suited to the violence required by military service, to being physically incapable of competing with or helping men in combat, to their achievements being earned by engaging in sexual favors—can hinder a woman’s ability to rise through the military ranks.
Focus group participants noted that one driver of these stereotypes may be related to motherhood. As an enlisted woman who participated in the DACOWITS focus groups noted:
[The child care facility is] open from 0600 to 1600 …. We have physical training at the last minute at 0500 or 0600 and I can’t drop my kid off, so I am going to be late. … [T]hen I get in trouble because I miss work, and everyone talks about me like I am trying to avoid work.
An enlisted man discussed the impact this has on the perceptions of women:
I have these three females that just don’t show up [to physical training]. They say it is because they need to bring their kids to daycare, but I don’t know. I think they are just afraid to PT because they are so weak after they had their kids. I have one female that has gotten out of taking a PT test for four years because she has three kids. … [I]t makes our unit look bad. It makes her look bad.
While women who seek abortion care may not have child care restrictions, they will have restrictions on physical activity after they receive an abortion. Bleeding, cramps, and pain during physical activity can persist for four to six weeks post-abortion, resulting in women spending time out of unit training. This unexplained absence may intensify any beliefs that women do not belong in the military.
As a male officer who participated in the DACOWITS focus groups noted:
[Women] are another distraction. … [I]f you have a [group] of people and preconceived notions of their capabilities as individuals you are not focusing on the mission. Gender bias is the same thing, maybe in a higher, more general way. When females disappear to do their “women health things” like breast exams or pap smears or whatever they do, it is just one more distraction from [the] unit. All their special treatment just takes the focus away from what I need my people to do[.]
Women taking time away from their units and from physical training to receive and recover from an abortion may be seen as an additional “distraction” in their units and heighten any preexisting gender stereotypes.
Poor communication has undermined the implementation of policies aimed at better integrating women into the military by allowing for misperceptions and rumors to persist. For example, when the women in combat ban was lifted, the National Defense Authorization Act (NDAA) for Fiscal Year 2015 mandated that gender-neutral occupational standards be implemented for all occupational specialties. The purpose of these standards was to ensure that an individual’s qualifications, not their gender, was the basis for occupational selection. Per Department of Defense (DOD) Instruction 1308.03, “DoD Physical Fitness/Body Composition Program,” administrative physical fitness requirements—which are used to assess the general health of service members—are age and gender normed, and are not to be used to assess a service member’s suitability for a specific occupation. However, opinion pieces cited gender-normed physical fitness standards—in other words, standards that were lower for women than for men—as a reason why women’s integration into previously closed occupations would not go well. Official communication on this issue was vague, and sometimes incorrect. An official Army briefing cited the NDAA’s mandate on gender-neutral occupational specialties as the rationale for making a gender-neutral physical fitness test, even though standards for physical fitness are not intended to be used to determine occupational suitability. This created confusion and served to strengthen assertions that standards were lowered to encourage or allow women to join combat occupations.
One of the key issues surrounding communication is that social media can get out ahead of official communication. This was also the case with the rollout of gender-neutral standards for occupational specialties. In the absence of official communication, misinformation spread widely on social media. As one enlisted man from the DACOWITS focus groups noted:
Nothing from the chain of command … but I think my [senior enlisted leader] said, “Oh they have a plan.” I saw on Facebook that the plan was to make sure women got through even if they failed. So, I guess that is their plan.
Service members—especially junior service members—who participated in the DACOWITS focus groups reported receiving more information about military policies from social media than from official command channels, and that social media rumors had negative impacts on service women during the rollout of previous policies. Regarding physical fitness standards for occupations newly opened to women, a senior enlisted woman noted:
After that story went up on [Military Service] Times Facebook page, the next day everyone came in spreading rumors about how it was going to be easier for women. Everyone got anxious. The females got anxious that they would have to go do things they didn’t want to do, and the males got anxious that they were going to get replaced by a lesser qualified female. I wish everyone would just not talk about things until they happen.
In the weeks since the Supreme Court opinion was leaked, there has been a flurry of information on social media—not all of it accurate—about what the overturn of Roe means for women, including service members. Yet despite pressure from senators and the inclusion of abortion protections in early drafts of the NDAA for Fiscal Year 2023, the Defense Department has not issued any official comments.
How the Defense Department Can Respond
Even before the decision was leaked, these three areas of concern—privacy and stigma, gendered stereotypes, and misinformation—were negatively impacting women’s recruitment and retention in the military. Women are more eligible to serve in the military than in the past, yet they are less likely to choose to join. Moreover, gender stereotypes exist in service recruiting efforts, can limit women’s military careers, and can lead to higher rates of separation. Indeed, women are 28 percent more likely than their male counterparts to leave the military at every stage of their careers.
With the repeal of Roe, service women will lose access to abortion care in several states. The Defense Department will need to respond to ensure that women have access to the full range of health care. The department’s response may affect military culture and how that response is communicated is crucial, leaving no room for misinterpretation that could heighten existing stereotypes and tensions.