Abortion in a military population: A review of the literature

Introduction: 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. Methods: 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. Results: 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. Discussion: 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.