Search

Background: The unintended pregnancy rate in the US military is higher than among civilians. While 42% of unintended pregnancies end in abortion among civilian women, there are no data on the prevalence of abortion in the military overall or by service branch.Objective: This analysis was conducted to estimate unintended pregnancy rates and the percentage of unintended pregnancies that resulted in abortion among active-duty US Navy members aged 44 years or younger reporting female gender in 2016.Design: Cross-sectional survey data from the 2016 Navy Pregnancy and Parenthood Survey, collected from August to November 2016.Participants: Our sample included 3,423 active-duty US Navy members aged 44 years or younger reporting female gender, generated from a stratified random sample of 38% of all active-duty Navy women in pay grades E2-E9 and O1-O5 in 2016; the survey had a 20% response rate for females.Main Measures: We calculated pregnancy and unintended pregnancy rates, the percentage of pregnancies that were unintended, and the percentage of unintended pregnancies resulting in birth and abortion in the prior fiscal year.Key Results: Overall, the self-reported unintended pregnancy rate was 52 per 1,000 participants and 38.1% of pregnancies were unintended. The adjusted unintended pregnancy rate accounting for abortion underreporting was 68 per 1,000 participants. Unintended pregnancy rates were highest among individuals who were younger (aged 18-24) and in enlisted pay grades, compared to their counterparts. Six percent reported their unintended pregnancy resulted in abortion. Six respondents reported becoming pregnant while deployed; none of these pregnancies resulted in abortion.Conclusions: In this first study to report on abortion prevalence among US servicemembers, we found the proportion of unintended pregnancies resulting in abortion among a sample of US Navy members in 2016 was much lower than civilians, yet unintended pregnancy rates were higher. [ABSTRACT FROM AUTHOR]

Objective: To estimate the proportion of obstetrician-gynecologists (ob-gyns) who provided induced abortion in the prior year, disaggregated by surgical and medication methods, and document barriers to provision of medication abortion.Methods: In 2016-2017, we conducted a cross-sectional survey of a national sample of American College of Obstetricians and Gynecologists Fellows and Junior Fellows who were part of the Collaborative Ambulatory Research Network. We sent the survey by email, and mailed nonresponders paper surveys. We performed descriptive statistics, χ tests, and logistic regression analyses.Results: Sixty-seven percent (655/980) of Collaborative Ambulatory Research Network members responded. Ninety-nine percent reported seeing patients of reproductive age, and 72% reported having a patient in the prior year who needed or wanted an abortion. Among those seeing patients of reproductive age, 23.8% (95% CI 20.5%-27.4%) reported performing an induced abortion in the prior year; 10.4% provided surgical and medication abortion, 9.4% surgical only, and 4.0% medication only. In multivariable analysis, physicians practicing in the Midwest (adjusted odds ratio [AOR] 0.31, 95% CI 0.16-0.60) or South (AOR 0.22, 95% CI 0.11-0.42) had lower odds of provision compared with those practicing in the Northeast, whereas those practicing in an urban inner city (AOR 2.71, 95% CI 1.31-5.60) or urban non-inner-city area (AOR 2.89, 95% CI 1.48-5.64 vs midsize towns, rural areas, or military settings) had higher odds of provision. The most common reasons for not providing medication abortion were personal beliefs (34%) and practice restrictions (19%). Among those not providing medication abortion, 28% said they would if they could write a prescription for mifepristone.Conclusion: Compared with the previous national survey in 2008-2009, abortion provision may be increasing among practicing ob-gyns, although important geographic disparities persist. Few provide medication abortion, but uptake might increase if mifepristone could be prescribed. [ABSTRACT FROM AUTHOR]

Introduction: More U.S. servicewomen than civilian women experience unintended pregnancies, which can impact their health, well-being, and careers. Despite this, federal policy limits abortion access and coverage for military personnel to cases of rape, incest, and life endangerment. This study aimed to document servicewomen's experiences with unintended pregnancy and abortion during deployment, and their knowledge and opinions of military policies related to sexual activity, pregnancy, and abortion.Material and Methods: Between June 2016 and July 2017, we conducted a cross-sectional online survey among a convenience sample of current and former U.S. Military, National Guard, and Reserves members whose last deployment ended in 2010 or later. We asked open- and closed-ended questions about demographics, experiences with pregnancy and abortion during deployment, and knowledge and opinions of military policies related to sexual activity, pregnancy, and abortion. We ran descriptive statistics on closed-ended questions and inductively coded open-ended question responses. This study was approved by the Allendale Investigational Review Board.Results: A total of 319 participants were included. The majority said that servicewomen are reprimanded for sexual activity and becoming pregnant during deployment in all or some circumstances. Among these respondents, one-third said that fear of reprimand for sexual activity affects deployed servicewomen's use of contraception. Twenty respondents became pregnant or discovered that they were pregnant during deployment; twelve were unable to access the pregnancy- and/or abortion-related services they wanted or needed. Among those whose last deployment ended in 2013 or later (n = 141), when federal policy expanded abortion coverage for servicemembers to include cases of rape and incest, the minority knew the correct coverage or provision policies for abortion in cases of rape and incest or life endangerment. The majority believed that the military should cover and provide abortion in cases of rape, incest, or life endangerment and for unwanted pregnancies.Conclusion: Among this convenience sample of current and former servicewomen with an overseas deployment that ended in 2010 or later, 6% became pregnant or discovered that they were pregnant during deployment, and most of these respondents reported being unable to access the pregnancy- and/or abortion-related services they wanted or needed. The majority reported lack of knowledge of military abortion policies and that servicewomen are reprimanded for pregnancy and/or sexual activity in some or all circumstances, with many noting this reprimand as a barrier to contraceptive use for some servicewomen. Predeployment health visits may be one intervention point for disseminating the military's abortion policies; commanding officers should also be well versed in these policies so that they are able to provide effective leadership to junior military members. [ABSTRACT FROM AUTHOR]