Policy Knowledge and Abortion Access for US Active-Duty Servicewomen: A Mixed-Methods Study

IF 2.8 4区医学 Q2 NURSING

Journal of midwifery & women's health Pub Date : 2025-11-05 DOI:10.1111/jmwh.70049

Caitlin Russell PhD, MBE, MSHP, WHNP-BC, Tiara Walz PhD, MHA, MBA, MSEd, FACHE, Laura Manzo PhD, MBA, MSN, CCRN, Shelby Mueller BSN, Sharon Messina, Sharon Arana, Keira Feng, Holly Harner PhD, MBA, MPH, RN, WHNP-BC, FAAN

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引用次数: 0

Abstract

Introduction

More than 80,000 US military servicewomen are stationed in states enforcing abortion bans. US Department of Defense (DOD) policies must adhere to the Hyde Amendment, which restricts abortion coverage. Little research exists regarding active-duty servicewomen's (ADSW) knowledge of these policies or their experiences accessing abortion care. This study examines the reproductive health policy knowledge and lived experiences of ADSW who have accessed abortion care.

Methods

A 24-item questionnaire was designed to measure reproductive health policy knowledge and explore reproductive health experiences among ADSW. Via secondary analysis, a subset of 178 participants self-reported obtaining an abortion while on active duty. A convergent mixed-methods design (quantitative and qualitative) was used.

Results

Most participants (65%; n = 115) did not know TRICARE covered abortion costs in cases of rape or incest; 77% (n = 137) erroneously believed they required leadership permission to get an abortion; and 87% (n = 155) did not know they were entitled to convalescent leave to recover after an elective abortion. More than half (53%; n = 94) took personal leave to access abortion care; 46% (n = 82) traveled more than one hour; 48% experienced financial difficulties; 31% (n = 55) experienced negative professional repercussions; 16% (n = 29) received convalescent leave; 92% (n = 164) were not offered mental health counseling; and 77% (n = 137) felt they would have benefited from mental health counseling postabortion. Qualitative themes included a systemic lack of DOD abortion policy knowledge and lived experiences of accessing abortion care (eg, financial burdens, stigma).

Discussion

Given the systemic lack of policy knowledge reported among study participants, the DOD should develop and implement a standardized abortion policy and access training for military health care professionals, leadership, and service members. Policies ensuring access to abortion should be adopted, codified, and implemented uniformly across all branches of service.

查看原文本刊更多论文

美国现役妇女的政策知识和堕胎途径：一项混合方法研究。

简介：超过8万名美国女兵驻扎在执行堕胎禁令的州。美国国防部的政策必须遵守海德修正案，该修正案限制了堕胎的覆盖范围。关于现役妇女对这些政策的了解或她们获得堕胎护理的经历的研究很少。本研究考察了获得堕胎护理的未成年未成年人的生殖健康政策知识和生活经历。方法：设计一份24题的调查问卷，对非裔美国妇女的生殖健康政策知识进行调查，并探讨她们的生殖健康经验。通过二次分析，178名参与者自我报告在服役期间堕胎。采用收敛混合方法设计（定量和定性）。结果：大多数参与者（65%,n = 115）不知道TRICARE包括强奸或乱伦案件的堕胎费用；77% （n = 137）的人错误地认为他们需要领导的许可才能堕胎；87% （n = 155）不知道他们有权在选择性堕胎后享受康复假。超过一半（53%,n = 94）的人请事假接受堕胎护理；46% （n = 82）的旅行时间超过1小时；48%的人经历过财务困难；31% （n = 55）经历了负面的职业影响；16% （n = 29）获得康复假；92% （n = 164）未接受心理健康咨询；77% （n = 137）的人认为他们会从堕胎后的心理健康咨询中受益。定性主题包括系统性地缺乏国防部堕胎政策知识和获得堕胎护理的生活经验（例如，经济负担，耻辱）。讨论：鉴于研究参与者报告的系统性政策知识缺乏，国防部应制定和实施标准化的堕胎政策，并为军事卫生保健专业人员、领导层和服务人员提供培训。应在所有服务部门采用、编纂和统一实施确保获得堕胎服务的政策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of midwifery & women's health 医学-护理

CiteScore

3.60

自引率

7.40%

发文量

103

审稿时长

6-12 weeks

期刊介绍： The Journal of Midwifery & Women''s Health (JMWH) is a bimonthly, peer-reviewed journal dedicated to the publication of original research and review articles that focus on midwifery and women''s health. JMWH provides a forum for interdisciplinary exchange across a broad range of women''s health issues. Manuscripts that address midwifery, women''s health, education, evidence-based practice, public health, policy, and research are welcomed