CAMBRIDGE, MA—Past studies have shown that the unintended pregnancy rate is higher among U.S. servicewomen than the general population and that servicewomen sometimes face barriers to contraceptive use.

Yet, according to a study in Military Medicine, little research has been conducted on contraceptive access and use experiences of nondeployed active duty servicewomen.1

Ibis Reproductive Health researchers and colleagues sought to remedy that by exploring the experiences of accessing contraception while in the U.S. military among active duty servicewomen who had an abortion.

From January 2015 to July 2016, the study team conducted qualitative in-depth interviews with 21 servicewomen who had obtained an abortion within the prior two years while active duty. Included were questions about participants’ experiences accessing and using contraception while in the military.

More than half of the respondents said they had obtained contraception from the military at some point and had positive feelings about the military’s contraceptive services.

Yet, the vast majority of participants described barriers to contraceptive access in the military. Among those were:

  • inadequate counseling,
  • challenges getting a preferred contraceptive method, and
  • the structure and functioning of the military health system.

Other issues were related to the demands of military service.

Participants also said they had issues with contraceptive adherence, product concerns and side effects. “Although not directly related to their service, in some cases, these barriers were exacerbated by their career,” the researchers pointed out.

“Active duty servicewomen who had an abortion experienced many barriers to accessing contraception while in the military,” study authors concluded. “These findings highlight the need to improve contraceptive counseling and access in the U.S. military. Results support the need to implement mandatory yearly and pre-deployment contraceptive counseling as required by the 2016 National Defense Authorization Act, offer contraceptive counseling in multiple settings, ensure military providers receive training to avoid contraceptive coercion, expand military clinic and pharmacy hours, increase the number of female military health care providers and providers able to administer all forms of contraception, and expand the contraceptive methods included under the Basic Core Formulary.”

Researchers said their study was limited because participants were self-selected and were asked to recall experiences up to several years in the past. They called for future studies to evaluate representative samples to understand the proportion of servicewomen with unmet contraceptive need.

Seymour JW, Fix L, Grossman D, Grindlay K. Facilitators and Barriers to Contraceptive Use Among U.S. Servicewomen Who Had an Abortion. Mil Med. 2018 Dec 7. doi: 10.1093/milmed/usy340. [Epub ahead of print] PubMed PMID: 30535236.