George Mason University Antonin Scalia Law School

A World Without Roe: What Effects Overturning Roe v. Wade May Have on Women in the Military

Written by Spring 2022 M-VETS Student Advisor Blake Pendleton.

In early May 2022, a draft opinion of Dobbs v. Jackson Women’s Health Organization et al. was leaked to the public.[1] According to the draft, the Supreme Court appears set to overturn Roe v. Wade later this summer, effectively eliminating federal constitutional protections of abortion rights.[2] Thus, individual states will be able to set varying standards and restrictions surrounding abortions, or ban them altogether. Of course, the vote is not definitive and the leaked document was only a draft of the final opinion, but it has already sparked efforts around the country to restrict or ban abortions. With the real possibility that Roe is overturned in the near future, many are preparing for the end of nationwide abortion rights. In this respect, there is sincere apprehension about the future of women’s access to reproductive health measures and abortions, including what effect this may have on the substantial number of women in the U.S. military.

The U.S. military consists of 1.3 million active-duty personnel, spanning all fifty states in approximately 450-500 bases.[3] Within this, women represent sixteen percent of the enlisted forces and nineteen percent of all officers.[4] Studies have also shown that women in the military are more likely than other American women to have an unplanned pregnancy.[5] Military women have a fifty percent higher rate of unplanned pregnancy than the general population.[6] And as of 2011, they had 72 unintended pregnancies per 1,000 women under the age of 44, as opposed to 45 per 1,000 in the general female population.[7] Further, nearly one in four military women report experiencing sexual assault in the military.[8] Nonetheless, significant numbers of female service members could soon be stationed in parts of the country with extreme limitations or outright bans on abortions. Essentially, “[i]f each state has the freedom to ban or allow abortions, the reproductive rights of women in the military would depend on where the Defense Department stations them, a decision in which they have little say.”[9]

In turn, woman service members in these areas may face tremendous hardship, and maybe even punishment, should they seek such procedures. For instance, thirteen states have “trigger laws” in effect which would ban abortions almost immediately upon Roe being overturned. Those states include Arkansas, Texas, Missouri, Kentucky, Louisiana, and Oklahoma, all of which have multiple military bases and house hundreds of thousands of troops. Similarly, twenty-six states have laws in place that lead many to presume that they are likely to ban abortions following overturning Roe.[10] Moreover, approximately seventeen states have limitations on abortions already in effect that can be enforced with or without Roe.[11] In all, according to one study, the restrictions that would follow Roe being struck down would mean almost thirty percent of women would be more than two hundred miles away from an abortion provider.[12]

Irrespective of Roe, women in the military already face more restrictions than civilian women when it comes to abortion. According to the Hyde Amendment of 1976, “No funds authorized or appropriated by Federal law…shall be expended for any abortion.”[13] Similarly, federal funds cannot be used for health benefits coverage that includes coverage of abortion.[14] In other words, the costs of the procedures in private facilities are not covered by service members’ Tricare health insurance, so they must pay out of pocket.[15] Additionally, 10 U.S.C. § 1093(b), military medical treatment facilities cannot be used to perform an abortion.[16] The only exception to these limitations is when the pregnancy is the result of a rape or incest, or when the life of the mother is endangered from the pregnancy.[17] For both exceptions, however, physicians must certify that they believe the pregnancy was the result of rape or incest, or an abortion was performed to protect the mother’s life – both often high bars to overcome.[18]

Thus, doctors on military bases are banned from performing abortions on female service members.[19] Women in the military are therefore forced to seek treatment at private facilities, which is also unlikely to be covered by their insurance. This also means that female spouses and dependents of service members must seek procedures at private facilities.[20] And adding another complication, spouses and dependents also on the same Tricare health insurance plan cannot have these procedures covered by insurance in most instances.[21] In fact, Tricare insurance also decides for service members and dependents who their military or civilian providers will be.[22]

With an overturn of Roe, this issue becomes magnified. Military women are unable to choose where they are stationed, and military facilities cannot provide elective abortions outside of extreme circumstances. As a result, the only options available are to go to a private facility off base or travel out of state. And either way, the procedure must be paid for out of pocket because it will not be covered by their military insurance. Even further, if a woman is stationed in a state with severe restrictions or complete bans on abortions, travelling out of state for a procedure could prove incredibly burdensome. To get an abortion out of state, military women would likely need to request leave from their commanders. And if deployed overseas in places where abortions are banned, requesting leave will be even more difficult or perhaps impossible. In some instances, this may also require disclosing the reason for requesting leave before it is approved. If the reason for the request is revealed, it could lead to negative comments, harassment, hostile work environments, and other negative behavior from dissenting colleagues.[23] Similarly, if a woman is known to be pregnant, but seeks an abortion privately, it may lead to questions and murmurs from those who notice that she is no longer pregnant. In all, women in such a position will face significant invasions of privacy or otherwise feel the need to “justify” their decisions to those around them to avoid scrutiny. Furthermore, some research suggests that many military women are unaware of the current military abortion policies, which could cause delays in treatment as they attempt to secure care from facilities that would not provide it.[24]

Even concealing the procedure carries negative medical implications. For instance, a woman may have to follow strict post-op instructions that do not align with military policies or the nature of her work.[25] As a result, she may have difficulty healing or experience adverse side-effects that would be avoided under proper care. Even more concerning, with restrictions or bans on abortions expected across the country, women stationed in such states may be forced to seek a procedure that is merely available to them at the expense of seeking the safest care.[26] In either instance, the concerns for the safety of military women in this regard are substantial.

A hypothetical example provides an illustrative summary of the positions military women may be in without the protections of Roe. Consider a woman in the military who becomes unexpectedly pregnant, a situation that statistics reveal is common. What are her options and their implications? For one, she can decide to go through with the pregnancy. Nothing may come of this, and she may not experience any negative outcomes whatsoever. However, there is a chance that it still negatively affects the trajectory of her career, as some jobs in the military are not available to pregnant women.[27] Second, she can also ask for a discharge from the military because of her pregnancy.[28] In fact, a 2020 report from the Government Accountability Office (GAO) found that despite increases in the number of women in the military over the past fifteen years, military women are twenty-eight percent more likely to separate from service than military men.[29] Among the common reasons influencing women’s decisions to separate were family planning, sexual assault, and dependent care.[30]

On the other hand, let’s assume she believes an abortion is the best, or maybe the only, option for a host of reasons – she does not want to have a child or go through the process of pregnancy and childbirth, she cannot financially afford to have a child, there are medical reasons why carrying a pregnancy to term may be medically detrimental (but not life threatening) to her, or the pregnancy is the result of a rape. Under the Hyde Amendment and 10 U.S.C. § 1093, federal funds could not be used for an abortion, nor can it be performed at a military medical facility unless she has sufficient evidence for a doctor to certify that the pregnancy was the result of a rape, or that the pregnancy will be life threatening. In all other circumstances, she is forced to go to a private facility and pay for the procedure on her own. Furthermore, if she is stationed in a state with trigger laws or one that is expected to ban abortion following an overturn of Roe (such as Texas, Oklahoma, Georgia, Utah, or Wyoming), she must travel out of state for a procedure. For some regions of the U.S., this may demand travelling hundreds of miles before reaching a state that allows abortion, which would certainly require requesting a leave of absence.[31] And underlying it all, with creations of criminal punishment in some states for women who obtain abortions, it also begs the question whether a military woman would be subject to criminal punishment through the civilian justice system or even under the Uniform Code of Military Justice.

So, what can be done? In lieu of the expected overturn of Roe, some branches of the military have begun considering options to provide protections for military women. For instance, the Army has reported that new policies have been drafted to provide protections should it become necessary.[32] Likewise, the Air Force recently passed laws following state restrictions on LGBTQ rights to provide medical aid, legal help, or relocation of families that may be expanded for service members living in states prohibiting abortions.[33] Some have also called on the federal government to amend or change internal military policies limiting the restrictions on abortions for service members.[34] In any respect, it may be time to take a second look at the considerable struggles pregnant military women currently face, and their magnification without the protections of Roe.

[1] Josh Gerstein and Alexander Ward, Supreme Court has voted to overturn abortion rights, draft opinion shows, POLITICO (May 3, 2022), https://www.politico.com/news/2022/05/02/supreme-court-abortion-draft-opinion-00029473.

[2] Id.

[3] Demographics of the U.S. Military, Council on Foreign Relations (July 13, 2020), https://www.cfr.org/backgrounder/demographics-us-military.

[4] Id.

[5] Id.

[6] Id.

[7] Camila Domonoske, ‘You’re on your own’: Servicewomen Describe Impact of Military’s Abortion Policy, NPR (Nov. 15, 2017), https://www.npr.org/sections/thetwo-way/2017/11/15/564336406/-you-re-on-your-own-study-describes-impact-of-militarys-abortion-policy.

[8] Melinda Wenner Moyer, ‘A Poison in the System’: The Epidemic of Military Sexual Assault, New York Times (Aug. 3, 2021), https://www.nytimes.com/2021/08/03/magazine/military-sexual-assault.html#:~:text=Of%20the%20more%20than%206%2C200,many%20convictions%20as%20in%202019.

[9] Jacqueline Feldscher, Reversing Roe Would Harm Military Readiness, Abortion-Rights Advocates Warn, Defense One (May 3, 2022), https://www.defenseone.com/policy/2022/05/reversing-roe-would-harm-military-readiness-abortion-rights-advocates-warn/366458/.

[10] Elizabeth Wolfe, 13 States Have Passed So-Called ‘Trigger Laws,’ Bans Designed To Go Into Effect If Roe V. Wade Is Overturned, CNN (May 3, 2022), https://www.cnn.com/2022/05/03/us/state-abortion-trigger-laws-roe-v-wade-overturned/index.html. See also Feldscher, supra note 9.

[11] Id.

[12] Oriana Gonzalez, Sara Wise, and Thomas Oide, Abortion could require 200-mile trips if Roe is overturned, Axios (Dec. 1, 2021), https://www.axios.com/2021/12/01/distance-abortion-roe-supreme-court-texas?utm_source=twitter&utm_medium=social&utm_campaign=editorial&utm_content=politics-abortion.

[13] Hyde Amendment Codification Act, S. 1488, 112th Cong. (2011).

[14] Hyde Amendment Codification Act, S. 1488, 112th Cong. (2011).

[15] Roxana Tiron, US Military Risks a Decline in Female Troops Under Roe Rollback, Military.com (May 7, 2022), https://www.military.com/daily-news/2022/05/07/us-military-risks-decline-female-troops-under-roe-rollback.html.

[16] 10 U.S.C. § 1093(b).

[17] Hyde Amendment Codification Act, S. 1488, 112th Cong. (2011).

[18]  Haley Britzky and Jeff Schogol, What Overturning Roe v. Wade could mean for the U.S. military, Task & Purpose (May 3, 2022), https://taskandpurpose.com/analysis/military-abortion-rights-supreme-court-roe-v-wade/.

[19] Tiron, supra note 15.

[20] Id.

[21] Id.

[22] Britzky and Schogol, supra note 18.

[23] Tiron, supra note 15.

[24] Domonoske, supra note 7.

[25] See id.

[26] Id.

[27] Id.

[28] Tiron, supra note 15.

[29] Id.

[30] Id.

[31] See Wolfe, supra note 10 (providing a map of current and potential future abortion laws across U.S. states).

[32] Rebecca Kheel, The Army Is Preparing for the End of Nationwide Abortion Rights as Senators Press to Keep Access, Military.com (May 12, 2022), https://www.military.com/daily-news/2022/05/12/army-preparing-end-of-nationwide-abortion-rights-senators-press-keep-access.html.

[33] See Feldscher, supra note 9.

[34] See Tiron, supra note 15.