Women in the Armed Forces face increased and unique barriers to abortion services compared to their NHS counterparts
There is currently a considerable lack of evidence and policy pertaining to abortion care within the UK Serving Armed Forces (UK AF) population. New research [1] led by Dr Victoria Kinkaid sought to address this critical evidence gap, as the first study of its kind to investigate the abortion experiences of UK Servicewomen and the unique barriers they face in accessing abortion services.
The World Health Organisation (WHO) recognises abortion as a common healthcare intervention fundamental to good reproductive health [2]. Abortion is a common pregnancy outcome; in the United Kingdom (UK), 1 in 3 women will have an abortion by the age of 45 [3]. Additionally, 48% of pregnancies globally are unintended (defined as ‘mistimed or unwanted) and 61% of these end in abortion [4].
Abortion is a stigmatised topic worldwide, including in the UK, and currently in the UK AF, there is no data or published literature on abortion in Servicewomen [5]. There is data published relating to abortion in Servicewomen from France and the United States (US), but this may be an imperfect comparison to UK Servicewomen for socio-cultural and political reasons, as well as differing routes to healthcare. For context, due to UK law, Defence Medical Services (DMS) - where Service personnel receive their primary care - cannot provide abortions, and abortion-care must be accessed through National Health Service (NHS) commissioned services.
The aim of this new research was to address the paucity of data on abortion experiences in UK AF Servicewomen and provide a basis for future support for Servicewomen.
This was conducted through a cross-sectional survey, which was sent to UK Servicewomen through formal and informal channels. The survey sought to understand the impact of being in the military on abortion decision-making and barriers to accessing care, to inform recommendations to support comprehensive abortion-care for Servicewomen.
There were 427 respondents from all ranks and across all three Services, representing 2.6% of the 16,290 females Serving in the Regular UK AF as of October 2023 [6].
The data was analysed for descriptive statistics, and it was found that 124 of the 427 respondents (29.0%) declared they previously had an abortion. Of these, 102 (82.3%) had their abortion in-Service, and 12 (11.8%) of these abortions were required when the Servicewomen was deployed overseas. We found that only 60 (58.8%) respondents who had an abortion in Service, involved their military medical centre.
Four key themes emerged from the qualitative data, these were;
- Life in the military
- Trust in information holders
- Influences, barriers and access
- Systemic lack of awareness
While some challenges mirror civilian experiences, UK AF personnel face distinct barriers due to military-specific factors like restricted movement, lack of stability, communal living, and a hierarchy that can disempower junior personnel.
The findings suggest a number of implications, which are:
- Creation and dissemination of evidence-based information for all stakeholders, including UK AF personnel, their chain of command and defence healthcare professionals.
- An update to military policy to include abortion.
- Encourage more research to further explore abortion experiences in UK AF personnel.
- Awareness raising amongst civilian abortion providers of the unique experiences of UK AF personnel when accessing abortion-care.
- Provision of education and support to UK AF personnel and their chain of command.
To take this work forward, and put the research into practice, the team successfully applied for a two year Armed Forces Covenant Fund Trust grant through their “Servicewomen: Seen and Heard Programme”. This funding will allow 16 Servicewomen to be trained as abortion peer supporters who will be able to deliver non-judgemental support to fellow Servicewomen who are thinking about an abortion, or who have accessed one, to ensure they feel heard, valued and find the support they want and need by someone who understands Service life. Training will commence early in 2026.
Abortion-care, as defined by WHO, encompasses more than the abortion itself. Although military medical services do not provide abortions in the UK, they and the wider military, should be striving to ensure they facilitate all aspects of comprehensive abortion-care for Servicewomen.
The full research study can be accessed here [1].
Many thanks Dr Victoria Kinkaid for writing this Research Spotlight.
References
- Kinkaid, V.E., Guest, R., Willman, A. and King, K., 2025. Experiences of abortion in the UK Armed Forces: a cross-sectional survey. BMJ Sexual & Reproductive Health. Available from: Link
- World Health Organisation (WHO). Abortion [Internet]. 2024 [cited 2024 Jul 1]. Available from: Link
- NHS. NHS Website. Overview Abortion. [Internet]. 2020. Available from: Link
- Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö, Beavin C, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. Lancet Glob Health. 2020;8(9).
- Kinkaid VE, Guest R, Appleyard TL. Abortion rates in UK servicewomen. BMJ Sex Reprod Health. 2024 Apr 3;bmjsrh-2024-202288. Available from: Link
- Ministry of Defence. UK Armed Forces Biannual Diversity Statistics: October 2023 [Internet]. London, UK ; 2023 Dec [cited 2024 Jul 1]. Available from: Link
