December 31, 2009

Military Abortion Ban: Female Soldiers Not Protected by Constitution They Defend

It's just another outrage - In a country where abortion is legal, the women who fight for the country are denied these medical services. It isn't clear what the intent is of those who would deny medical care for these women soldiers. It couldn't be because they care about the fetus since they allow abortions in military hospitals in cases of rape, incest, or threat to the life of the mother - none being the fault of the fetus. It couldn't be because they care about the woman or they wouldn't endanger her by denying her medical services for any reason. It must be a nasty case of misogynists in positions of power.

By Kathryn Joyce

December 15, 2009
Unable to get an abortion during a tour of duty in Iraq, a soldier is left with no option but to do it herself—a humiliating but not uncommon dilemma. Women in the military are forced to obtain a leave to get the care they need; but if they’re honest about why, they put their military career in jeopardy. If they’re not, they put their military career in jeopardy.

Female soldier in Anbar Province in 2006. US Army photo by Lance Cpl. Clifton D. Sams

You hear these legends of coat-hanger abortions,” a 26-year-old former Marine sergeant told me recently, “but there are no coat hangers in Iraq. I looked.” Amy (who prefers not to use her real name) was stationed in Fallujah as a military journalist two years ago when she discovered she was pregnant. As a female Marine, a distinct minority in the branch, Amy was fearful of going to her chain of command to explain her situation.

For military women, who lack all rights to medical privacy, facing an unplanned pregnancy is a daunting obstacle. Thanks to anti-abortion forces in Congress, military hospitals are banned from providing abortion services, except in cases of life endangerment, rape, or incest (and for the latter two, only if the patient pays for the service herself). Amy says her options were “like being given a choice between swimming in a pond full of crocodiles or piranhas.”

“I have long been aware of the stigma surrounding this circumstance and knew my career would likely be over, though I have received exceptional performance reviews in the past,” Amy explains. Although Fallujah has a surgical unit, and abortion is one of the most common surgical procedures, Amy knew that if her pregnancy were discovered, she would be sent back to her home base at North Carolina’s Camp Lejeune, where she would then have to seek a private abortion off-base, or she could request leave in Iraq and try her luck at a local hospital. She also knew she could face reprimands from her commanding officers for having had sex in Iraq (part of a broader prohibition on sex in war zones), and that she might not be promoted as a result: a potentially career-ending situation in the Marines, where failure to obtain regular promotions results in being discharged. Moreover, as a woman in the military, accustomed to proving herself to her male peers over her six-year career, Amy was wary of appearing a “weak female.”

“If you get sent home for something like that, everyone will know about it,” says Amy. “That’s a really bad stigma in the military. I thought, that’s not me, I’ve worked harder and I could outrun all the guys. So I chose to stay, and that was just as bad.”

From a remove of two years, Amy now sees the sex that resulted in her pregnancy as rape: something that may have qualified her for an on-base (though self-funded) abortion. However, at the time, because the rape wasn’t brutally violent, and because she had seen fellow servicewomen be ostracized for “crying rape” in the past, she imagined nothing but trouble would come of making a complaint.

Instead, using herbal abortifacient supplements ordered online, Amy self-aborted. Unable to find a coat hanger she used her sanitized rifle cleaning rod and a laundry pin to manually dislodge the fetus while lying on a towel on the bathroom floor. It was a procedure she attempted twice, each time hemorrhaging profusely. Amy lost so much blood on the first attempt that her skin blanched and her ears rang. She continued working for five weeks, despite increasing sickness, until she realized she was still pregnant.

The morning after her second attempt, she awoke in great pain, and finally told a female supervisor, who told Amy to take an emergency leave to fly back to the United States where a private abortion clinic could finish the procedure. However, Amy was afraid that she would miscarry on the 15-hour plane ride and have no medical escort to help her. She went to the military hospital instead and told the doctor everything. Shortly thereafter, her company first sergeant and other officers were notified of Amy’s condition. The first sergeant came to her hospital room to announce that Amy would be punished under Article 92 of the Uniform Code of Military Justice, which addresses violations of general regulations, for having had sex in a war zone.

That night, Amy miscarried alone in her shower. Fearful of the advice of a sympathetic female officer who suggested that Amy might be charged for the abortion as well (she wasn’t), she flushed the fetus down the toilet. “I don’t believe there was ever a life or a soul there,” Amy says, “but I feel undignified for doing that.” When her nonjudicial punishment (a plea sentence for a misdemeanor-like offense) went through, Amy was fined $500 and given a suspended rank reduction.

Master Sergeant Keith Milks, a public affairs officer in Amy’s former unit, the II Marine Expeditionary Force, says he can’t comment specifically on Amy’s case, as the administration action of the punishment and Amy’s personnel details are covered by privacy provisions. However, he says, her sentence is in keeping with the options for disciplining soldiers for breaking the prohibition on sex in a war zone.

At Amy’s request, she was sent home from Iraq, after a military psychiatrist determined that she was “too psychologically unstable” to remain, and diagnosed her with acute anxiety, PTSD, and depression. “They convinced themselves that anyone who would do a self-abortion is crazy,” Amy says. “It’s not a crazy thing. It’s something that rational, thinking women do when they have no options.”

Alexa Kolbi-Molinas, staff attorney for the ACLU Reproductive Freedom Project, says Amy’s horrifying story is the logical outcome of the longstanding military ban on abortion that affects 200,000 female service members as well as female military spouses and dependents living on military bases covered by the armed forces’ Tricare health coverage. Shocking as the story may be, Kolbi-Molinas says, “If you restrict women to unsafe abortions, this is what will happen.”
Military Women “Do Not Receive the Protection of the Constitution they Defend”.

Starting in 1979, Defense Department appropriations bills have been used to restrict or prohibit the use of federal funds—meaning all military health coverage—for abortion services at overseas military hospitals. Although President Clinton reversed the ban shortly after taking office, anti-abortion forces in Congress made the ban permanent in 1995, preventing future presidents from altering the rules by executive order.

What began as a funding ban, compelling women to pay for abortion services themselves, was later extended into a more comprehensive embargo on performing abortions in any military hospital except in cases of rape, incest, or threat to the life of the mother. Rep. Susan Davis (D-CA), argued that “servicewomen do not receive the protection of the Constitution they defend,” and tried unsuccessfully in 2005 and 2006 to repeal the ban—or at least to bring it in line with current Medicaid standards by allowing abortion funding in rape and incest cases. Opponents like Kansas Republican Jim Ryan postured in response claiming that, “allowing self-funded abortions would simply turn our military hospitals overseas into abortion clinics.”

In fact, before Roe v. Wade the situation was reversed: servicewomen were pressured into having abortions due to a military policy of automatically discharging pregnant women. That policy ended with Crawford v. Cushman, a 1976 US Appeals Court case ruling that the discharge rule violated due process.

The result of the ban is that active-duty servicewomen and military dependents are faced with a number of equally unappealing options: venture out to local hospitals while overseas, to medical facilities that may have different standards of care, where medical workers may not speak English, or where there is animosity towards the United States; seek a back-alley abortion in a country that prohibits abortion; or undertake an arduous process of obtaining permission from commanding officers to fly home or to a neighboring country, find space on a military transport, or pay for a commercial flight home (a prohibitive cost for lower-ranking servicewomen), and return to their units aware that their superiors know intimate details about their medical records.

Kolbi-Molinas says the ACLU has received reports about commanding officers attempting to interfere with women taking leave to obtain abortions. Even for those who are able to obtain an abortion off-base, says Bethany Niebauer, a military spouse and writer at RH Reality Check, the lack of medical privacy in the military means women often return to social shaming “for making a choice with which her superiors might disagree.”

A General Accounting Office report on the issue in 2002 found that the policy was a humiliation for servicewomen, who must seek travel approval from commanding officers, many of whom “have not been adequately trained about the importance of women’s basic health care.” Furthermore, servicewomen may be uneasy with the appearance of requesting special treatment, or may face commanding officers who disapprove of abortion—a serious concern for women reliant on these officers for career advancement.

Vicki Saporta, President of the National Abortion Federation, says that military women seeking abortions face a no-win situation. “If you’re a woman in the military, you’re going to have to obtain a leave to get the care you need. If you’re honest about why you need that care, you put your military career in jeopardy. If you’re not honest, then you put your military career in jeopardy.”

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