In the wake of the Dobbs decision by the Supreme Court, service members are left in limbo as to how they can get reproductive care as some states are banning abortions.

The Defense Department is finding its hands are mostly tied in what it can do to help service members seeking abortions outside of the guidelines set out by the Hyde amendment. Those restrictions keep military clinics from providing abortions except in the case of rape, incest or harm to the person carrying the fetus, also known as “covered abortions.”

The Supreme Court ruling forces service members in need of an abortion outside of those circumstances to cope with a confusing patchwork of states across the nation with different laws about reproductive rights. In many cases, service members stationed in the south will need to travel hundreds of miles to a state that provides abortions, putting their privacy, finances and leave from work in peril.

In response, one step DoD can take is educating its troops on their options. The Pentagon is putting together women’s health page that will be a “one-stop-shop” for abortion and reproductive information, Seileen Mullen, the acting assistant Defense secretary for health affairs told the House Armed Services Military Personnel Subcommittee on Friday.

DoD already provides free contraceptives in some military treatment facilities, Mullen said. The Pentagon is looking into expanding that access.

The hearing brought forth successful women in the military who stated that abortions early in their career helped them stay in the service, but were also expensive, time consuming and hard to manage due to the Pentagon’s lack of benefits in the area.

In fact, subcommittee Chairwoman Rep. Jackie Speier (D-Calif.) noted it’s expected that 50,000 service members currently in the military will have an abortion in their lifetime. However, in the past five years, military treatment facilities provided about 20 covered abortions. The statistic highlights service members’ reliance on civilian healthcare for abortions and the high barrier of proving rape to meet Hyde amendment requirements.

It also calls into question the mental health impacts of possibly forcing service members to carry fetuses to term, especially when they will be born with terminal defects that will allow them to only live minutes after birth.

Dr. Jackie Lamme, an OB-GYN and Naval medical officer, noted that while working overseas she had to advise a women that the military could not provide abortion care after a fetus was deemed to have severe malformation. The fetus would be unlikely to survive until delivery.

“My patient asked about ending the pregnancy,” Lamme said. “I had to tell her that legally, since her life was not at risk, I was unable to offer that option in a military facility and it would not be covered by her health insurance. If she wanted to end the pregnancy she would have to return to the States and pay for the procedure with no assistance from TRICARE. Her care would cost thousands of dollars, plus the cost of international plane tickets, hotel rooms and other expenses. There was no way this young enlisted family had the means for that undertaking.”

Federal News Network previously reported on some of the hardships service members seeking abortion care would now face.

Service members will have to take leave to travel outside of a state that bans abortions to receive care.

Taking that leave can be a complex and time sensitive issue for service members, however.

“If a person needs to leave the area for this type of medical care, then there has to be a conversation with the chain of command because you can’t just leave,” Tammy Smith, former Army personnel chief, told Federal News Network. “There’s a leave form where there’s a process, there’s accountability, there’s all these things unique to our military community.”

The bottom line is service members must get permission from their commanding officer before taking time off to go get an abortion in another state. Otherwise, they risk criminal punishment.

Katherine Kuzminski, senior fellow at the Center for a New American Security, said leave requests can lead to uncomfortable situations. If someone needs to take leave quickly to get an abortion, they may need to disclose they are pregnant to their superior officer to explain the reasoning for the leave.

“The decision rests with the unit level commander,” she said. “There could be challenges there as well depending on the needs of the military and the needs of the unit. It could also bring into question the individual commanders flexibility for such a decision.”

Congress can pass a law to codify abortion access and supersede the Supreme Court ruling. However, the current climate makes that unlikely. In a usually robustly bipartisan subcommittee, only one Republican, subcommittee Ranking Member Rep. Mike Gallagher (R-Wis.) attended the hearing.

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