{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T09:59:56Z","timestamp":1780999196293,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Perspect Sexual Reproductive"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Hyde Amendment limits US military abortion care and coverage for active\u2010duty servicewomen (ADSW). ADSW face numerous barriers to care when seeking an abortion. The purpose of this study was to explore the lived experiences of US servicewomen who had an abortion while serving on active duty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Researchers conducted a qualitative secondary analysis of free\u2010text response data using thematic analysis. We developed the codebook using a modified version of Coast et\u00a0al.'s (2018) framework for\n                      <jats:italic>Trajectories of women's abortion related care.<\/jats:italic>\n                      Data were collected between December 2021 to June 2022 and included\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009178 participants who self\u2010reported having an abortion while serving on active duty in the US military.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Most participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009122, 62%) cited unplanned pregnancy as their reason for having an abortion. Some participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922, 12%), identified as having a \u201cmedically necessary\u201d abortion (i.e., miscarriage, ectopic pregnancy). Emergent themes included lack of understanding about abortion care, financial and logistical barriers to accessing abortion care often exacerbated by military policies, lack of medical privacy, and subpar care received from military treatment facilities during pregnancy options counseling or TRICARE covered abortion care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>ADSW experience systemic barriers to care and often seek care outside of the military medical system to protect their privacy. Military healthcare professionals do not provide adequate pregnancy options counseling or patient education regarding pregnancy loss. The US Department of Defense should enact policies ensuring access to abortion care to maintain the physical well\u2010being and mission readiness of servicewomen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/psrh.70064","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:36:01Z","timestamp":1777469761000},"page":"159-169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cIt's My Dark Secret\u201d: A Qualitative Study on the Abortion Experiences of US Active\u2010Duty Servicewomen"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0156-7892","authenticated-orcid":false,"given":"Caitlin","family":"Russell","sequence":"first","affiliation":[{"name":"University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiara","family":"Walz","sequence":"additional","affiliation":[{"name":"US Army Medical Center of Excellence  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0415-4288","authenticated-orcid":false,"given":"Laura","family":"Manzo","sequence":"additional","affiliation":[{"name":"Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby","family":"Mueller","sequence":"additional","affiliation":[{"name":"University of Massachusetts \u2013 Boston  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Messina","sequence":"additional","affiliation":[{"name":"US Air Force  Washington D.C. USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Arana","sequence":"additional","affiliation":[{"name":"US Air Force  Washington D.C. USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keira","family":"Feng","sequence":"additional","affiliation":[{"name":"University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Harner","sequence":"additional","affiliation":[{"name":"Jefferson College of Nursing  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"2024 Demographics Profile Active\u2010Duty Members [Internet]","author":"Department of Defense","year":"2025"},{"issue":"2","key":"e_1_2_7_3_1","first-page":"11","article-title":"The Women's Reproductive Health Survey (WRHS) of Active\u2010Duty Service Members","volume":"10","author":"Meadows S. O.","year":"2023","journal-title":"RAND Health Quarterly"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usac354"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss7307a1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214\u2010109X(20)30315\u20106"},{"issue":"2","key":"e_1_2_7_7_1","first-page":"9","article-title":"How the Dobbs Decision Could Affect U.S. National Security","volume":"10","author":"Hunter K. M.","year":"2023","journal-title":"RAND Health Quarterly"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102020\u2010003813"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691050902842741"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.70049"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1363\/psrh.12044"},{"key":"e_1_2_7_12_1","unstructured":"\u201cHyde Amendment Codification Act [Internet] \u201dS.142 https:\/\/www.congress.gov\/bill\/113th\u2010congress\/senate\u2010bill\/142\/text."},{"key":"e_1_2_7_13_1","unstructured":"\u201cCovered Services: Abortion [Internet] \u201d2024 https:\/\/www.tricare.mil\/CoveredServices\/IsItCovered\/Abortions."},{"key":"e_1_2_7_14_1","unstructured":"J.Tester \u201cDepartment of Defense Appropriations Act 2025 [Internet] \u201dS.4921 2024 https:\/\/www.congress.gov\/bill\/118th\u2010congress\/senate\u2010bill\/4921."},{"key":"e_1_2_7_15_1","volume-title":"Chapter\u00a04: Abortions. In: TRICARE Policy Manual 6010.60\u2010M [Internet]","author":"Defense Health Agency","year":"2021"},{"key":"e_1_2_7_16_1","volume-title":"Abortion Services and Military Medical Facilities [Internet]","author":"Burrelli D.","year":"2013"},{"key":"e_1_2_7_17_1","unstructured":"\u201cPlans: TRICARE Prime [Internet] \u201d2025 https:\/\/tricare.mil\/Plans\/HealthPlans\/Prime."},{"key":"e_1_2_7_18_1","volume-title":"Tricare Plans: Prime [Internet]","author":"Department of Defense","year":"2025"},{"key":"e_1_2_7_19_1","volume-title":"TRICARE 101 [Internet]","author":"Department of Defense","year":"2025"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2019.10.006"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2011.04.014"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usy340"},{"key":"e_1_2_7_23_1","volume-title":"Army Regulation AR 600\u20108\u201010 Personnel\u2010General: Leaves and Passes","author":"U.S. Army","year":"2020"},{"key":"e_1_2_7_24_1","volume-title":"Fundamentals of Military Readiness [Internet]","author":"Congressional Research Service","year":"2020"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2024.110703"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.01.035"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-69909-7_3470-2"},{"key":"e_1_2_7_28_1","volume-title":"MAXQDA 2022 [Computer Software]","author":"VERBI Software","year":"2021"},{"key":"e_1_2_7_29_1","volume-title":"ACOG Guide to Language and Abortion [Internet]","author":"American College of Obstetricians and Gynecologists","year":"2024"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2023.116216"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920\u2010021\u201001276\u20102"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31823fe923"},{"key":"e_1_2_7_33_1","volume-title":"Guidance for Implementation of the Postpartum Hemorrhage Bundle (PPHB) [Internet]","author":"Defense Health Agency","year":"2021"},{"key":"e_1_2_7_34_1","volume-title":"Deployment Health Procedures [Internet]","author":"Defense Health Agency","year":"2019"}],"container-title":["Perspectives on Sexual and Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psrh.70064","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/psrh.70064","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/psrh.70064","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T09:21:00Z","timestamp":1780996860000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/psrh.70064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/psrh.70064"],"URL":"https:\/\/doi.org\/10.1111\/psrh.70064","archive":["Portico"],"relation":{},"ISSN":["1538-6341","1931-2393"],"issn-type":[{"value":"1538-6341","type":"print"},{"value":"1931-2393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]},"assertion":[{"value":"2025-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}