Federal law restricts the Department from performing abortions or paying to have them performed unless the life of the mother would be endangered if the fetus were carried to term, or unless the pregnancy is the result of rape or incest. In the case of a Service member who seeks an abortion related to a sexual assault, the Service member would seek these services through their medical provider and does not need to obtain permission or other forms of documentation from their Command. The treating provider must document their good faith belief that the pregnancy is a result of rape, and would then either perform the procedure at the MTF or refer to another provider within the same MTF to provide the abortion. If the abortion cannot be performed at the MTF, the provider would refer the patient to the private sector or transfer the patient to another MTF with the capability to perform the abortion. If the Service member reported a sexual assault to a Sexual Assault Response Coordinator, a Sexual Assault Prevention and Response Victim Advocate, or the Family Advocacy Program, the Service member would be asked if they want referrals for services, to include for medical and mental health services. The member could receive a referral from the SARC, SAPR VA, or FAP to an appropriate health care provider wherein their request for an abortion could be made. SARCs, SAPR VAs, and FAP would not discuss the details of health care with victims, since they are not qualified or authorized to discuss health-related matters or to provide personal opinions on health care issues.

In all cases involving minors, DOD personnel should immediately consult with the servicing legal counsel.

All necessary medical and psychological services and supplies related to a covered abortion may be provided by the MTF or by a TRICARE authorized provider for eligible dependents of a Service member. This may include ultrasound performed prior to the abortion, pathology services, pregnancy tests, office visits, and any applicable requirements mandated by state and/or local laws.

When an MTF provider encounters a child the provider suspects has been sexually abused, the child will be given priority for care at an MTF.  MTF providers will refer DOD minor- dependents who are victims of sexual assault for follow-on care, which may include referral to a Domestic Abuse Victim Advocate or Family Advocacy Program. A DAVA coordinates and manages care for a victim of sexual assault that occurs within a family or between intimate partners. FAP/DAVA personnel are covered professionals who are required to report suspected child abuse directly to local civilian child welfare services in accordance with law and DOD policy.

The patient need only share this information with their MTF health care provider for a referral to a DOD provider who can perform the abortion. Providers are required, per DOD policy, to notify a Sexual Assault Response Coordinator or Family Advocacy Program that they are treating a patient who reports to have been sexually assaulted so that the SARC or FAP can inform the victim of services and reporting options. There is no requirement that the health care provider inform the SARC or FAP that the patient requested an abortion. A SARC or FAP staff member may also assist in connecting Service members with a provider for medical care, including abortion. However, that Service member will need to share with the medical provider that the pregnancy was the result of a sexual assault in order to receive a covered abortion.

There is no requirement for a patient to formally report or participate in a formal investigation of a sexual assault for the patient to access abortion services at an MTF. The treating provider is required to notify the Sexual Assault Response Coordinator or Family Advocacy Program that they are treating a patient who indicates they are a victim of sexual assault and the pregnancy was the result of a sexual assault, so that information on available resources and reporting options can be provided; however, a beneficiary is not required to utilize any of the services or make a formal restricted or unrestricted report of a sexual assault to be eligible for the abortion. In addition, the provider does not provide the name of the patient to the SARC when the patient declines to make a report of sexual assault or speak with the SARC. The health care provider will document that they, in good faith, believe the pregnancy is a result of rape or incest, based on the patient’s report.

Provision of covered abortions (which includes abortions performed to terminate pregnancies resulting from rape) continues to be legal and authorized under federal law and it remains DOD policy to provide such services, consistent with federal law, even in states that require a law enforcement investigation to be eligible for abortion service. No such investigation is required for DOD providers at an MTF to perform an abortion. DOD providers at an MTF may continue to provide such services as part of their Federal duties if medically appropriate, even if those services are restricted or prohibited by state law.

Service members and beneficiaries who seek an abortion as a result of rape are eligible to receive that abortion, referred to as a “covered” abortion, from a military medical treatment facility or network provider, without cost. They need to disclose that the pregnancy is the result of having been the victim of rape to their health care provider, who can facilitate access to that covered abortion.