Unintended pregnancy among U.S. military active duty servicemembers: Estimates for 2018 and trends since 2005

Objectives: To evaluate the prevalence of and factors associated with unintended pregnancy in the past 12 months among women and men in the United States (U.S.) military in 2018, as well as trends in unintended pregnancy between 2005 and 2018. Study design: This was a cross-sectional study using the 2018 Department of Defense Health Related Behaviors Survey of active duty servicemembers. We selected a stratified random sample from members of all military service branches and used weighted logistic regression models to identify associated independent factors. A 9.6% weighted response rate to the online survey resulted in 16,806 active duty servicemembers analyzed; 4993 women aged 17 to 44 years and 11,813 men aged 17 to 45+ years. We used data from five independent surveys: 2005, 2008, 2011, 2015, and 2018 to examine trends over time. Results: A total of 5.6% (95% CI: 4.5%–6.7%) of servicewomen reported unintended pregnancy and 2.4% (95% CI: 1.9%–2.9%) of servicemen reported to have caused unintended pregnancy. Unintended pregnancy was associated with contraception nonuse, younger age, and being either married or cohabiting. Conclusion: The decrease in prevalence of unintended pregnancy among U.S. servicemembers since 2005 mirrors the general U.S. population. Differing contraception policies during basic training across military services may influence rates of unintended pregnancy. Unintended pregnancies place a large burden on the military healthcare system, as the majority of women serving in the military are of reproductive age, and thus require care before, during, and for years after giving birth. Implications: Unintended pregnancy among U.S. military servicewomen relatively mirrors that seen in the U.S. population. Contraceptive policies affect unintended pregnancy throughout servicemembers’ duration of service. As they are more likely to live in states which restrict access to abortion services, servicewomen with unintended pregnancy may face increased obstacles to care.