Military in Europe Stalls on Abortions

Military doctors and other medical personnel at American facilities in Europe are refusing en masse to perform abortions, hamstringing efforts to implement a new Clinton Administration policy intended to broaden the military community’s access to the controversial procedure.

Two days after taking office, President Clinton reversed a ban that, since 1988, has prohibited American military hospitals abroad from providing abortion services to military personnel and their dependents.

But more than two months later, military doctors, nurses and anesthesiologists are refusing to assist in abortions on moral and religious grounds. As a result, the Pentagon has been unable to comply completely with Clinton’s order.

“As of today, we have no takers,” said Col. Ogden DeWitt, assistant chief of staff for the Army’s clinical services in Europe.

For Clinton and his advisers, the Jan. 22 order was designed to ensure that military families and servicewomen posted abroad would have the same access to abortions that is assured Americans at home. Clinton ordered that no government money should be used to provide an abortion, so military facilities were to charge women $477 for the procedure, assuming it was done on an outpatient basis and no complications arose.

But within the military, with its strong tradition of religious and political conservatism, Clinton’s order has stirred both moral anguish on the divisive issue of abortion and concern that the Administration will impose its political agenda on an unwilling population of military doctors.

At a time when the armed forces have been roiled by Clinton’s downsizing proposals and his bid to open the military’s ranks to homosexuals, the Pentagon’s response to Clinton’s abortion initiative has once again prompted charges of insubordination.

“I find it hard to believe that every single person working overseas has a personal conscientious objection to providing abortions,” said Rep. Patricia Schroeder (D-Colo.). “I think this is just one more time they’re trying to jerk Clinton around.”

Military officials said that none of 44 obstetricians and/or gynecologists in the European theater are willing to perform abortions. That would force female soldiers and military dependents instead to undergo the operation at local clinics in their host countries.

Similar difficulties have been reported at American installations in Asia.

At the Pentagon, officials said that early efforts to implement Clinton’s order are still under way. But they noted that surveys had found wide opposition; they also said that military doctors have never been forced to perform operations or procedures to which they are opposed.

Experts said the military doctors’ unwillingness to perform abortions reflects a trend that is widespread in the civilian medical community as well.

They said the military’s concern could reflect another civilian trend: that with declining interest, fewer medical schools are teaching doctors how to perform abortions. But critics say those explanations do not justify delays in setting up a system making abortions available to the military community abroad.

“Respect for individuals’ moral or religious objections” is important, said Elizabeth Symonds, a Washington attorney for the American Civil Liberties Union who specializes in reproductive rights issues. “Nonetheless, the military can still accommodate those objections and . . . provide the services needed. I fail to understand why they can’t accommodate both.

“They showed us how flexible they can be during the Persian Gulf War. I would think this would be somewhat less of a logistics and management challenge for them,” Symonds said.

But military spokesmen in Europe insisted that the standards of care and costs of the procedure in foreign clinics are comparable to what women could expect at military facilities; they, thus, contend that the military’s failure to provide abortions does not pose undue hardship.

“We do very few things in this theater in isolation,” DeWitt said in a telephone interview from Heidelberg headquarters. “We use the host-nation facilities for everything; we would not be able to deliver care without host-nation support.”

At the Pentagon, officials said one suggestion under review would establish regional military abortion clinics to serve groups of military communities dispersed broadly overseas. That would require not only the consolidation of small teams of abortion providers at, say, a single base in Germany and another in South Korea but also that the military provide transportation to the centers for women seeking their services.

But the need to transport patients to such centers, said one Pentagon official, could raise questions about whether the Pentagon’s budget was being used to subsidize abortion services.

Such funding issues also arose when military planners considered the possibility of training other, willing medical personnel to perform abortions.

But Symonds of the ACLU also warned that, if abortion services are offered at central locations, the requirement for distant travel could, in effect, deny some American military dependents and servicewomen their rights to an abortion. “Delay in timing is very, very important in these situations,” Symonds said. “For an individual woman, two days’ delay might make the difference between the first and second trimester. And two days might be life-threatening.”

The military’s own practices abroad could make the issue even trickier.

Lt. Col. LaMont G. Olson, the Army’s head social worker in Europe, said in a telephone interview that the American military must “live under the host-nation laws.” Only Spain, which has only a small U.S. military presence, outlaws abortion, but other countries have restrictions.

“One of the laws in Germany is that you cannot abort as a means of birth control,” Olson said. “You have to have a reason for an abortion, whether it’s financial, medical or whatever.”

In fact, the number of women seeking abortions through the military appears to be low, with only one request reported since the ban was lifted in January.

In 1988, the last year patient-paid abortions were available in the military overseas before being banned by the Ronald Reagan Administration, only eight abortions were reported. In 1983, the number was 100.

But there is no way of knowing how many female soldiers or military dependents return to the United States to undergo abortions or how many seek abortions in their host nations without going through military channels.

Olson said three to five women a month inquire about abortions at each of eight Army hospitals scattered across Belgium, Holland, Italy and Germany. So far, he said, there have been no complaints about the military’s failure to offer the procedure.

“We help them arrive at a decision they’re going to be able to live with the rest of their lives,” he said. Unwed mothers and women with unwanted pregnancies are automatically sent for counseling through the Army family advocacy program, he said, adding, “We go through all the alternatives.”

He said referrals to host-nation abortion facilities are made, if necessary. “There are very, very, very few (people who) refuse to go to a facility here,” Olson said.

Healy reported from Washington and Jones reported from Bonn.