Doctors at the US Department of Veterans Affairs (VA) would be barred from performing abortions, even in cases of rape and incest, under new rules proposed by the Trump administration.
The draft regulations, which also forbid providers from counseling female veterans about terminating a pregnancy, have generated nearly 20,000 comments in the federal register from conservative activists, abortion rights supporters and female veterans, many of them survivors of sexual assault.
“I am a veteran, a mother, and my abortion saved my life,” wrote Mary Dodson-Otten, a 41-year-old nurse and air force veteran who lives outside Atlanta, Georgia.
Dodson-Otten told the Guardian she ended a pregnancy in her 20s after she got pregnant by an abusive boyfriend who was a fellow service member. Without the abortion, she said, “I don’t think I would have survived, whether it would have been him hurting me or me hurting me.”
Mary Dodson-Otten (center) pinning on the rank of Senior Airman. Photograph: Courtesy Mary Dodson-Otten
The rule proposed by the Trump administration has an exception that allows abortions to take place “when a physician certifies that the life of the mother would be endangered if the fetus were carried to term”. But abortion rights advocates said the exception was too limited.
“Women are going to die,” predicted Caitlin Russell, a former US army captain who served two tours in Afghanistan and studies female veterans’ health at the University of Pennsylvania.
She said the exception would force “a woman to lie in the hospital bed until that woman is on death’s door” and cited high-profile cases of women dying after being denied miscarriage care in states that have strict abortion bans.
Sexual assault remains endemic in the military. About one in three women and one in 50 men respond “yes” when asked by their VA provider if they had been forced to endure sexual activity against their will while in uniform. Separate anonymous surveys have put the figure as high as two in three female veterans.
VA researchers have also found one in three female veterans experience intimate partner violence, a rate far higher than women who never served in the military.
Rita Graham, a former US army artillery officer and research director of the Service Women’s Action Network (SWAN), said the rules were “unsafe and cruel and strip our military community of their right to make their own healthcare decisions.
“We fought for our freedoms and deserve the healthcare that comes with that,” she said.
The availability of abortions is relatively new at VA. The agency has only provided them under limited circumstances since 2022, following a policy change implemented by the Biden administration after the supreme court ended the federal right to abortion in Dobbs v Jackson Women’s Health.
In an emailed response to questions, the VA press secretary, Peter Kasperowicz, described the Biden administration’s policy as “politically motivated” and said it violated a 1992 law that forbade the agency from providing abortions “except for such care relating to a pregnancy that is complicated or in which the risks of complication are increased by a service-connected condition”.
Legal experts say that law has been superseded. They note it also bans the VA from providing infertility and pregnancy care, which the agency continues to offer.
The VA also characterized the change as a matter of patient safety, claiming the “infrequency” with which the VA has performed the procedure since the 2022 policy was enacted had “raised safety concerns”.
According to the agency, veterans and their beneficiaries have received only 140 abortions per year under the policy through the VA.
Trump’s VA secretary, Doug Collins, is a staunch abortion opponent.
As a congressman, he received an A+ rating from Susan B Anthony Pro-Life America and referred to the 1973 supreme court decision that established the right to abortion as “barely coherent”.
Women are the fastest-growing group of military veterans, with a significant proportion of female veterans of reproductive age living in Florida, Georgia and Texas – states with near total abortion bans.
The comment period for the proposed rules runs through 3 September. Democrats on Capitol Hill have proposed legislation that would overrule the regulations should they go into effect and establish the legal right for veterans and eligible dependents to receive abortion care, medication and counseling through the VA as a matter of law.
The bill has little chance of passage given Republican control of Congress, however.
When the VA introduced the proposed rule on 4 August, Republicans on the House veterans affairs committee, led by its chairman, Mike Bost of Illinois, released a joint statement praising the decision.
“It’s simple,” they said. “Taxpayers do not want their hard-earned money spent on paying for abortions – and VA’s sole focus should always be providing service-connected health care and benefits to the veterans they serve.”