{
  "abstract": "Background Pregnancy during military service requires service women to navigate the demands of military work and healthcare systems traditionally designed around male bodies—factors that influence their health and well-being. This qualitative evidence synthesis (QES) explored the lived experiences of pregnant active-duty service women (ADSW) across global armed forces.Methods This study followed the Cochrane-Campbell Handbook for qualitative evidence synthesis and PRISMA guidelines, with the protocol pre-registered in the Cochrane Qualitative and Implementation Methods Group registry. In August 2024, six databases (MEDLINE, EMBASE, CINAHL Plus, APA PsycINFO, Military and Government Collection, Web of Science) and ProQuest Dissertations were searched from inception to 2024 using terms related to ‘woman,’ ‘pregnancy,’ and ‘military.’ We included English-language qualitative or mixed-methods studies—peer-reviewed articles, book chapters, and doctoral theses—focusing on pregnancy experiences from early pregnancy to childbirth. Studies on veterans, reservists, fertility treatments or postnatal experiences were excluded.Results After removing duplicates, 2,374 articles underwent dual blinded screening of titles and abstracts; 72 proceeded to full-text review. Twenty-one studies, published between 1989 and 2024 and covering land, air, and sea forces, met inclusion criteria—most (18) from the United States. Thematic synthesis identified five core themes: structural and social conditions; multi-modal resistance to pregnancy; impact on psychological safety and trust; response strategies (resisting, navigating, hiding, surviving); and enabling conditions and support. Confidence in findings was assessed using GRADE-CERQual, with methodological quality evaluated via the Cochrane Qualitative Methodological Limitations Tool.Conclusion This study shows how pregnant ADSW navigate institutional and interpersonal barriers, often facing stigma and resistance across healthcare, workplace, and social settings while also highlighting their resilience and agency. These conditions can shape how women engage with antenatal care, at times prompting self-sacrificing decisions and adaptive behaviours as they take personal responsibility for their health within constrained systems. Despite policies offering support, a clear disconnect remains between policy and lived experience.",
  "authors": [
    {
      "affiliations": [
        "Defence Medical Services, UK Armed Forces, Lichfield, UK",
        "Centre for Military Women’s Research, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Kirsten Morris"
    },
    {
      "affiliations": [
        "Centre for Military Women’s Research, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Lauren Godier-McBard"
    },
    {
      "affiliations": [
        "Centre for Military Women’s Research, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Claire Hooks"
    }
  ],
  "title": "P05-4 Pregnancy experiences in the armed forces: a qualitative evidence synthesis",
  "uid": "c8ce6834-1deb-5306-8ed1-9cdf10adff7d"
}