“The American Medical Association, the Society for Adolescent Health and Medicine, the American Public Health Association, the American College of Obstetricians and Gynecologists, the AAP, and other health professional organizations have reached a consensus that a minor should not be compelled or required to involve [their] parents in [their] decision to obtain an abortion, although [they] should be encouraged to discuss the pregnancy with [their] parents and/or other responsible adults.” (1)
Overview of Parental Involvement Laws
38 states require teens to involve a parenting adult in their abortion decision. Some states require parents or guardians be notified that their teen is seeking abortion, others require parents to actually consent to the procedure. Even in states without parental involvement laws, however, most teens who seek abortion care choose to involve a parenting adult (most often their mother) in that decision. See each state’s parental involvement laws from Guttmacher.
Teens have the capacity to make independent abortion decisions
“Existing research shows that most minors 14 to 17 years of age are as competent as adults to provide consent to abortion, are able to understand the risks and benefits of the options, and are able to make voluntary, rational, and independent decisions.” (1)
Read more about adolescent capacity in health care decisions.
Benefits of Voluntary, Supportive Parental Involvement
Even in states without parental involvement laws, most teens choose to involve a parenting adult in their abortion decision (2). Teens are more likely to disclose their pregnancy and involve their family in pregnancy decisions if their family has a history of warmth, rapport, and involvement in past problem-solving (1).
If a parenting adult assumes a caring, supportive role in their teen’s abortion decision, the teen benefits immensely. Some ways that parenting adults can support their teens:
- Discuss pregnancy options and weigh the potential outcomes
- Navigate the healthcare system by helping them choose a provider and get to the clinic
- Financial support and access to parental insurance (if it covers abortion)
- Accompany the teen to appointments and help them understand the procedure and follow up care
- Provide emotional support during the abortion process
- Care for their teen after an abortion procedure or during the medication abortion process
- Monitor for complications after the procedure and support compliance with follow up care or prescriptions
Adverse Effects of Forced Parental Involvement
Teens who do not involve a parent in their abortion decision often fear their parent’s reaction to the pregnancy or termination decision. Teens who strongly oppose involving parents in their abortion decision tend to predict family reactions accurately (3). Some reactions include fear of violence, abandonment, or that they will be forced to continue the pregnancy (4). Research continues to refute the concept that adolescents are unable to make their own decisions regarding abortion and forcing teens to involve a parent that they know could abuse or abandon them is more likely to cause harm (4).
Forcing parental involvement with laws requiring notification or permission can also cause delays in care. Young people typically suspect that they are pregnant later than adults do (Finer). Many states including Texas, Mississippi, and Missouri that enacted parental involvement laws saw significant increases in the gestational age at which teen patients were able to receive abortion care after parental involvement was required (1). Delaying abortion care can limit which care options a person can seek, increases risk of the procedure, and can jeopardize whether or not a patient can even seek care in their home state.
In states that require parental involvement, teens who cannot involve their parents in their abortion decisions can seek a judicial bypass. Judicial bypass is a legal process in which a judge determines a teen’s maturity to make their own abortion decision and whether it is in their best interest to involve their legal guardian in that decision. As providers, we can support teens through this process by sharing with them what to expect.
Ways that judicial bypass can cause medical or psychological harm:
“Many experts disagree with the Supreme Court rulings on judicial bypass, arguing that the process does indeed constitute an “undue burden” for adolescents seeking abortion care.” (1)
- COMMITTEE ON ADOLESCENCE, Paula K. Braverman, William P. Adelman, Elizabeth M. Alderman, Cora C. Breuner, David A. Levine, Arik V. Marcell, Rebecca O’Brien; The Adolescent’s Right to Confidential Care When Considering Abortion. Pediatrics February 2017; 139 (2): e20163861. 10.1542/peds.2016-3861 (AAP)
- Webster RD, Neustadt AN, Whitaker AK, Gilliam ML. Parental involvement laws and parent-daughter communication: policy without proof. Contraception. 2010;82(4):310–313[PubMed]
- Benshoof J. Planned Parenthood v Casey: the impact of the new undue burden standard on reproductive health care. JAMA. 1993;269(17):2249–2257[PubMed]
- Coleman‐Minahan, K., Jean Stevenson, A., Obront, E., & Hays, S. (2020). Adolescents Obtaining Abortion Without Parental Consent: Their Reasons and Experiences of Social Support. Perspectives on Sexual and Reproductive Health, 52(1), 15-22.
- Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Timing of steps and reasons for delays in obtaining abortions in the United States. Contraception. 2006;74(4):334–344