By: Elise D. Berlan, MD, MPH, FAAP
Most U.S. states require that a minor seeking an abortion involve parents in the decision. In this time when so many laws and policies about abortion are being decided, it's crucial that everyone understands the impact on adolescents.
We respect the diversity of beliefs about abortion and encourage any teenager considering an abortion talk to a parent or trusted adult before making such a big decision. Most teens do this voluntarily.
Laws requiring a parent's involvement in a teen's legal abortion are not helpful, and may cause harm. And while there is a lot of disagreement and debate about these laws, there is one thing that all of us can agree on:
The AAP believes minors should be encouraged, not required to involve parents in decision to end pregnancy
There is no law that can mandate healthy family communication. Laws requiring parental notice or consent actually may endanger the teens they intend to protect by increasing the possibility of:
Delayed access to medical care
Illegal and self-induced abortion
Family violence
Homelessness
Suicide
Later abortions, which are associated with increased risks compared to earlier abortions
The AAP strongly supports health and
sexuality education, abstinence, the use of
birth control by sexually active teens and the right to seek an abortion.
Along with several other leading health professional organizations, we believe a minor should be encouraged, but not required, to involve their parents in their decision to end a pregnancy. Current evidence shows that the harmful effects of parental consent and notification laws outweigh the benefits.
The AAP believes confidentiality for teens considering abortion protects their health and safety
Many teens are fortunate to have loving and supportive parents, and they overwhelmingly include their parents in their reproductive health decisions. Teens who are willing to involve their parents in their abortion decision usually benefit from adult experience, wisdom, emotional support and financial assistance (if the parents' health insurance policy covers pregnancy termination).
However, pregnant teenagers also come from a variety of backgrounds. Some live in dysfunctional or challenging homes—where they risk physical and emotional abuse when they tell their parents that they are pregnant or are terminating the pregnancy. According to multiple studies cited in the AAP's policy statement, adolescents who are strongly opposed to telling parents about their abortion plans tend to be correct about harmful family reactions.
In
Hodgson v Minnesota, the majority of the U.S. Supreme Court agreed that mandatory parental involvement risks family upheaval and can be dangerous for minors in homes in which physical, emotional or sexual abuse occurs. Making matters worse,
research on abusive and dysfunctional families shows that violence tends to escalate during a family member's pregnancy and as children go through adolescence.
The AAP believes healthy family bonds are essential for abortion discussions
As pediatricians, we work to support strong family relationships. Teens are most likely to disclose a pregnancy to their parents if they have a history of good
communication—one with warmth, understanding, and shared problem-solving.
Even when not required, most minors who seek an abortion voluntarily involve at least one parent in their decision. A
review of parent involvement laws and parent-child communication showed that in states without parent involvement laws, 34% to 91% of minors told their parents about their plans to seek an abortion.
Teens who do not want to involve their parents in decisions about ending a pregnancy are urged to seek guidance and support from other trusted adults—those who may not be legal guardians but serve as parent figures. It is important to have a support system when making hard decisions, no matter what decision is made.
What parents can do
Parents are encouraged to develop their listening, communicating and nurturing skills as their child grows. Respecting and valuing your child's perspective increases the likelihood they will come to you when making adolescent decisions.
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