July 26, 2012 — Summary of "Abortion-Seeking Minors' Views on the Illinois Parental Notification Law: A Qualitative Study," Kavanagh et al., Perspectives on Sexual and Reproductive Health, July 2, 2012.
Thirty-seven states currently have laws requiring adolescents to notify their parents or obtain their consent before having an abortion, Erin Kavanagh and colleagues from the University of Chicago wrote in a study examining minors' opinions on the laws.
Pregnant minors who choose not to inform their parents cite a variety of reasons for that choice, including fear of physical violence, Kavanagh and colleagues noted. In addition, a 2009 comprehensive literature review indicated that parental involvement laws are linked with an increase in minors traveling outside their home states to seek abortion services but that the laws have little effect on minors' overall abortion, birth and pregnancy rates.
For this study, the researchers aimed to determine how minors in Illinois perceive parental involvement laws. Illinois is the only state in the Midwest without a parental involvement law in effect. A 1995 law that would require parental notification has been enjoined since it passed because of ongoing legal challenges. The law would allow exceptions for medical emergencies or abuse. If a minor cannot involve her parent, she must obtain a judicial waiver by convincing a judge that she is "sufficiently mature and well enough informed to decide intelligently whether to have an abortion" or that notification would not be in her best interest.
If the Illinois law took effect, the nearest jurisdictions without such laws would be New Mexico, New York and Washington, D.C.
The researchers conducted 10-minute interviews with 30 minors who had diverse racial and socioeconomic backgrounds and sought abortion care at two freestanding clinics and one hospital-based clinic in the Chicago area between June 2010 and September 2010.
The researchers recorded participants' demographic characteristics, pregnancy histories and gestational age of their current pregnancy. They then gave participants a brief description of the Illinois parental notification law and judicial bypass option, allowed them to ask questions, and assured them that the law was not in effect. Participants were then asked open-ended questions about whether their parents knew about the abortion, opinions of the law and views on the effects of the legislation.
Eighty-percent of participants were ages 16 or 17 and 70% were black. About 47% lived with their biological mother and without a biological father or stepfather, with 60% living in households in which someone received public assistance. Seven percent had previously been pregnant and 70% were fewer than 12 weeks pregnant.
Fourteen of the thirty participants had voluntarily informed a parent about their pregnancy and abortion decision, while nine had not told a parent, and seven initially had decided not to tell a parent but were pressured into telling or said a third party had told a parent.
Twenty-two participants did not believe there should be parental notification laws, while four supported the laws and four were undecided. Whether a participant had notified her parent was not necessarily linked to her opinion of the legislation, the researchers noted.
Participants' age was associated with their notification status. Half of participants who were ages 14 or 15 had voluntarily informed a parent, while the other half had been pressured into telling or a third party had told. By comparison, 46% of participants who were ages 16 or 17 had told a parent, 37% had decided not to tell and 17% had been pressured or subject to third-party notification. Almost all participants said they voluntarily informed other people -- such as boyfriends, friends or aunts -- about their pregnancy or abortion decision.
"One of the strongest themes was concern that the parental involvement law could harm minors," the researchers wrote. They found that participants were concerned about both "subjective harms" -- such as parental judgment and loss of reproductive autonomy -- and "objective harms" -- such as parental abuse or forced continuation of pregnancy.
A few participants said parents have a fundamental right to be notified, but the majority said "seeking support from a trusted adult -- though not specifically a parent -- could benefit minors," according to the researchers. A few noted that parental notification could be beneficial if complications arose from the abortion procedure.
Participants also were concerned about the judicial bypass system and "viewed the need to navigate the court system, travel to the courthouse, confide in a judge and forfeit privacy as clear obstacles to abortion access," the researchers wrote. However, a few said that within the constraints of the law, having an option to not tell a parent was valuable.
"The most prominent theme that emerged was participants' overall concern that a parental involvement law could threaten a minor's ability to make independent decisions about pregnancy resolution," the researchers wrote. They noted that the concern over an "individual's right to reproductive autonomy" echoes reasoning articulated by the U.S. Supreme Court, which "has specifically held that a parent cannot have absolute veto power over a minor's abortion decision." The researchers suggested that policymakers consider these concerns when "weighing the benefits and harms of parental involvement laws."
The researchers wrote that although all but one state with a parental involvement law has a judicial bypass option, lawmakers "should consider the practical burden placed on minors who pursue judicial bypass and ensure that adolescents can easily maneuver the process without confronting logistical barriers."
They also called for expanding the "category of individuals who qualify as parental figures" under the laws, noting that 20% of participants did not live with their biological parents. The researchers added that giving "minors more choice in deciding whom to involve may lessen the potential harms identified by participants."
The researchers argued that minors' opinions should be included in debates about parental involvement laws so lawmakers can better understand how the measures can "interfere with [minors'] right to make reproductive health decisions." They called on health care providers who work with adolescents to "share their recognition that while adult assistance can be beneficial, individuals' circumstances can be complex and parental involvement should not be mandated."