Yesterday, I responded to Adam Lee’s post answering questions about abortion with some answers of my own. Adam then responded in the comments:
Just polling the crowd here. There was only one question on this list that I thought posed a difficult dilemma, which was whether there should be parental notification for a teenager seeking an abortion.
Unlike most of the questions, this is one case where I think there are genuine interests that collide. I think that parents should have a role in medical decisions for their minor children, but I also think that if a teenage girl needs an abortion but doesn’t want to tell her parents, there’s probably a good reason for that. What does everyone else think about this?
I hadn’t considered this a particularly difficult question myself. I don’t see a compelling need to uniformly notify parents about abortions, but it took some thinking to work out why.
I started by taking a step back to reproductive decisions in general. Do I support a parental notification requirement for the use of birth control? Absolutely not, and for easily articulated reasons.
Human beings (physcially) mature sexually far sooner than we mature emotionally and as decision-makers, as a general rule. In our society, we’ve decided that managing sexual maturity is an individual responsibility, but we don’t have any agreed-upon standards for how that should be done. We also don’t have social systems in place to support young people who make decisions at this point that they may later regret or who take risks that end in unintended consequences.
Then there is the fact that nearly half of all sexual assault victims in the U.S. are assaulted before they reach the age of majority.
Basically, we have a compelling social case for making the use of birth control within this age group as ubiquitous as the use of seatbelts. Medically, economically, in terms of neonatal health and the quality of infant care, as a reduction of harm to the victims of crime–it is better for us if people this age do not reproduce. We have a stake in this. It doesn’t automatically override a parent’s interest, but it sets the framework in which we should consider that interest. The parent’s interest doesn’t stand alone here any more than it does in the case of vaccination.
When we move from birth control to abortion, we aren’t changing much. Our societal interest still stands. We add, however, an immediate medical interest on the part of the pregnant person. This was always there in the abstract in a discussion of birth control. It becomes even more important now.
Simply put, a pregnancy carried to term is always going to be more medically risky and morely likely to carry long-term, negative medical consequences than an abortion, particularly an early abortion. This is even more true for those who are just pubertal or post-pubertal. Pregnant teens–and pre-teens–have very good medical reasons not to carry a pregnancy to term.
Additionally, they have a medical interest in safe terminations. Putting barriers in the way of young people terminating pregnancies in sterile environments using best medical practices does not stop them from trying to terminate those pregancies. It means that many of them will try less safe methods without medical supervision. It means, in extreme cases, that abortion becomes infanticide.
In other words, if we base our decision on the outcome to the patient, early medical abortion is the standard of care for most teen and almost all preteen pregnancies. So says science. So says societal interest. So say the teenagers who want to end their pregnancies.
That’s where we need to start before we even consider any parental interest. That tells us what we’re suggesting when we say that parents have to be notified and approve before an abortion can be performed on a minor.
So what are we suggesting? That parents be allowed to object to and obstruct standard medical care that their children have requested and that is in their children’s best medical and other interests.
We aren’t saying parents have the right to keep their children from avoiding pregnancy as a consequence of sexual activity. We’ve already decided the minor’s interest prevails here. We allow them to buy condoms without parental permission. We allow them to buy condoms without parental notification.
We aren’t saying parents should be the ones to negotiate medical risks for their child. The data on gestational risk versus abortion risk is extremely one-sided. There is no evidence-based debate on which is riskier. There is no gray area on which is indicated medically.
What we are doing is saying that parents should get to veto the interests of both society and their children when it comes to matters of abortion. Thus some parents will make their children live with this wholly preventable consequence of having sex as well as the additional risks and long-term consequences it imposes on them. Essentially, if we require parental notification and approval, we’re giving parents an opportunity to punish their children by denying them medical care or to decide that their religious beliefs about embryos and fetuses are more important than both their child’s wishes and health.
Nobody is proposing that parents be allowed to force their children to have abortions, just that parents be allowed to stop them. The only justification for creating laws that allow this veto is that some parents will object to the abortion. That is the point of requiring parental notification and approval, to stop abortions.
Without these laws, minors and their doctors will make these health decisions together. Given the state of medical consensus, that will result in abortions for the children who want them. Parents will still be told, when a child thinks it is appropriate. Doctors will still urge children to talk these things over with their parents when it’s safe to do so, because social support for good reproductive decision-making makes it more likely that good decisions will be made. Child social services will still be alerted if there is a suggestion that the child involved is being abused.
That is the state of things if we do not require parental approval. Children will continue to make decisions about their own reproduction no matter what we do. People whose vocation it is to care for these children will continue to do so and do it as well as they can. Parents who make it clear to their children that they share that mission will continue to be included in their children’s lives and decisions. Parents who do not have their children’s best interests at heart will continue to be safely circumvented. That’s how it already works when no one is interfering.
Adding laws that require parental notification and approval doesn’t support children better. All it does is give a parent a chance to make a decision that everyone else has to pay for. I can’t support that.