Home | Business News | Browse by Publication | P | Perspectives on Sexual and Reproductive Health

Minors' behavioral responses to parental involvement laws: delaying abortion until age 18.

Article Excerpt
Laws in many states require that abortion providers notify parents or obtain written consent from them before an abortion is performed on a minor; these laws are often referred to as parental involvement laws. Evaluation of these laws has focused on changes in the abortion, birth and pregnancy rates after implementation. Relatively few studies, however, have evaluated the effect of these laws on the timing of minors' abortions. There are no studies that specifically evaluate the extent to which these mandates cause minors to delay abortion until age 18 in order to circumvent the parental involvement requirement, or the extent to which this behavior increases the prevalence of late-term abortions among older teenagers. If parental involvement laws cause a delay in abortion among minors, they may increase the clinical and financial burden of the procedure. (1)

Evidence of the effect of parental involvement laws on the timing of abortion is not conclusive. Some studies have shown no change in the proportion of abortions performed in the second trimester or later. (2) Others have suggested a rise in this proportion; however, in most cases, it has not been statistically significant. (3,4) An evaluation in Minnesota showed that after the state's parental notification law went into effect, the proportion of minors' abortions that occurred in the second trimester or later increased significantly. (5) However, it also showed that this increase was the result of a substantial decline in the rate of abortions occurring among minors within 12 weeks' gestation, and not the result of a rise in the rate of abortions occurring after 12 weeks. Researchers reported similar findings in Mississippi. (3,4) Implementation of Mississippi's parental consent law was associated with an increase in mean gestational age at the time of abortion among minors, but not in the rate of second-trimester abortions. (4)

Parental involvement laws can cause minors to delay an abortion for several reasons. Some minors need to seek a judicial bypass to terminate a pregnancy without parental involvement. Others travel out of state for the abortion. Those who involve their parents may delay informing them out of embarrassment or fear of punishment. Each response is likely to vary by the age of the minor. Survey data indicate that younger minors are more likely than older minors to involve their parents in their decision to have an abortion or to obtain reproductive heath services. (6,7) Older minors may be more likely to seek a judicial bypass, since they are more likely to prevail; they may also be more capable of arranging an out-of-state abortion. Finally, some 17-year-olds may delay an abortion until they turn 18. Joyce, Kaestner and Colman reported that after Texas implemented a parental notification law, the likelihood of a second-trimester abortion increased among minors who were between 17 years and six months and 17 years and eight months at the time they conceived. (8) The authors did not explore whether this intriguing increase represents a conscious decision to delay the termination until age 18.

In this study, we extend the analysis of Joyce, Kaestner and Colman, and evaluate whether Texas's law is associated with a delay in abortion until age 18 among older minors, and whether such delays lead to more second-trimester abortions among older teenagers. We distinguish this type of delay from a general increase in gestational age that might occur among minors of all ages after introduction of a parental involvement law. This behavior has not been studied before, because researchers have lacked detailed information on age and a sufficiently large sample to detect changes among a subgroup of minors.

METHODS

Data

We use individual-level data from induced termination of pregnancy certificates for the years 1997-2003 from the Texas Department of State Health Services. Abortion data from Texas are noteworthy in that they contain the patient's exact date of birth as well as the date of the procedure and the clinician's estimate of gestational age in weeks. With this information, we are able to estimate the teenager's age in months at the time of conception and at the time of the abortion.

Texas's parental notification requirement went into effect in January 2000. We define all abortions occurring among teenagers who conceived between January 1, 2000, and December 31, 2003, as postlaw events, and abortions among those who conceived between August 1, 1997, and July 31, 1999, as prelaw events.* We exclude all abortions among those who conceived between August 1, 1999. and December 31, 1999, since these minors could have been subject to the law, given the time that may elapse between pregnancy recognition and pregnancy resolution. For simplicity, we refer to the prelaw period as 1998-1999.

Changes in the Risk of Second-Trimester Abortion

We analyze the association between Texas's law and the likelihood of minors' delaying abortion until age 18 by evaluating the change between the prelaw and postlaw periods in the proportion of abortions that were obtained at age 18. We limit this analysis to minors who were at least 17 years and six months old at the time they conceived, because it would be virtually impossible for younger minors to delay abortion until age 18. The data confirm that between 1998 and 2003, no abortions occurred at age 18 among minors who conceived at age 17 years and five months. We repeat the analysis for 16-year-olds, evaluating the change in the proportion who terminated their pregnancy at age 17. While 16-year-old minors are also subject to the law, they cannot delay abortion in...

View this article FREE - Now for a Limited Time, try Goliath Business News
Free for 3 Days!