Parental Consent and Notice for Contraceptives Threatens Teen Health and Constitutional Rights

Currently, no state or federal laws require minors to get parental consent in order to get contraception. Increasingly, however, proposals are being introduced to restrict teens’ access to reproductive health care by calling for parental consent or notification.

Examples of Minors Who Would Face Harm
Teens in a variety of circumstances would be affected if required to obtain parental consent for contraception:

  • A young woman seeking contraception from a clinic—birth control pills, DepoProvera, diaphragm—would be forced to obtain parental permission
  • A minor who buys condoms at a pharmacy could be turned away without parental consent
  • A teen who seeks emergency contraception because of forced or unanticipated intercourse would need approval, even though emergency contraception must be used within 72 hours of unprotected intercourse.

Two types of mandatory parental contact for contraception are sometimes proposed:

  • Mandatory parental consent would force teenagers to get permission from one or two parents before getting contraception.
  • Mandatory parental notification would require young people to tell one or two parents about their plans to get contraception. Mandatory notification poses the same danger of discouraging contraceptive use by teens as does the requirement of consent. If a minor is fearful about discussing contraception with a parent, there is no difference between ‘telling’ the parent and getting parental permission

Federal Programs Require Confidentiality for Teens
Two federal programs - Title X and Medicaid - protect teens’ privacy and prohibit parental consent requirements for teens seeking contraception1. Title X provides funds to states for family planning services; Medicaid covers health care services for low-income women. Both programs mandate that, in exchange for receiving monies from the federal government, health care services treat all patients confidentially, including teens.

Attempts by states to implement parental consent requirements for contraceptive services that are funded by these programs have been invalidated when challenged in court. Courts find that the requirements impermissibly conflict with federal program requirements. Federal program rules mandating confidentiality preempt state efforts to make new requirements. Nevertheless, states have continued to introduce legislation that would mandate parental involvement in teens’ private contraceptive decisions.

Both Consent and Notification Damage Teens
Parental contact requirements discourage teens from seeking contraception, even though they may already be sexually active. Confidentiality can be a determining factor for teens deciding whether or not to seek contraceptive protection2.

Teenagers Need Access to Contraceptive Services
Almost half of women in the United States have intercourse by the time that they turn 183. While the teen pregnancy rate today has dropped slightly in the past twenty years, almost one million teens become pregnant each year. A sexually active teen using no contraception has a 90% chance of becoming pregnant within a one year period, according to the Alan Guttmacher Institute4.

Lack of contraception increases the chances of unintended pregnancy. Nearly 80% of teen pregnancies are unplanned in the U.S5. Teen pregnancy rates are much higher in the U.S. than in other industrial countries - double the rates in England; nine times as high as the Netherlands. 6 Lack of contraception also increases the possibility of exposure to sexually transmitted diseases. About three million U.S. teens acquire a sexually transmitted infection every year7.

Parental Contact Laws Threaten Teens' Health
Supporters of measures forcing teens to notify or get consent from their parents argue that they promote the best interests of young women and improve family communications.

These arguments are out of touch with reality. These proposed laws threaten adolescent health and well-being. Even teens who could comply with parental consent requirements will face delays in getting contraceptive services. Additional clinic visits, missed school or work time, and increased expense will result.

Many young women live in nontraditional situations—with one parent, a stepparent, other relatives, or on their own. Contact with biological parents, if required by law, may be impossible.

Some teens face violence or other severe consequences from parents as a result of informing their parents that they are seeking contraceptive services. Minors fearful of retribution may forgo using contraception altogether, even though they are already sexually active.

Teens who seek contraceptive services are generally sexually active already. They benefit from meeting with health care providers, who can provide screening, counseling about sexually transmitted diseases, and education about other reproductive health concerns.

States May Not Impose Additional Restrictions on Title X Programs
Several courts have found that state parental consent requirements may not be imposed on federally funded family planning programs. Where states accept Title X and Medicaid funds, they cannot require minors to obtain parental consent prior to using those services.

Parental Consent for Contraception Is Unconstitutional
Minors have a right to privacy that includes their ability to use contraception.

The U.S. Supreme Court said in 1977 that denial of contraception is not a permissible way to deter sexual activity. 8

Courts that have addressed attempts to impose parental consent or notification requirements have found that these types of laws conflict with a minor’s constitutional right to privacy9.

Although states may require parental consent for a minor’s abortion when sufficient alternatives, such as judicial bypass, are in place, the same reasoning does not apply to contraception. According to the U.S. Supreme Court, "The states’ interest in protection of the mental and physical health of the pregnant minor, and in protection of potential life are clearly more implicated by the abortion decision than by the decision to use a nonhazardous contraceptive." 10

Access to contraceptive services is considered a fundamental privacy right and has remained so for over three decades.

SUMMARY:

Teens' Lives Would be Endangered by Bad Policy and Bad Law
Placing barriers on teen access to contraception is dangerous to the health and welfare of young women because it increases their risk of unplanned pregnancies. The costs to society from teen pregnancy are enormous.

While programs with federal family planning money are forbidden from requiring parental consent or notice for teen services, teens also have a constitutional right to privacy that encompasses their decision to obtain contraception, a right that lawmakers should acknowledge and respect.

For more detailed information or an analysis of proposed legislation restricting teen access to contraception, contact the Center for Reproductive Rights.

Endnotes

1 Title X, 42 U.S.C. § 300 et. seq. (1991 & Supp. 1998); 42 C.F.R. § 59.15 (1998)

2. Diane M. Reddy et al., Effect of Mandatory Parental Notification on Adolescent Girls’ Use of Sexual Health Care Services, 288 J. Am. Med. Ass’n 710, 710–14 (2002); Guttmacher Instit., State Policies in Brief: Minors’ Access to Contraceptive Services (Mar. 11, 2006), available at http://www.guttmacher.org/statecenter/spibs/spib_MACS.pdf; Confidential Health Care for Adolescents: Position Paper of the Society for Adolescent Medicine, 35 J. of Adolescent Med. 160, 162 (2004).

3. Centers for Disease Control, U.S. Dep’t of Health and Human Services, Fertility, Family Planning, and Reproductive Health of U.S. Women: Data From the 2002 National Survey of Family Growth (Series 23, No. 25) 73 tbl. 34 (Dec. 2005).

4. Harlap et al., Preventing Pregnancy, Protecting Health: A New Look at Birth Control Choice in the United States (New York: AGI, 1991), Figure 5.4, p. 36.

5. Henshaw, "Unintended Pregnancy in the United States," Family Planning Perspectives (1998):30(1):24-29, 46, Table 1.

6. AGI, Sex and America’s Teenagers (New York: AGI, 1994), pp. 19-20.

7. Ibid,. p.38.

8. See Carey v. Population Services Int’l, 431 U.S. 678, 693–96 (1977).

9. See Planned Parenthood Ass’n of Utah v. Matheson, 582 F. Supp. 1001, 1009 (D. Utah 1983); T.H. v. Jones, 425 F. Supp. 873, 880–81 (D. Utah 1975), aff’d on statutory grounds, 425 U.S. 986 (1976).

10. Carey, 431 U.S. at 694.