Telling parents: Clinic policies and adolescents' use of family planning and abortion services.

U.S. courts have consistently upheld the right of mature minors to consent for contraceptive and abortion services. (1) In 1976, the Supreme Court ruled in Planned Parenthood of Central Missouri v. Danforth (2) and in Bellotti v. Baird,s {3) that parents cannot veto a minor's decision to obtain an abortion. In 1979, the Court reaffirmed that decision, indicating that neither consent nor notification may be required without offering a minor prompt administrative or judicial review to determine whether she is mature enough to give informed consent and, if she is not, whether the abortion is in her best interests. (4) These decisions have also been interpreted as establishing the right of mature minors to obtain prescription contraceptives on their own; their right to obtain nonprescription contraceptives was established by the Supreme Court in 1977 in its ruling in Carey v. Population Services International. (5)

Despite these decisions, a number of states have attempted to impose parental consent requirements through legislative action; these laws have generally been struck down by the courts, (6)usually because they did not allow prompt judicial review. Two states, however, have recently enacted parental consent requirements: Louisiana's law was passed late in 1980, and the Massachusetts law is being stayed under a temporary restraining order until the U.S. Court of Appeals for the First Circuit has reviewed an appeal of a lower-court decision upholding the law. Both the Louisiana and Massachusetts laws differ from previous statutes in that they allow a teenager to petition the court in order to obtain an abortion without previously notifying or involving her parents. (7)

Only four states--Maryland, Montana, Tennessee and Utah--have notification requirements for the provision of abortion services to minors (in Maryland, doctors are not required to notify parents if they believe that the minor will be subjected to physical or psychological abuse if her parents know about her abortion).6 The Utah law has been appealed to the U.S. Supreme Court after being upheld by the Utah State Supreme Court; (9) a decision is expected early in 1981.

Family planning agencies that receive federal funds under Title X of the Public Health Services Act or under Titles XIX or XX of the Social Security Act are required to provide services to sexually active minors "without regard to age or marital status." A recent federal district court decision has held that no agency receiving such funds can require parental consent or notification before providing birth control services to minors. (10)

Private agencies providing abortion or family planning services that do not receive such federal funds, however, are free, in the absence of a specifically applicable statute, to require consent or notification of parents or to serve minors on their own consent.

It is not likely, given the current concern about family values, that there will be a quick end to the controversy over parental involvement in the decision of adolescents to use birth control and obtain abortions. It is useful, therefore, to examine the current parental consent and notification policies followed by abortion and family planning service programs, as well as the extent to which teenagers are already talking to their parents about these decisions, and, if they are not, what they would do if their parents were told. This article summarizes the findings of two national surveys conducted by The Alan Guttmacher Institute (AGI) that address these questions.

Methodology--1. Clinic Policies