Teenagers and pregnancy: The law in 1979.

Since January 1976, when we last reviewed state laws and policies affecting the right of teenagers to consent for their own birth control and other reproductive health care, (1) the U.S. Supreme Court has in effect issued at least a partial bill of reproductive rights for minors. In three landmark cases--two involving abortion and one dealing with contraception--the Court has laid down a federal constitutional framework with which all future laws and regulations must comply. In so doing, the Court has rendered obsolete many of the laws we previously described that had restricted access of young people to fertility control services, and has clarified the rest. Thus, out of the old patchwork of statutes, case law, attorneys generals' opinions and administrative rulings there is finally emerging a coherent body of law based on two fundamental principles:

* the constitutional right of mature minors to obtain reproductive health services on their own consent, and

* the constitutional right of all minors to have an alternative to parental involvement in implementing their decisions about such health care.

By 1976, liberalization of state laws and reduction of the age of majority had established the right of unmarried women aged 18 or older to consent for most aspects of their own medical care in at least 45 states and the District of Columbia. In 48 states and the District, they could consent for most pregnancy-related health services, including abortion. In a number of states, however, minors still encountered obstacles to obtaining contraceptive services or terminating unwanted pregnancies without the consent of their parents.

Abortion and Parental Consent

When the Supreme Court ruled in 1973 (in Roe v. Wade (2) and Doe v. Bolton (3)) that women have a constitutional right (with the concurrence of their physicians) to obtain abortions, it left open the question of the validity of laws that required minors to secure the consent of their parents in order to obtain the procedure. A number of states enacted statutes requiring such consent for unmarried minors. These laws have been challenged in the courts on the ground that adolescent women, like adults, have a right of privacy which entitles them to decide, in consultation with their physicians, whether or not to terminate an unwanted pregnancy.

On July 1, 1976, the U.S. Supreme Court decided the cases of Planned Parenthood of Central Missouri v. Danforth (4) and Bellotti v. Baird. (5) These decisions firmly established the principle that minors have rights-though not necessarily identical with those of adults-to access to sex-related health care. In the Danforth case, the Court was called upon to decide the constitutionality of a Missouri statute which required the written consent of a parent or person acting in place of a parent before an unmarried woman younger than 18 could obtain a first-trimester abortion, unless "the abortion [was] certified by a licensed physician as necessary in order to preserve the life of the mother." The Court ruled that this law was unconstitutional, because a state may not "impose a blanket provision...requiring the consent of a parent or person in loco parentis as a condition for abortion of an unmarried minor during the first 12 weeks of her pregnancy." It added that a state "does not have the constitutional authori ty to give a third party an absolute, and possibly arbitrary, veto over the decision of the physician and his patient to terminate the patient's pregnancy, regardless of the reason for withholding the consent."