A major problem for minors: post-Roe access to abortion

Nnow that the Supreme Court has lifted constitutional protections for access to abortion, more than two dozen states will ban or severely restrict access to abortion. Young people, especially those under 18, will be disproportionately affected by this decision.

The existing barriers to legal access to abortion, which for many people are already insurmountable, serve as a foretaste of what to expect and the inequality that will continue to grow. In Indiana, for example, consent for a minor to have an abortion requires the completion of a notarized consent form; personal, state-led counseling; an ultrasound; and a waiting time of 18 hours.

As teens also face greater barriers to pregnancy prevention, including barriers to access to birth control and limited access to comprehensive sex health education, the door is being closed to them at every turn.


Teens under the age of 20 make up 12% of those who have abortions nationally; minors 17 years of age or younger account for about 4% of all abortions in the US. This means that in the United States, at least 50,000 adolescents require abortion care each year. Furthermore, teenage pregnancies are more likely to be unintended and end in abortion than pregnancies in older individuals. This means that teens will be disproportionately affected by this legal decision.

Teens’ right to access safe and confidential abortions has been affirmed by the American Academy of Pediatrics, the Society for Adolescent Health and Medicine, and the North American Society of Pediatric and Adolescent Gynecology. Yet access to abortion for teens is more regulated by law than access for adults. Currently, minors cannot access confidential abortion care in 38 states because parental notification or consent is required to obtain an abortion. While judicial bypass is a legal option for obtaining an abortion without parental intervention, the process is complicated, cumbersome, and time-consuming.


Even when young people can overcome legal obstacles, they face economic, information and access barriers. The cost of an abortion, which is likely to rise in a post-Roe world, makes it inaccessible to many teens. Teens and their guardians are rarely aware of existing federal and state restrictions on insurance coverage for abortion care until an abortion is required. There are federal restrictions on Medicaid plans and several state restrictions on both public and private insurance plans.

The teenage “abortion road trip” is already part of American cultural discourse in books and movies. These fictionalized versions will pale in the harsh reality of traveling ever greater distances to have an abortion as Roe’s constitutional precedent is shattered. Illinois, New York and other states where abortion remains legal will become a “safe haven state” for people across the country seeking abortions, but many young people won’t be able to travel hundreds of miles to get to a clinic.

Minors face restrictions when independently purchasing interstate bus, train, or airline tickets. It is particularly difficult to cover travel costs for young people who are not financially independent. Supportive adults may fear legal repercussions if they help transport a minor across state lines to seek abortion care. Existing laws requiring wait times and multiple appointments make these trips more time consuming, expensive and challenging.

Coupled with delays in recognizing that a pregnancy has begun and providing medical care, which is more common in teens, pregnancy-based abortion prescriptions will have a greater impact on teens’ ability to access abortion care. While telecare may be an option for those seeking drug abortion, these services are almost completely limited to those 18 and older in states that allow telecare, leaving younger teens without this medically safe option.

Existing laws and barriers have done a lot of harm to teens as they contribute to unnecessary medical complications due to delays in care.

These barriers are exacerbated by poverty, race and other social statuses. The teenage pregnancy rate is higher among young people who are poor, people of color, LGBTQ+, and those in foster care or in the criminal justice system. They are also the least likely to have resources and social networks to support them in overcoming barriers to abortion access — or as new parents. When young people have children without a real choice of whether or not to grow up, existing inequalities grow.

As the right to make decisions about pregnancy and parenthood becomes more limited, teens’ rights to physical autonomy and reproductive freedom must be protected so they can determine their own future.

Immediate efforts should focus on supporting abortion funds that provide people with financial and logistical support and helping legal groups to assist minors in obtaining judicial bypass and other legal matters. Policymakers in states with protected access to abortion should repeal forced parental involvement laws, as Illinois recently did. Access to telehealth medication abortion should also be extended to minors in these states as well. And policymakers must be held accountable for ensuring that everyone in all states has access to comprehensive sex education and the full range of birth control options.

Teens deserve to have autonomy over their bodies. It is time to fight for this fundamental right.

Tracey Wilkinson is a pediatrician and assistant professor of pediatrics at Indiana University School of Medicine. Julie Maslowsky is an associate professor of community health sciences at the University of Illinois Chicago School of Public Health. Laura Lindberg is professor of urban-global health at the Rutgers School of Public Health.

A major problem for minors: post-Roe access to abortion

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