Parental consent for abortion?

Dear Frosh, 

You ask great questions with some complex answers. The answers to your questions depend on a few factors. The laws around access to abortion and minors vary by state within the United States and continue to change following the overturning of Roe v. Wade. Some states allow minors (meaning those under 18) to have an abortion without notifying their parents, while other states require parental notification or even parental permission. In terms of abortion access for minors, it’s also good to be aware of mandatory waiting periods between a counseling session and the abortion. You might also want to look into whether or not abortion is covered, or is allowed to be covered, by health insurance. Thinking through this information can help you determine whether you'll be able to access the services you need in the state where you currently reside. 

Because each state varies in their abortion laws, especially around parental consent, it would be difficult to list them all out. However, the Guttmacher Institute offers a comprehensive overview of abortion-related laws state-by-state. Of these laws: 

• Some states require at least some form of parental involvement in an abortion decision by a minor. 
• Some states in the U.S. require one or both parents to consent. 
• Some states require that one or both parents be notified (though consent isn't required). 
• Some states require both parental notification AND consent. 

For those states that require parental involvement, the United States Supreme Court has ruled that parents cannot legally block their child from obtaining an abortion, so a judicial bypass procedure can be initiated. This process is a way for the minor to appear in court to make their case for why they want to receive the abortion without the knowledge or consent of their parents. For those looking for support with the Judicial Bypass process, resources such as the Judicial Bypass Helpline can be helpful in providing free and confidential information. As with most other abortion laws, access to an abortion for a minor due to a medical emergency or abuse also varies by state. 

Another potential factor for consideration when seeking an abortion—even for those who aren't minors—is insurance. In the aftermath of the overturning of Roe v. Wade, information regarding insurance coverage for abortion is constantly changing. Each state varies in terms of what abortion-related coverage they allow providers to offer. While some states use public funds to provide abortions deemed medically necessary to those enrolled under Medicaid, others explicitly forbid the use of state funds for abortions unless the patient’s life is at risk, or their pregnancy is the result of circumstances such as rape or incest. When it comes to private insurance, a few states currently require that plans offer abortion coverage. While some states will allow you to purchase abortion coverage from a private health insurance provider at an additional cost, others only allow said providers to offer abortion-related care to patients in life-threatening situations. As an alternative to insurance, the National Network of Abortion Funds also offers a list of funds in all fifty states and the District of Columbia (as well as three international funds) that can assist in covering abortion-related costs. 

It might be good to consider and plan for any health or billing information that may be shared by insurance providers. If you’re still on your parents’ insurance plan, many times health information, such as birth control use, sexually transmitted infection (STI) tests, and abortion services, is made available to the primary policy holder of the health insurance plan. While the Health Insurance Portability and Accountability Act (HIPAA) protects an individual’s health privacy and states that only necessary information needs to be included, the Explanation of Benefits (EOB) sent out by insurance companies can often include these details. What constitutes as “necessary information” is up to each individual insurer—however, a patient may be able to ask an insurance provider what information is included on an EOB, where it will be sent, or even work with an insurer or provider to change what information is included on a specific EOB. 

Another consideration if you’re planning to travel for an abortion is that many states have mandatory waiting periods. Every state requires patient consent and information before the procedure, and more than half require patient counseling. Of the states that require counseling, most require at least a 24-hour waiting period between the initial session and the procedure. However, some states mandate up to a 72-hour waiting period. One-third of all U.S. states require that the first counseling session be done in-person, requiring two trips and potentially more time off of work or school. During the counseling sessions, some states require that certain information be covered, including information that hasn't been found to be medically accurate, which may further deter people from seeking abortions. Some of this includes inaccurate information about stopping a medication abortion, the future effects on fertility, and its effects on the risk of breast cancer. 

The differences in states’ abortion-related policies and procedures can certainly be overwhelming. The biggest takeaway from all of these numbers, though, is that your coverage and obstacles to accessing an abortion will vary based on your location. In the United States, legislation and regulations on abortion are changing frequently, which can make it more or less accessible depending on your age and where you’re located. Keeping an eye on what’s happening in your state help keep you informed for the future. The Center for Reproductive Rights maintains a map detailing abortion regulations in each state which can help provide more information about the specifics of current reproductive legislation and any new developments. 

Wishing you the best,