Removal of parental consent requirement reduces gestational duration at abortion for minors

Individuals below the age of 18 are faced with significant barriers when receiving abortion care due to additional parental consent requirements. To address this, the 2020 ROE Act in Massachusetts removed these requirements for minors aged 16-17 years. A new study reveals that this policy change led to a ~60-day decrease in gestational duration at abortion among this age group, highlighting the importance and impact of decreasing barriers to abortion access for minors.

Adolescents aged 15 to 17 years and those younger than 15 years of age account for 3% and 0.2% of all abortions in the United States, respectively. However, logistical challenges and consent requirements pose significant barriers to these age groups when accessing abortion care. In December 2020, the Massachusetts state legislature passed the ROE Act, which removed the requirement for parental consent for abortion for 16 to 17-year-olds while retaining it for individuals aged 15 years or younger. 

In a recent study published in the American Journal of Public Health, Dr. Isabel Fulcher and her colleagues determined how changes in parental consent requirements affected abortion timing in minors. Explaining the rationale behind their study, Dr. Fulcher explains, “Delays force minors into later gestational durations, increasing the cost of abortion care and limiting options, often meaning the difference between accessing medication abortion or requiring a procedural abortion.” 

The team analyzed data from abortions performed at the Planned Parenthood League of Massachusetts from May 2017 to June 2022 among individuals aged 16-19 years. The primary outcome of interest was the gestational duration at the time of abortion. The control group for this study comprised individuals aged 18-19 years, as they were nearest in age to the study group (adolescents aged 16-17) without being affected by parental consent requirements. 

The results showed that a total of 749 abortions were performed among minors aged 16-17 years during the study period. Of these, 524 and 225 abortions were in the period before and after the ROE Act, respectively. Comparing the pre- and post-ROE Act periods, the average gestational duration dropped from 62.0 to 58.3 days or a decrease of 5.46 days. In comparison, 2773 abortions were received by individuals ages 18 and 19 in the same time period. In this control group, the average gestational duration at abortion dropped from 58.1 to 56.7 days. 

Some other noteworthy findings of this study included an increased proportion of medical abortion in the post-ROE Act period, and an increased use of abortion funds and self-paid care. 

These findings support the hypothesis that mandated parental consent results in delayed care for minors obtaining abortions. Emphasizing the importance of this study, Dr. Fulcher explains, “While our study does not establish causality, these results highlight an important trend in which minors obtain abortions at earlier gestational durations when they are not required to obtain parental consent or judicial bypass.” The implications are clinically significant, as the risk of abortion-related complications increases by approximately 38% for each additional week beyond 8 weeks’ gestation. 

This study provides empirical evidence relevant to legislative efforts aimed at improving abortion access for minors. It emphasizes reinforcing the principle of reproductive autonomy and ensuring that minors can make timely and safe reproductive health decisions without unnecessary delays. 

“Our data support other states working to remove medically unnecessary restrictions and suggest that removing parental consent for minors aged 15 years or younger in Massachusetts could also help ensure expeditious access to abortion care,” concludes Dr. Fulcher.