Laws that require parental notification for teens to receive prescription contraception at family planning clinics could increase the risk of teen pregnancy, according to a study by Rachel Jones, Ph.D., and her colleagues.
“Family planning clinics need to be supported in the work that they are doing with teens,” said Dr. Jones, senior research associate at the Alan Guttmacher Institute (JAMA 2005;293:340–8).
The study found that if a law required clinics to inform parents in writing when their teenagers got prescription birth control, 18% of teens would have sex using no contraceptive method or would rely on rhythm or withdrawal.
About 1% of teens surveyed said their only reaction to such a law would be to stop having sex, the study said.
Most teens said they would continue to use the services at the clinic even if parental notification was required or would use over-the-counter contraceptives, such as condoms.
The implications are that mandated parental notification laws would discourage few teens from having sex and would likely increase rates of adolescent pregnancy and sexually transmitted diseases, the study authors concluded.
The study was based on a nationwide survey of 1,526 adolescent females under age 18 years who were seeking sexual health services, excluding abortion and prenatal and postnatal care, at publicly funded family planning clinics in 33 states.
About 60% of respondents said their parents were aware that they were using a clinic for sexual health services. In most cases, the teens had either voluntarily told their parents or they had come to the clinic at the suggestion of a parent.
About one-third of teens surveyed said that their parent or guardian was unaware that they were obtaining sexual health services at the clinic. About 4% said they were unsure if their parents knew.
Reasons respondents gave for not informing their parents included:
▸ Not wanting parents to know of the teen's sexual activity.
▸ Not wanting parents to be disappointed by the teen's sexual activity.
▸ Not feeling comfortable with discussing sex with their parents.
▸ Not wanting parents to know the reason for the teen's clinic visit.
▸ Wanting to take responsibility for their own health.
Concerned Women for America (CWA), a group that supports abstinence-only education, discounted the study. CWA said the study is biased because its authors are researchers associated with the Alan Guttmacher Institute, which is affiliated with Planned Parenthood.
CWA contends that Planned Parenthood is concerned that greater parental involvement will mean less business for them.
“Policymakers need to stop treating parents as a suspect class, presumed not to have their own kids' best interests at heart,” Wendy Wright, CWA's senior policy director, said in a statement.
“Adolescents benefit when their parents are involved in their lives, and policymakers shouldn't forbid their involvement in their daughters' and sons' most important decisions,” she said.
Texas and Utah currently require parental consent for teenage use of state-funded family planning services, and a similar restriction exists in one county in Illinois.
Last year, lawmakers in Kentucky, Minnesota, and Virginia introduced bills that were aimed at imposing parental consent requirements on teens seeking contraception.
On the federal level, lawmakers have introduced proposals in recent years to require parental involvement in teenagers seeking contraceptives at federally funded clinics; none has become law.
“All this history does not bode well for the future,” Cynthia Dailard said in a teleconference sponsored by the Alan Guttmacher Institute.
Ms. Dailard, a public policy associate at the institute, predicted that parental notification for sexual health services will be high on the federal agenda in the wake of the 2004 elections.
In addition, several newly elected senators have aggressively advocated against the use of federal dollars for family planning, she said.