State-level Abortion Restrictions Will Negatively Impact Teens and Children

Source: Figure based on Child Trends’ calculations of abortion data from: https://www.guttmacher.org/sites/default/files/report_
downloads/pregnancies-births-abortions-us-1973-2017-appendix-tables.pdf

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This blog first discusses four reasons for why we expect teens to be uniquely—and perhaps disproportionately—impacted by additional state-level abortion restrictions. We conclude by noting that policymakers in states that enact restrictions on abortion must find and invest in other ways to support teens who become pregnant.

1. While teens are a decreasing percentage of the population who get abortions, pregnant teens are more likely to get an abortion than older pregnant people.

The average teenager is unlikely to get pregnant, but pregnant teens are more likely to terminate their pregnancy than older pregnant people. Approximately one in four pregnancies among teens ended in abortion in 2017, a higher percent than among other age groups (Figure 2). Teens are more likely than older pregnant people to report a pregnancy as unintended, which likely drives their decisions to terminate more often.

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Figure 2: Percent of pregnancies ending in abortion by age, 2017

Source: Figure based on Child Trends’ calculations of abortion data from: https://www.guttmacher.org/sites/default/files/report_
downloads/pregnancies-births-abortions-us-1973-2017-appendix-tables.pdf

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2. Relative to older people, teens are more likely to learn that they are pregnant further into their pregnancies.

Teens are more likely to be affected by state-level restrictions on abortion based on gestation because the average gestational age at which a teen finds out they are pregnant (7.4 weeks) is higher than for pregnant people overall (5.7 weeks). Teens commonly have irregular menstrual cycles, which means they may be less likely to identify a missed period than an older person. Black and Hispanic teens are also more likely to experience stress, racism, exposure to toxins, and chronic health conditions—factors with significant socioeconomic and regional disparities, and which are all linked to earlier first menstruation and irregular menstrual cycles. Additionally, many teens—even those who are sexually active—lack a comprehensive understanding of how pregnancies occur (or what behaviors put them at risk for a pregnancy).

3. Pregnant teens face additional state regulations that can delay abortion care.

Currently, nearly three quarters of states require that teens’ parent(s) either be informed or consent to abortion services. Most pregnant teens under age 18 talk to their parents about their pregnancies and desire for abortion care but some do not, driven by fear of emotional or physical abuse, ruined parental relationships, being kicked out of the house, or other negative repercussions. Although these teens can get a judicial bypass, this process—disproportionately sought by Black and Hispanic teens, teens on Medicaid, and teens with a prior pregnancy—takes extra time. Parent consent or notification laws can negatively impact accessibility of abortion care for minor teens in three ways: 1) Abortion costs increase in later trimesters, 2) abortion care may be limited in some states when care is sought after legally determined gestational limits, and 3) some teens may delay seeking judicial bypass because it can be stigmatizing or shaming.

4. Teens have more difficultly accessing in-clinic or medication abortions.

An immediate consequence of the Dobbs decision is increased physical distance to abortion providers, which limits access. Although many abortion patients travel for care, teens often lack the necessary financial resources—especially lower-income and rural youth. Additionally, even with parental support, accessing abortion out of state can require traveling for multi-day appointments, missing school, traveling with multiple family members if there aren’t care providers for younger siblings, or spending multiple days away from home. Adolescents may also have a harder time getting accurate information on abortion (especially medication abortion); research suggests that adolescents’ medical providers may have incomplete knowledge about medication abortion. Prior research finds that low-income patients and Black, Hispanic, and Indigenous patients had more difficulty accessing medical abortions after previous abortion bans, which will also likely be true for new bans.

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Teens who become pregnant will need ongoing, stable supports to navigate pregnancy and parenthood in healthy ways.

Many teens who decide to become parents are dedicated, present, and loving, and engage in caretaking with grace and strength. However, those who are able to do this often receive love and support from their own families, as well as financial, emotional, and educational resources for themselves and their children.

We anticipate that, post-Dobbs, state-level abortion bans or restrictions will increase the number of pregnant teens who want abortions but cannot get them. With less access to abortion, many teen parents will need additional supports to be successful parents, including support with caretaking, continued education, high-quality job training or employment, extended family support (e.g., grandparents), or subsequent pregnancy prevention (15% of all births among teens are repeat births). If teens are forced to carry pregnancies to term and become parents (adoption is rare, even for teen parents) without additional, high-quality supports from states, we expect additional negative physical health, mental health, relationship, and economic outcomes for teens and their children, and potential increases in deep poverty for children.