Teen abortion down since notification law passed
Posted: Thu Mar 09, 2006 8:33 am
17-year-olds delaying procedure, study finds
By LAURA BEIL / The Dallas Morning News
Abortion rates among Texas minors have dropped, apparently because of the state's parental notification law, although it may be driving some older girls into second-trimester terminations.
The findings emerged from the first comprehensive analysis of teen abortion and birth rates since passage of Texas' parental notification act. The law, which took effect in 2000, requires a physician to notify the parent of a minor girl seeking an abortion.
The researchers found that the abortion rate among 15-year-olds was 18 percent lower in the three years after the law went into effect than it was in the two years before. For 16-year-olds, the rate dropped 25 percent, and for 17-year-olds it fell 22 percent.
Abortion rates in Texas and nationally have been falling for more than a decade, but the new study, published today in the New England Journal of Medicine, suggests that the law has accelerated this trend. Among 18-year-olds – girls closest in age to minors but unaffected by parental notification – the decline was 7 percent.
The larger drop in rates among younger girls suggests the law may be making the difference.
While other studies have examined parental notification, the authors of the new study tried to overcome flaws in previous work, said lead researcher Ted Joyce of the City University of New York. For example, the scientists pinned the analysis to a girl's age at conception, not just at delivery or abortion.
Other studies also have not effectively accounted for girls traveling to neighboring states for abortions.
Dr. Joyce and his colleagues focused much of their analysis on 17-year-olds, who provide the closest comparison to 18-year-olds and, he says, may be most affected by the parental notification requirement. Studies have suggested that the older a teenager is, the less likely she is to discuss abortion with her parents. A 15-year-old girl might be inclined to involve her parents even if the law did not dictate it, he said.
Postponing procedure
When the researchers analyzed the numbers for 17-year-olds, one new phenomenon appeared: While this group's overall rate of abortion fell, the data suggested that many girls were postponing the procedure. The study found a spike in second-trimester abortions for those who became pregnant within six months of their 18th birthday, when they would be past the law's reach.
The numbers work out to about 70 extra second-trimester abortions each year in Texas.
"These kids are the kids who have the capability of waiting until they are 18," Dr. Joyce said.
The state's abortion and birth rates generally fell for all teenagers studied. For example, among 17-year-olds, the rate dropped from 18.7 to 14.5 abortions per 1,000 girls. On average, there were more than 14,600 abortions each year among teenagers in the two years before the law, and about 13,500 after. During that time, births among teens also dropped from 65,055 to 64,717.
The study did not examine sexual activity or the use of contraception among teenagers.
The author of the law, state Sen. Florence Shapiro, R-Plano, was pleased with most of the data.
"I strongly believe that the bill we passed accomplished what we were trying to do," she said. She said that before the bill was enacted, the state already required parental notification for other medical treatments involving minors. "My goal was to connect parents and children."
The jump in second-trimester abortions, she said, was an exception to the larger trend.
Abortion rights advocates, however, say they are alarmed to learn that some girls delay to a more advanced stage of pregnancy to avoid their parents.
"More 17-year-olds having later abortions is a negative outcome," said Sarah Wheat of NARAL Pro-Choice Texas. Later abortions can carry a higher risk of complications. She said the study also highlights the complexity of government involvement.
Regardless of laws, "there are women who will be determined to seek an abortion," she said. "You can put bans in place, but there can be any number of circumstances where a woman will be so determined to have an abortion that she will find a way to do it."
The researchers said they focused on Texas because it is the largest state to require parental notification, and births and abortions occur frequently enough for detailed analysis. Also, Dr. Joyce said, most surrounding states have similar notification laws, which would discourage girls from crossing the state line.
Past research
"I think the reduction in abortion is completely in line with past research," said Phillip Levine, an economist from Wellesley College in Massachusetts who has studied the impact of abortion laws.
Past studies have found little effect on teen birth rates but a drop in abortions, suggesting fewer pregnancies as well. The new analysis is the first to find an increase in births among any age group that corresponded with a decline in abortions, which may mean, the researchers said, that more teenagers are having babies they did not plan.
"If this minor did not want to have this birth, is that a good outcome?" Dr. Joyce said. "What are the consequences to the offspring of the women who have the unintended birth?"
However, Dr. Levine pointed out that the rise in birth rate appeared only among one group of older 17-year-olds, and was not a broader trend among minors. "One way to interpret these results is there was a reduction in pregnancies as well."
All of these results are important to understand, the authors write in the journal, particularly as other states and the federal government consider similar parental notification requirements.
"These findings," they write, "are relevant to an assessment of the likely effect of pending legislation to extend such laws."
By LAURA BEIL / The Dallas Morning News
Abortion rates among Texas minors have dropped, apparently because of the state's parental notification law, although it may be driving some older girls into second-trimester terminations.
The findings emerged from the first comprehensive analysis of teen abortion and birth rates since passage of Texas' parental notification act. The law, which took effect in 2000, requires a physician to notify the parent of a minor girl seeking an abortion.
The researchers found that the abortion rate among 15-year-olds was 18 percent lower in the three years after the law went into effect than it was in the two years before. For 16-year-olds, the rate dropped 25 percent, and for 17-year-olds it fell 22 percent.
Abortion rates in Texas and nationally have been falling for more than a decade, but the new study, published today in the New England Journal of Medicine, suggests that the law has accelerated this trend. Among 18-year-olds – girls closest in age to minors but unaffected by parental notification – the decline was 7 percent.
The larger drop in rates among younger girls suggests the law may be making the difference.
While other studies have examined parental notification, the authors of the new study tried to overcome flaws in previous work, said lead researcher Ted Joyce of the City University of New York. For example, the scientists pinned the analysis to a girl's age at conception, not just at delivery or abortion.
Other studies also have not effectively accounted for girls traveling to neighboring states for abortions.
Dr. Joyce and his colleagues focused much of their analysis on 17-year-olds, who provide the closest comparison to 18-year-olds and, he says, may be most affected by the parental notification requirement. Studies have suggested that the older a teenager is, the less likely she is to discuss abortion with her parents. A 15-year-old girl might be inclined to involve her parents even if the law did not dictate it, he said.
Postponing procedure
When the researchers analyzed the numbers for 17-year-olds, one new phenomenon appeared: While this group's overall rate of abortion fell, the data suggested that many girls were postponing the procedure. The study found a spike in second-trimester abortions for those who became pregnant within six months of their 18th birthday, when they would be past the law's reach.
The numbers work out to about 70 extra second-trimester abortions each year in Texas.
"These kids are the kids who have the capability of waiting until they are 18," Dr. Joyce said.
The state's abortion and birth rates generally fell for all teenagers studied. For example, among 17-year-olds, the rate dropped from 18.7 to 14.5 abortions per 1,000 girls. On average, there were more than 14,600 abortions each year among teenagers in the two years before the law, and about 13,500 after. During that time, births among teens also dropped from 65,055 to 64,717.
The study did not examine sexual activity or the use of contraception among teenagers.
The author of the law, state Sen. Florence Shapiro, R-Plano, was pleased with most of the data.
"I strongly believe that the bill we passed accomplished what we were trying to do," she said. She said that before the bill was enacted, the state already required parental notification for other medical treatments involving minors. "My goal was to connect parents and children."
The jump in second-trimester abortions, she said, was an exception to the larger trend.
Abortion rights advocates, however, say they are alarmed to learn that some girls delay to a more advanced stage of pregnancy to avoid their parents.
"More 17-year-olds having later abortions is a negative outcome," said Sarah Wheat of NARAL Pro-Choice Texas. Later abortions can carry a higher risk of complications. She said the study also highlights the complexity of government involvement.
Regardless of laws, "there are women who will be determined to seek an abortion," she said. "You can put bans in place, but there can be any number of circumstances where a woman will be so determined to have an abortion that she will find a way to do it."
The researchers said they focused on Texas because it is the largest state to require parental notification, and births and abortions occur frequently enough for detailed analysis. Also, Dr. Joyce said, most surrounding states have similar notification laws, which would discourage girls from crossing the state line.
Past research
"I think the reduction in abortion is completely in line with past research," said Phillip Levine, an economist from Wellesley College in Massachusetts who has studied the impact of abortion laws.
Past studies have found little effect on teen birth rates but a drop in abortions, suggesting fewer pregnancies as well. The new analysis is the first to find an increase in births among any age group that corresponded with a decline in abortions, which may mean, the researchers said, that more teenagers are having babies they did not plan.
"If this minor did not want to have this birth, is that a good outcome?" Dr. Joyce said. "What are the consequences to the offspring of the women who have the unintended birth?"
However, Dr. Levine pointed out that the rise in birth rate appeared only among one group of older 17-year-olds, and was not a broader trend among minors. "One way to interpret these results is there was a reduction in pregnancies as well."
All of these results are important to understand, the authors write in the journal, particularly as other states and the federal government consider similar parental notification requirements.
"These findings," they write, "are relevant to an assessment of the likely effect of pending legislation to extend such laws."