According to Houston OB-GYN Hillary Boswell, she has witnessed the impact of abortion bans on teenage girls, resulting in a higher number of them choosing to continue their pregnancies.
“It’s truly heart-wrenching to witness the growing number of pregnant 13-year-olds I’ve had the privilege of assisting,” expressed Boswell, as she reflects on the impact of Texas’ ban on abortions after six weeks, implemented in September 2021. The situation worsened in June 2022 when the U.S. Supreme Court overturned Roe v. Wade, resulting in a complete abortion ban in Texas.”
“They would enter the clinic, visibly distressed,” Boswell expressed, reflecting on her ten years of providing healthcare to underprivileged women and girls at local health centers. She shared the immense difficulty of being unable to assist them in obtaining an abortion when they desired one, stating, “It was incredibly challenging and went against everything I had trained for.”
According to a study conducted by the University of Houston, teen fertility rates in Texas have increased for the first time in 15 years following the implementation of the state’s six-week abortion ban.
The rise in teenage fertility in Texas was relatively small, at just 0.39%. However, researchers from the University of Houston consider this change to be significant, as it marks a reversal of a 15-year trend, especially when considering the decline in the national teen fertility rate during the same time period. Notably, the increase in fertility rates was more pronounced among Hispanic teenagers (1.2%) and Black teenagers (0.5%), while the rate among white teenagers decreased by 0.5%.
The Texas data is the first indication that abortion bans could potentially result in a rise in teenage pregnancies. With the spread of abortion restrictions in the aftermath of Roe v. Wade, where 13 states now have complete bans, experts and providers anticipate similar trends in other states. Consequently, the long-standing downward trend in teenage births over the past three decades could be at risk.
Boswell and other providers are expressing concern over the increasing difficulty that teenagers face when trying to access contraception and abortions. They worry that the incoming Trump administration may further exacerbate these challenges. This is particularly worrisome because teenage pregnancies are already riskier, and it is well-documented that teenagers disproportionately seek abortions in comparison to other age groups. The Supreme Court overturning Roe v. Wade has only added to the obstacles that teenagers face in obtaining the necessary reproductive healthcare.
According to Bianca Allison, a pediatrician and assistant professor at the University of North Carolina School of Medicine, Texas serves as a representative example of the challenges faced in other parts of the country. She highlights that historically, the discussion on reproductive autonomy and rights has often neglected young individuals who are minors but have the potential for reproductive decisions.
Access to pills
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Since the fall of Roe, the availability of telehealth has become crucial for individuals seeking abortions. In fact, medication abortions now make up almost two-thirds of all abortions performed. The Society of Family Planning has reported an increase in the overall number of abortions in the U.S., largely due to the growing utilization of this more accessible method.
The Trump administration has the potential to increase the difficulty of obtaining abortion pills by reversing the existing policy of the U.S. Food and Drug Administration (FDA), which currently permits them to be shipped via mail. Several anti-abortion groups are pushing for the enforcement of the Comstock Act, a law dating back to 1873 that they argue could be leveraged to criminalize the sending or receiving of abortion medication at a federal level.
Some states have implemented regulations that require patients to have in-person visits with physicians in order to obtain abortion medication, effectively preventing them from accessing it through telemedicine.
Louisiana recently implemented a new policy classifying mifepristone and misoprostol, the medications used in nonsurgical abortions, as controlled substances. This means that it is now illegal to possess these medications without a prescription. Following suit, a lawmaker in Texas has also introduced a similar proposal.
According to Julie Maslowsky, an associate professor at the University of Michigan who specializes in adolescent reproductive and sexual health, she strongly believes that there will be a setback in our efforts to reduce teen pregnancies.
According to Maslowsky, it is crucial to provide individuals with a range of options to prevent pregnancy if they do not wish to become pregnant. He also highlighted that the majority of teenagers do not have the desire to be pregnant.
Teenage girls often face challenges when it comes to obtaining abortion care due to limited financial resources, lack of transportation options, and limited independence compared to adult women. These factors make it difficult for them to access abortion services across state lines or afford the cost of abortion medication. In fact, the price of medication abortion can be as high as $800, as reported by Planned Parenthood.
According to Rosann Mariappuram, senior reproductive rights policy counsel at the State Innovation Exchange, a nonprofit that advocates for progressive policies, many teenagers face challenges when attempting to purchase abortion medication online. These difficulties arise from a lack of credit or debit cards, as well as a lack of secure mailing addresses to receive the pills. Consequently, abortion funds that aim to support individuals who cannot afford this care have been grappling with the overwhelming demand.
In a significant number of states, parental consent or notification is mandatory before a minor can undergo an abortion. This requirement adds another obstacle for teenagers seeking abortion services. Additionally, teenagers are more prone to experiencing irregular menstrual cycles, which can make it harder for them to identify a missed period as a potential sign of pregnancy. Shockingly, approximately one-fourth of women may not even realize they are pregnant within the six-week gestational time limit imposed for abortions in Florida, Georgia, Iowa, and South Carolina.
Mariappuram stated that lawmakers in Oklahoma and Indiana have put forth arguments claiming that IUDs and emergency contraceptives should not be covered by insurance or made available, as they consider them to be types of abortions. Furthermore, she mentioned that a law in Texas, which came into effect in April, now requires family planning clinics to obtain parental consent for minors seeking birth control.
“They are coming for contraception,” she said, highlighting the fact that equating contraceptives with abortion care is a clear indication of their intentions.
Health risks, diminished prospects
Teenage girls from disadvantaged backgrounds are at a higher risk of experiencing teenage pregnancy. The national teen birth rate has consistently shown racial disparities, with rates among Black, Hispanic, and Native American girls being at least twice as high. Furthermore, while the average age at which girls have their first menstrual period has been decreasing for all girls, this trend is especially noticeable among racial minorities.
Mayra Pineda-Torres, an assistant professor of economics at Georgia Tech specializing in gender and inequality, emphasizes that the downstream impacts of abortion restrictions vary among different individuals. She highlights the racial component in this issue, suggesting that it may further exacerbate racial inequalities and limit access to abortion services.
Teenage motherhood can often disrupt a girl’s education and hinder her long-term financial prospects. Additionally, pregnancy poses specific health risks for teenagers, increasing the likelihood of serious complications such as preeclampsia and low birth weight for their babies. Recognizing these risks, the American Academy of Pediatrics advocates for granting teens access to legal abortion care.
According to Joe Pojman, founder and executive director of the Texas Alliance for Life, those who oppose abortion view teen pregnancies and births as a better option than teen abortions. He emphasized that the state of Texas has implemented various programs aimed at providing support to families, including teenage parents, in order to ensure the well-being of their children.
According to Stateline, Pojman explained that the program aims to equip participants with essential skills like budget management, job application, and overall self-sufficiency.
“We want to avoid promoting the idea of a child being responsible for the decision to end the life of her unborn child,” he stated.
Last month, Missouri Attorney General Andrew Bailey, along with his Republican counterparts in Kansas and Idaho, took legal action by filing a lawsuit. Their aim was to compel the FDA, through a Texas judge, to restore the restrictions on mifepristone. Their argument centered around the negative impact that lower teen birth rates have had on their respective states. They claimed that this decline in population has resulted in financial losses in terms of federal funds and reduced congressional representation.
According to certain studies, the findings contradict the notion. Research conducted by the federal government reveals that teen pregnancy incurs a significant cost of approximately $11 billion annually for taxpayers. This is primarily due to increased public expenditure on healthcare and foster care, as well as higher rates of incarceration for children of teen parents. Furthermore, teen pregnancy also contributes to lower levels of education and income.
According to Allison, a pediatrician from North Carolina, pregnancy is not a harmless experience and is not always met with joy and excitement by many individuals in the country.