1. Lipman, Terri H. PhD, CRNP, FAAN
  2. Tiedje, Linda Beth PhD, RN, FAAN

Article Content

Zavodny, M. (2004).American Journal of Public Health,94(8), 1347-1351.


Since 1970, federally funded clinics have provided contraceptives to all who seek them under Title X of the public Health Service Act. As a nurse working in a county family planning clinic in the 1970s, I recall early challenges about providing services to unmarried minors without parental consent, but several court decisions have affirmed that clinics receiving federal funds do not have to require parental consent or notification. The arguments remain largely what they were in the '70s: Proponents of parental notification say such requirements would lower pregnancy rates by encouraging teens to talk with their parents about sex and possibly use abstinence. Opponents of such requirements argue that teen pregnancy rates would increase because minors would switch to less effective, nonprescription contraceptives or not use any birth control.


In April 1998, a McHenry County, Illinois clinic provided the environment for an evidence-based answer to fertility effects of a parental consent policy for minors-they began requiring parental consent before providing minors with contraceptives. There was only one public health clinic in the county, and because the new policy violated Title X stipulations, the county used its own funds to pay for contraceptive services. The clinic referred teens who did not wish to involve their parents to clinics in nearby counties.


Results indicated that in the 2-year period before the new policy was put into effect, 2.92% of all births in McHenry county were to women younger than 19 years. In the 2 years after the new policy was in place, that percentage rose to 3.44%. Relative to the three comparison counties, McHenry births for women under 19 rose significantly; indeed, births declined in the other counties. Abortion rates were not significantly affected (although parental consent for abortion remained unrequired).


Because this study examined suburban, predominately white communities, the results may not apply to other areas. However, results corroborate a Wisconsin study that found that 47% of minors would stop using family planning services if their parents were notified (Reddy, Fleming, & Swain, 2002). Policy makers need to attend to this evidence and the unintended consequences of parental consent laws for prescription birth control services.

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Comment by Linda Beth Tiedje




Reddy, D. M., Fleming, R., & Swain, C. (2002). Effect of mandatory parental notification on adolescent girls' use of sexual health care services. JAMA, 288, 710-714. [Context Link]