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Across the U.S., opponents of reproductive rights are waging an attack on the right of adolescents to access contraception and abortion services, and are pumping millions of dollars into abstinence-only education programs at the expense of comprehensive sex education. Adolescents are being denied their right to reproductive self-determination, as well as services and information they need to make responsible and informed decisions that affect their safety and health. The dangerous strategy of anti-choice lawmakers and activists includes three main components:
- denying access to comprehensive education that enables teens to make responsible and informed decisions;
- denying access to confidential family planning services, including emergency contraception (EC), which help to prevent unwanted pregnancies and sexually transmissible infections (STIs); and
- denying access to safe and confidential abortion services.
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The Center for Reproductive Rights urges policy makers to make the health and safety of adolescents a priority instead of passing punitive legislation that will inevitably harm young women.
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Dangerous Abstinence-Unless-Married Programs
The strategy to deny adolescents their right to reproductive choice is demonstrated by the continued increases in funding for abstinence-until-marriage programs. These programs prohibit any discussion of contraceptives—apart from statistics on failure rates—in favor of ideological messages claiming that sexual activity outside of marriage will lead to psychological and physical harms.
There is no proof available that abstinence-only education programs have decreased sexual activity, unwanted pregnancies or the spread of STIs among American teens, according to the preliminary findings of a study funded by the U.S. Department of Health and Human Services (DHHS). The study concluded that "no definitive research has linked the abstinence education legislation with downward trends in [teen pregnancy rates]." Despite this, the Bush Administration has significantly increased funding for abstinence-only programs in recent years. In fiscal year (FY) 2002, over $100 million was allocated for abstinence-only programs -- twice as much as was allocated in the previous year. In FY 2003, $117 was allocated to these programs, and Bush’s FY 2004 budget request would increase federal funding for abstinence-only education to $135 million, an $18 million increase from FY 2003. For FY 2003, abstinence-only funding has reached an all-time high of $168 million. Meanwhile, there is no federal program dedicated to supporting comprehensive sexuality education that includes information on contraception and prevention of STIs, as well as abstinence.
The Bush Administration and other anti-choice activists have also extended their attacks to adolescent’s ability to access comprehensive reproductive health services beyond U.S. borders. The $15 billion HIV/AIDS assistance bill, recently signed into law by President Bush, requires that at least one-third of the yearly disbursement of the funds for prevention programs—roughly $200 million a year—be set aside for abstinence-only education programs. This restriction ignores pressing global realities that point to the importance of comprehensive sexuality education for young people in regions devastated by the rise of sexually transmissible infections such as HIV/AIDS. Furthermore, in countries targeted by the U.S. program, abstinence is not possible for many women and girls due to the lack of access to education and economic opportunities. These funding restrictions will force organizations on the frontlines of HIV/AIDS prevention and family planning to decide between accepting desperately needed funds or continuing with programs that directly confront the realities of HIV/AIDS transmission.
Continued Attacks on Access to Contraception
The anti-choice strategy of denying access to reproductive health services has intensified due to efforts to require mandatory parental involvement for contraceptives. On June 12, 2003, federal lawmakers introduced the "Parent’s Right to Know Act," which would require parental involvement in a minor’s decision to obtain contraceptives from federally funded health clinics. The Act would require health clinics that receive funds through Title X—the landmark act that provides federal funds for family planning services—to notify or obtain the consent of a parent at least five days prior to dispensing contraceptives to a minor.
For many adolescents, especially low-income teens, Title X clinics are the only real option for obtaining prescription contraceptives. If enacted, this legislation will have a chilling effect on the number of sexually active adolescents who use contraception. A study published in August 2002 in the Journal of the American Medical Association found that nearly 60% of sexually active girls under the age of 18 would stop seeking reproductive health services if their parents knew they were trying to obtain contraceptives. The study concluded that mandatory parental notification would, "impede girls’ use of prescribed contraceptive services, with the majority of the girls continuing to have sexual intercourse despite restricted access to prescribed services." The Parents’ Right to Know Act threatens to increase unwanted pregnancy rates and decrease contraceptive use and teens’ access to reproductive health services.
For more information on the Title X program and the importance of maintaining confidentiality for teens, see:
Anti-choice lawmakers have also introduced the "Schoolchildren’s Health Protection Act" which would eliminate all federal funding from any school district that distributes emergency contraception (EC) through school-based health clinics. Emergency contraception is a form of contraception that can prevent pregnancy after unprotected sexual intercourse. Emergency contraception must be taken within five days of intercourse and, in most states, must be prescribed by a physician. Lack of timely access is therefore a significant obstacle for many adolescents who seek to obtain emergency contraception. If passed, this bill will inhibit teens who have had unprotected sex or experienced contraceptive failure from obtaining the services necessary to avoid unintended pregnancy. Each year, nearly one million U.S. teens become pregnant and half of these pregnancies end in abortion. Withholding access to EC for teens seeking to avoid pregnancy is misguided and ignores the research demonstrating EC’s efficacy in preventing pregnancy and abortion. According to the Alan Guttmacher Institute, as many as 51,000 abortions were averted by use of emergency contraceptive pills in 2000. Preventing teens’ access to EC in schools will likely increase the number of unintended pregnancies and abortions. For more information see our section on emergency contraception.
In addition, the Bush Administration’s modifications to the Privacy Rule erode the medical privacy of minors. The privacy rule is the federal regulation governing the disclosure of individually identifiable health information. The recent modifications fail to guarantee minors’ confidentiality by giving broad discretion to health care providers to disclose medical information to a minor’s parent, so long as disclosure does not violate state law. Minors currently have the right to obtain a variety of reproductive health care services confidentially, such as testing and treatment for STIs, pregnancy testing, prenatal care and contraceptives and these regulations threaten that right in some states. For more information see the Center’s comments to the proposed rules submitted to the Department of Health on April 25, 2002. (in Correspondence to the Hill)
Access to Abortion Services Inhibited
When adolescents are denied both comprehensive sex education and confidential contraceptive services, the end result is an increased demand for abortion services. However, minors’ access to these services is being restricted throughout the country. To date, forty-four states have adopted forced parental involvement laws that require minors to notify or obtain the consent of one or both parents, or obtain a judicial bypass, before having an abortion. (Thanks to the work of organizations like the Center for Reproductive Rights, only thirty-five states currently enforce these measures). These laws pose dangerous and unnecessary restrictions on access to abortion. While studies show that many young women discuss their pregnancies and choices to have abortions with at least one of their parents—and the younger they are, the more likely they are to involve their parents—those who decide to avoid parental involvement are usually well justified. Fear of abuse, pressure to have an unwanted child, or threats of being thrown out of the house are some of the reasons that keep minors from involving their parents. For battered teens and incest survivors, the risks associated with parental involvement are especially high.
The battle over forced parental involvement laws has historically occurred in the states, but federal legislation dubbed the "Child Custody Protection Act" (CCPA) as well as the "Parental Notification and Intervention Act" could alter this political and legal landscape. CCPA would prohibit anyone other than a parent from helping a minor cross state lines to obtain an abortion if the minor has not first complied with her state’s forced parental involvement laws. CCPA would magnify the dangers of parental involvement laws for young women by making it more likely that they would travel out of state alone to obtain an abortion. In addition, CCPA would create confusion for young women, adults seeking to help them, and health-care providers, who would be forced to decipher the laws of multiple states as well as federal requirements. Please see our comprehensive section on CCPA and how it will affect teens and abortion providers around the country if enacted.
Another threat comes from the "Parental Notification and Intervention Act," which would require minors to notify their parents or guardians of the decision to undergo an abortion at least 96 hours prior to obtaining the procedure. The act flouts Supreme Court precedent by failing to allow for a constitutionally-required judicial bypass option and by requiring two physicians to approve a waiver of the law if a young woman’s medical condition requires her to undergo an abortion. The bill would also enable parents to block minors from obtaining abortions in federal district court.
The "Child Interstate Abortion Notification Act" (CIANA) is the most recent attack on the reproductive rights of young women. Introduced in the House in February 2005, CIANA in addition to requiring parental notification, mandates a 24 hour delay for minors to receive an abortion even with a custodial parent present. On April 27, CIANA passed in the House, 270-157.
If not defeated, these persistent attacks on the reproductive rights of minors will likely lead to an increase in the numbers of young women facing unintended pregnancy and abortion. With the emphasis on abstinence-until-marriage sex education programs and an increase in punitive proposals such as the "Parent’s Right to Know Act," young women will face increased health risks and reduced options. If bills such as the "Child Custody Protection Act" become law, young women with unintended pregnancies will be forced to seek an abortion alone, to self-abort, to carry an unwanted pregnancy to term, or face the sometimes dangerous consequences that result from delays in reproductive health services.
1. In fall 1998, the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, awarded a competitive contract to Mathematica Policy Research to conduct an independent evaluation of Section 510 abstinence education programs. The final study evaluation report will be completed in summer 2005. See http://www.mathematica-mpr.com/3rdLevel/abstinence.htm#Schedule.
2. Reddy DM, Fleming R, Swain C. Effect of mandatory parental notification on adolescent girls' use of sexual health care services. JAMA (United States), Aug 14 2002, 288(6) p 710-4.
3. Rachel K. Jones, Jacqueline E. Darroch and Stanley K. Henshaw. Perspectives on Sexual and Reproductive Health, Volume 34, Number 6, November/December 2002. Contraceptive Use Among U.S. Women Having Abortions in 2000-2001. See http://www.agi-usa.org/pubs/journals/3429402.html.
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