White Kari, Narasimhan Subasri, Hartwig Sophie A, Carroll Erin, McBrayer Alexandra, Hubbard Samantha, Rebouché Rachel, Kottke Melissa, Hall Kelli Stidham
Steve Hicks School of Social Work and Department of Sociology, University of Texas at Austin, TX, Austin, USA.
Department of Behavioral, Social, and Health Education Sciences and Center for Reproductive Health Research in the Southeast, Emory University, Atlanta, GA, USA.
Sex Res Social Policy. 2022 Mar;19(1):264-272. doi: 10.1007/s13178-021-00539-0. Epub 2021 Feb 13.
Thirty-seven states require minors seeking abortion to involve a parent, either through notification or consent. Little research has examined how implementation of these laws affect service delivery and quality of care for those who involve a parent.
Between May 2018 and September 2019, in-depth interviews were conducted with 34 staff members involved in scheduling, counseling, and administration at abortion facilities in three Southeastern states. Interviews explored procedures for documenting parental involvement, minors' and parents' reactions to requirements, and challenges with implementation and compliance. Both inductive and deductive codes, informed by the healthcare quality framework, were used in the thematic analysis.
Parental involvement laws adversely affected four quality care domains: efficiency, patient-centeredness, timeliness, and equity. Administrative inefficiencies stemmed from the extensive documentation needed to prove an adult's relationship to a minor, increasing the time and effort needed to comply with state reporting requirements. If parents were not supportive of their minor's decision, participants felt they had a duty to intervene to ensure the minor's decision and needs remained centered. Staff further noted that delays to timely care accumulated as minors navigated parental involvement and other state mandates, pushing some beyond gestational age limits. Lower income families and those with complex familial arrangements had greater difficulty meeting state requirements.
Parental involvement mandates undermine health service delivery and quality for minors seeking abortion services in the Southeast.
Removing parental involvement requirements would protect minors' reproductive autonomy and support the provision of equitable, patient-centered healthcare.
37个州要求寻求堕胎的未成年人告知父母或获得父母同意。很少有研究探讨这些法律的实施如何影响那些需要告知父母的人的服务提供和护理质量。
2018年5月至2019年9月期间，对东南部三个州堕胎机构中参与安排日程、咨询和管理工作的34名工作人员进行了深入访谈。访谈探讨了记录父母参与情况的程序、未成年人和父母对这些要求的反应，以及实施和遵守方面的挑战。主题分析采用了由医疗质量框架提供信息的归纳和演绎编码。
父母参与法律对四个护理质量领域产生了不利影响：效率、以患者为中心、及时性和公平性。行政效率低下源于证明成年人与未成年人关系所需的大量文件，增加了遵守州报告要求所需的时间和精力。如果父母不支持其未成年子女的决定，参与者认为他们有责任进行干预，以确保未成年子女的决定和需求始终处于核心地位。工作人员还指出，由于未成年人要应对父母参与及其他州规定，及时护理出现延误，一些人因此超过了孕周限制。低收入家庭和家庭安排复杂的家庭在满足州要求方面困难更大。
父母参与规定损害了东南部寻求堕胎服务的未成年人的医疗服务提供和质量。
取消父母参与要求将保护未成年人的生殖自主权，并支持提供公平的、以患者为中心的医疗保健。
