Dr. Connie Mitchell is a nationally recognized expert on the health care of victims of violence and abuse. She serves on the AMA National Advisory Council on Violence and Abuse and is a member of the Board of Directors of Physicians for Reproductive Choice and Health [7].
If Prop 85 passes, teens in California will be forced to wait until their parents are notified before having an abortion. The more I think about the impact this initiative could have on young women in my state, the more I've found myself contemplating what passing this law would mean in real life. Just how long will a pregnant young woman have to wait before she can have an abortion?
Let's imagine a typical patient-we'll call her Jane. She comes to see her doctor on a Monday to discuss an unintended pregnancy. Jane and her physician discuss her pregnancy in terms of her overall health and Jane decides to have an abortion. Before 5 pm that day, her physician sends a first class certified letter to Jane's parents informing them of her decision. Jane goes home to wait. Under Prop 85, the physician can assume the letter was delivered two days after it was mailed. So, in Jane's case, as of Wednesday, 5:00 pm, she can assume the letter as been delivered and now she begins the second waiting period. This is the 48 hour "reflection period" that would be mandated by this law. By the end of the week, Friday, 5:00 pm, Jane can have her termination procedure done.
Jane represents the best case scenario under Prop 85. Now, imagine what might happen in the worst case scenario.
Let's say that Rachel visits her physician on a Friday afternoon and decides to have an abortion. She is frightened of her parents' reaction to her pregnancy and wants to seek a judicial bypass. It's too late to go that day, so she makes her way to court on Monday. Rachel's hearing takes place on Wednesday, and the following day the judge denies her petition. She decides to appeal the decision. The appeal hearing takes place three court days later, and on Tuesday, Rachel learns her appeal was denied-she must notify her parents of her decision to have an abortion. Her doctor sends out a letter on Wednesday, and the cycle of waiting begins for another young woman. By the time Rachel's parents are notified and she waits through the mandatory delay, as many as 18 days could have passed since she first decided to have an abortion.
These scenarios aren't just idle speculation-it is important to consider how abstract laws about "48 hour reflection periods" are going to be implemented in the real world of courts and judges and bureaucracy. Any doctor can tell you that teens usually seek medical treatment when they are further along in pregnancy than pregnant older women, because they tend to be less aware of their bodies, take longer to realize that they are pregnant or must work through their shame and fear of stigma. We already know that parental notification laws cause teens to further delay [8] seeking healthcare at a moment when timing is critical. For teens who can't speak to their parents, parental notification and judicial bypass impose yet another delay of almost 3 weeks!
The American Medical Association (AMA) and the American Academy of Pediatrics (AAP) oppose mandatory parental notification in part because these delays impede timely access to healthcare and increase the health risks to our teens. (Check out the AMA report on parental notification [9] and AAP's policy [10]) Forcing women to wait for healthcare is bad medicine and bad public policy.
As I contemplate the delays Prop 85 might impose on young women in California, I have to ask: how much risk are parents willing to take in order to satisfy their "need to know"? At the end of the day, isn't the safety of our teens the most important issue for parents?