The gynecologist Dr. Hillary Boswell of Houston says she has seen the impact of abortion bans on teenage girls: more and more of them are carrying their pregnancies to term.
“These are vulnerable girls, and it’s just heartbreaking to see how many pregnant 13-year-olds I’ve had to care for,” Boswell said, referring to the change since Texas banned abortions after six weeks in September 2021. In June 2022, after the US Supreme Court ruled on Roe v. Wade repealed, Texas enacted a complete ban on abortion.
“They would come in and be very distressed,” said Boswell, who spent the last decade treating underserved women and girls in community health clinics. She said it was “so hard not to be able to help them get an abortion if they wanted one – and it goes against everything I’ve trained for.”
In the year after Texas began implementing its six-week abortion ban, teenage fertility rates in the state rose rose for the first time in 15 years, according to a study published earlier this year by the University of Houston.
Overall, the augment in teenage fertility in Texas was diminutive: just 0.39%. But the University of Houston researchers said the change is significant because it reverses a 15-year trend and because the national teen fertility rate has fallen over the same period. They also found that the gains were greater for Hispanic teens (1.2%) and black teens (0.5%), while the rate for white teens fell by 0.5%.
So far, the Texas data is the first evidence that abortion bans could lead to an augment in teen births. But as abortion restrictions have expanded after Roe — 13 states now have outright bans — some providers and other experts predict there will be an augment in other states. If so, then that of the nation almost 30-year trend Decline in teen births may be at risk.
Boswell and other providers point out that teenagers are having a harder time accessing contraceptives and abortions — and they worry that the fresh Trump administration could make things even more challenging for teenagers whose pregnancies are riskier disproportionate sought abortions before the Supreme Court overturned Roe.
“In many ways, Texas is kind of a microcosm of what we’re going to see in other parts of the country,” Dr. Bianca Allison, a pediatrician and assistant professor at the University of North Carolina School of Medicine. “Historically, there has always been a feeling that young people – minors but with reproductive potential – are excluded from the discussion about reproductive autonomy and rights.”
Access to pills
People seeking abortions are relying on the wider availability of telemedicine for medication abortions, which now account for nearly two-thirds of all abortions. The number of abortions in the U.S. has increased since Roe’s fall, largely because more people are using the more accessible method, they said Family Planning Society.
But the Trump administration could make the pills harder to obtain by reversing a current U.S. Food and Drug Administration policy that allows them to be sent by mail. Some anti-abortion groups want the Trump administration to enforce the Comstock Act, a long-dormant 1873 law that they believe could be used to make sending or receiving abortion drugs a federal crime.
States could also require personal doctor visits for abortion medications, effectively preventing patients from accessing them via telemedicine.
And Louisiana last month began classifying mifepristone and misoprostol – the two drugs used in non-surgical abortions – as controlled substances, making possession of these drugs without a prescription a crime. A Texas state legislator has proposed similar laws in his state.
“I would absolutely predict that we will see a reversal of our progress in reducing teen pregnancy,” said developmental psychologist Julie Maslowsky, an associate professor at the University of Michigan who studies adolescent reproductive and sexual health.
“If someone doesn’t want to be pregnant, they should have every option to prevent pregnancy,” Maslowsky said. “And the majority of teenagers don’t want to get pregnant.”
Teenage girls tend to have less money, less access to transportation, and less independence than adult women. That makes it more challenging for them to cross state lines for abortion care or to obtain and pay for abortion medications. A medication abortion can cost up to $800, according to Planned Parenthood.
“Many teens have difficulty ordering abortion drugs online because they don’t have credit or debit cards or a safe place to send the pills,” said Rosann Mariappuram, senior advisor for reproductive rights at State Innovation Exchange, a nonprofit organization , which advocates for progressive policies. There have been abortion funds to support people who cannot afford the treatment battle to keep up with demand.
Thirty-six states Before a minor can have an abortion, parental consent or notification is required, which poses another obstacle. And teenagers are more likely to have irregular menstrual cycles, making them less likely to notice missed periods. Total approx a quarter of women Maybe they don’t realize they’re pregnant at six weeks Duration of pregnancy for abortions in Florida, Georgia, Iowa and South Carolina.
It’s just heartbreaking to see how many pregnant 13 year olds I’ve had to care for over the last three to four years.
– Dr. Hillary Boswell, Houston gynecologist
Additionally, a Texas law that went into effect in April requires family planning clinics to obtain parental consent for minors seeking contraception. Lawmakers in Oklahoma and Indiana have argued that IUDs and emergency contraceptives are types of abortions and therefore should not be covered by insurance or unavailable, Mariappuram said.
“This confusion between contraceptives and abortion care is just evidence that they come here for contraception,” she said.
Health risks, worse prospects
Teenage girls from disadvantaged backgrounds are at higher risk of becoming pregnant. They existed persistent racial disparities in the national teen birth rate, with rates at least twice as high for black, Hispanic and Native American girls. And while the average age of a girl’s first menstrual period is sinking for all girlsThe trend is particularly pronounced among ethnic minorities.
“Those downstream impacts [of abortion restrictions] are not the same for everyone,” said Mayra Pineda-Torres, an assistant professor of economics at Georgia Tech who specializes in gender and inequality. “The reality is that there is still a racial component here that could exacerbate racial inequities or lack of access to abortion services.”
Teenage motherhood often affects a girl’s education and reduces her long-term financial prospects. And pregnancy poses a particular health risk for adolescents: they are more likely to have stern consequences Complicationsincluding blood pressure-related diseases such as: pre-eclampsiaand their babies are more likely to be born underweight. For these reasons the American Academy of Pediatrics says teens should have access to legal abortion care.
But for abortion opponents, teenage pregnancies and births are preferable to teenage abortions. Joe Pojman, founder and executive director of the Texas Alliance for Life, said the state has programs to support families, including teen parents, care for their children.
“[The program] teaches them a variety of things like how to manage a budget, how to apply for a job, and how to basically make the child self-sufficient so they can live,” Pojman told Stateline.
“We don’t want to encourage a child to be responsible for taking the life of their own unborn child,” he said.
Last month, Missouri Attorney General Andrew Bailey filed a lawsuit with other Republican attorneys general in Kansas and Idaho asking a Texas judge to order the FDA to reinstate restrictions on mifepristone. They argued that lower teen birth rates hurt their states by shrinking their populations and costing them federal money and representation in Congress.
However, some studies suggest the opposite. The federal government cites research showing that teenagers are pregnant Cost Taxpayers about $11 billion a year because it leads to higher public spending on health care and foster care, higher incarceration rates for children of teen parents, and lower education and income levels.
“Pregnancy is not benign,” said Allison, the North Carolina pediatrician. “For many people across the country, it’s not a joyful and welcome thing.”
