Researchers hope new report fuels reproductive health care research involving minors

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EXPERT Q&A

Related story: Abortion policy is changing every day. Minors are the most vulnerable- and the least understood

A new report from Youth Reproductive Equity, a national collaborative of researchers and clinicians, outlines a research agenda to examine the impact of the Dobbs decision on minors.

The lead author of the report, "Adolescence Post-Dobbs: A Policy-Driven Research Agenda for Minor Adolescents and Abortion," is Julie Maslowsky, associate professor at the University of Michigan School of Nursing and an affiliate of the Population Studies Center at the Institute for Social Research. She discusses details of the report.

[Link]Julie Maslowsky

To the best of your knowledge, what has happened to adolescents' access to abortion and reproductive health care after the Supreme Court's Dobbs decision overturned Roe v. Wade and the constitutional right to an abortion two years ago?

Prior to Dobbs, minors already faced many more legal and logistical barriers to abortion access than adults. Now, those barriers have increased. More than half of U.S. adolescents now live in a state with severely restricted or no abortion access. We don't yet know the full impact of these restrictions on young people seeking abortion or on adolescents who are coming of age at this chaotic time. However, we know that even very young rape victims are unable to access abortion in restrictive states and that there has been a spike in the number of young people seeking permanent sterilization, with higher rates of sterilization in states with abortion bans. The impacts are already dire.

Why are minors underrepresented in abortion and reproductive health research studies and will this report address that?

The field of abortion research does not have a strong tradition of including minors in their studies. We identify six enduring and overarching challenges relating to infrastructure, oversight, and workforce composition and capacity that systematically hamper the field's ability to produce actionable research evidence related to minors and abortion. We propose recommendations to address these challenges: researcher training; diversify the research workforce; encourage interdisciplinary expertise; eliminate roadblocks to approving research proposals involving minors; prioritize funding; and disseminate and translate research.

What impact does excluding minors have on policy and reproductive health?

Minors are disproportionately impacted by new abortion restrictions and are often targeted by restrictive state abortion policies or overlooked in protective policies. Minor abortion access is regulated by all the laws that impact adults as well as many minor-specific laws, which we review in our report. Even when minors can overcome legal obstacles, they face greater barriers related to cost, information and access than adults. Minor adolescents are in a vulnerable position legally. In political negotiations, minors' rights are often restricted as a compromise in order to secure votes for abortion policies that apply to adults. Restricting the rights of minors sets a dangerous precedent for other marginalized groups.

What are the areas of adolescent reproductive health care policy and research that are most neglected or misunderstood by science?

Minors are systematically underrepresented in all areas of abortion research. We need to include them in all types of abortion-related studies.

Regarding minors and abortion and reproductive health care policies, are there areas that are more neglected or misunderstood by the public than others?

One common misunderstanding is that policies that require parents to be involved in a minor's decision to have an abortion are protective. In fact, research shows that these policies cause harm to those youth for whom involving their parents is not possible or not safe. Several studies document evidence of delays in care-seeking after introduction of a parental involvement requirement, in particular for those traveling from out of state for care.

Delays are even more pronounced among those who cannot involve a parent and instead seek judicial bypass. For example, studies of minors seeking judicial bypass in Massachusetts and Illinois highlight that they obtain abortion care 5-6 days later than those who satisfy parental consent or notification requirements, sometimes pushing them past the 10-week limit for medication abortion and limiting their options for care. Judicial bypass has also been shown to cause emotional harm and trauma to young people seeking abortion and to not consistently function as a true alternative to parental involvement in some settings where requests for bypass are denied.

What are a few of the most compelling facts that researchers do know about minors and abortion that the public should know?

Abortion restrictions do not only impact minors who become pregnant or those who seek abortion care. Restricted access to reproductive health care is impacting all U.S. minors. The experience of adolescence itself has fundamentally changed: adolescents are thinking differently about many aspects of their lives: their relationships, where to live or go to college, how to vote, and what their future may look like. For example, recently, several studies have shown nationwide increases in the number of young people who are choosing to undergo permanent sterilization. These increases are larger in states with abortion bans.

Who will use this report and why would they want to use it?

The report's target audiences are researchers, funders of research and individuals and
organizations who help translate research evidence into policy. The recommendations of the report will help to shape research and funding portfolios and guide research questions to be more applicable to policy. The report is a comprehensive treatment of the issue, from why minors matter in the abortion debate and how they're driving it, to what state policies currently impact minors' abortion access (either by protecting or restricting it), to a specific research agenda focused on policy-driving data, to recommendations for building the field's (and the nation's) capacity to generate evidence-based policies for minors.

Co-authors include Laura Lindberg of Rutgers University and Emily Mann of the University of South Carolina.

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