Decision Making Regarding Teenage Pregnancy and Abortion

Decision Making Regarding Teenage Pregnancy and Abortion:

A Legal and Ethical Issue in Pediatric Nursing

Department of Nursing

Utah Valley University

Cortney Shumway, UVU SN

Decision Making Regarding Teenage Pregnancy and Abortion:

A Legal and Ethical Issue in Pediatric Nursing

The discussion about elective abortion has been a growing controversial topic, significantly in the last few decades. As research and studies focuses on this “hot” topic, more information and understanding of the subject is available.  We have more information now about the topic than we have in previous years, and because of this education as Karen Gajewski (2015) explains:

the overall rate of abortion in the United States is down 12 percent in both liberal and conservative states. Pro-choice advocates say this is largely due to a decline in teenage pregnancy rates, better sex education, and increased access to contraceptives, especially intrauterine devices. (p. 48)

This topic is important to pediatric nursing practice because many teenagers, and their families are not fully aware of the consequences and legal decisions that come with a teenage pregnancy. Nurses have a profound impact on the education and teaching on this subject, so it’s important to stay updated about the issues on the topic, so when encountered, the nurse will know how to handle and assess the situation. The purpose of this paper is to provide detailed information regarding legal and ethical issues associated with decision-making in teenage pregnancy.

Research Strategy

Articles were searched in the PubMed, ScienceDirect, NCBI, Business Source Premier, Points of View Reference Center, and Google Scholar databases under the keywords “abortion” and “teenage pregnancy”, which yielded thousands of results. The search was narrowed down with keywords, “elective”, “confidentiality”, “statistics”, “prevalence”, “law and legislation”, “parental consent” and “minor”. After the narrowed search, the articles were then researched and read thoroughly, and a number of the results were found relevant to the topic discussed in this paper. This method of research was effective in finding the most current and updated information regarding ethical issues associated with abortion and teenage pregnancy.

Background

To get a basis on the subject, an elective or induced abortion is defined as a procedure or medication to intentionally terminate a pregnancy based on personal choice (Women’s Health Care Physicians, 2015). Statistics show “almost 350,000 U.S. teenagers under the age of 18 become pregnant each year, 82% of these are unintended” (Laws restricting teenagers’ access to abortion, 2015). Research from the physicians of Sunderby Hospital found “induced abortions were 22.9 per 1,000 women younger than 20 years” (Mukkavaara, Öhrling & Lindberg, 2011, p. 721). These statistics support the fact that teenage pregnancy and elective inductions are prevalent. Thus far, abortion has been a well-studied subject, but as for teenage pregnancy, there is a lot more legal and ethical issues regarding their decision and consent in proceeding with the abortion. Unmarried, pregnant adolescents face a variety of difficult decisions regarding an unwanted pregnancy. They must choose whether to abort the fetus, or carry it to term, then to keep the child or give it up for adoption. Since the child is not legally an adult, whose choice is it to make the decision? Do the parents have to be notified? Can the teenager, make that decision on their own? Whose ultimate consent is needed? This paper will review and summarize literature that has been discussed and published regarding these questions related to legal and ethical aspects of decision-making in teenage pregnancy, focusing on abortion.

Findings and Results

First of all, what facilitates or influences an adolescent in making the crucial decision of abortion? Let’s take a look. One study in California, focused on the intentions and decisions of pregnant teenagers. The sample of participants included 187 pregnant women between the ages 15-18, who had no previous children, unmarried at conception, and needed to make a decision about the baby. Each participant was interviewed a series of questions regarding the decision and intentions of the pregnancy, individually- without the presence or influence of any family members. “32% of the sample had intended the pregnancy, 25% had not cared and 43% had not intended to become pregnant” (Frost & Oslak, 1999, p. 9). Results of this study concluded that one-in-three women considered an abortion. Their reasons included, they had support for abortion from friends or relatives, they thought it was easy and accessible to get an abortion, they didn’t want to carry a baby to term, and the pregnancy was unwanted. The study also noted “79% of participants thought that if a law were enacted requiring minors to obtain parental consent prior to an abortion, it would present a major obstacle for teenagers seeking abortion” (Frost & Oslak, 1999, p. 18).

In general terms, legally parents have the authority to make medical decision on behalf of their children younger than 18 years based on the fact that children lack maturity and judgment to make decisions on their own. However, there are ethical issues that come into play. Teenagers who avoid seeking out parental advisement may have very good reasons for not doing so. Advocates of mandatory parental involvement argue that such requirements would deter many teenagers from having sex. After McHenry County, Illinois, began requiring parental involvement for minors, research concluded ratio of births to women younger than 19 increased, while decreasing in nearby counties with racially and economically similar populations that did not require parental consent (Jones & Boonstra, 2004). Another study showed:

22% of teens who did not tell a parent about their abortion decision feared that, if they told their parents, they would be kicked out of the house. More than 8% feared that they would be physically abused because their parents had beaten them before. Of those who did not tell a parent, 12% did not live with either parent and 14% had parents who abused drugs or alcohol. (Laws restricting teenagers’ access to abortion, 2015).

 There is no evidence that government coercion requiring parental notification and consent in regard to minor medical decision, increases the rate at which adolescents inform their parents about planned abortions. In some cases, teenagers will not seek the adequate health care needed when conceived and will take matter in their own hands, this can be unsafe and present further complications. Mandating the involvement of parents jeopardized teenagers’ health. There are various reasons that alter the parent’s involvement in medical decisions.