In the United States, the teen birth rate has been declining for the past several years, thanks in part to better access to birth control and other forms of contraception. But for those teenage girls who do become pregnant, a number of state laws prevent minors from obtaining an abortion without parental consent. These same horrible state laws are also forcing teens to give birth without epidurals — and other critical care.
The state of women's health care in America is startling, at best: The United States has the highest maternal death rate in the developed world. Since the inauguration of President Donald Trump, the GOP has tried — largely in vain — to dismantle the Affordable Care Act, putting essential health benefits for women in jeopardy at every iteration of their repeal effort. According to the Centers for Disease Control and Prevention, the U.S. teen birth rate has reached historic lows, and yet the quality of health care for some pregnant teenage girls at their most critical stage — labor and delivery — is utterly failing them.
In the state of Ohio, the majority of minors require parental or guardian consent for most medical procedures. For pregnant teens, this creates a huge gap in care when it comes to giving birth, as teens need parental consent to obtain an epidural. When faced with the possibility of having to give birth naturally, these laboring girls are hit with another bombshell: They cannot consent to a C-section without a parent or guardian.
The Office of Adolescent Health at the U.S. Department of Health and Human Services notes that in 2014 (the year for which most recent data is available), the U.S. teen birth rate was 24.2 births per 1,000 adolescent females. Ohio, by comparison, had a higher teen birth rate than the national average, at 25.1 births per 1,000 adolescent females. And yet, despite the fact that Ohio has more teen pregnancies than the national average, the gap in care for these girls is significant.
Maureen Sweeney, a registered nurse in Ohio, told WOSU of her time on her labor and delivery rotation during nursing school. She recounted the story of a 15-year-old runaway who came into the emergency department in labor. Due to Ohio law, the young laboring patient couldn't receive an epidural because she didn't have — and couldn't obtain — parental consent.
When Sweeney went to intervene by calling Child Services, who can provide consent in the absence of a parent or guardian, they were unable to send an agent until the start of normal business hours. Sweeney's patient, however, was laboring at 3 a.m., and her baby wasn't about to wait for the business day to start. "I had to go in, sit down with her and talk about the fact that she wasn't going to be able to get an epidural, and she was going to have to do this naturally," Sweeney told WOSU. She described that her patient "broke down."
Worse still, WOSU reported that even when pregnant teens do have a parent involved or present during labor, they may actually withhold epidural as a form of "punishment" for getting pregnant. Dr. Michael Cackovic from The Ohio State University Wexner Medical Center told WOSU the most he can do in that instance is try and coax the parent into providing consent for their laboring teen. "To take the mom aside and say, you know, this isn't some life lesson here," Cackovic said. "This is basically pain and there's no reason for somebody to go through that."
To combat this unnecessarily cruel gap in health care for pregnant teens, two Ohio state representatives introduced HB 302 in July. In a statement on the Ohio State Legislature website, State Rep. Kristin Boggs said:
I believe that all expectant mothers should have access to healthcare and safe delivery options, regardless of their age. I hope this legislation will encourage expectant mothers to get the care they need to support their health, and their baby’s health, even if their legal guardians are unwilling to support their pregnancy.
The bill will be considered by committee, where hopefully, it can proceed to the Ohio State Legislature for a full vote to make sure that all Ohioans get safe, compassionate health care.
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