Primary Submission Category: Reproductive health
A systematic review of barriers to abortion among minor adolescents in the U.S.
Authors: Naomi Thyden Renee M. Odom Joanna Paul Rosie Hanneke Eleanor Esbrook Laura Lindberg Julie Maslowsky
Presenting Author: Naomi Thyden*
One in four pregnancies among minors (under age 18) end in abortion in the U.S., the highest proportion of any age group. Although minors face unique barriers to abortion care such as less autonomy and fewer resources, they are often aggregated with all pregnancy capable people or left out of research altogether. A better understanding of influences on adolescent barriers to abortion care is needed to develop policy and practices to support young people’s reproductive autonomy. We conducted a systematic review to compile adolescent-focused research about barriers to accessing abortion care. We searched PubMed, Embase, CINAHL, PsycINFO, Sociological Abstracts, PAIS Index, Web of Science, and NexisUni and screened search results in Covidence. Inclusion criteria were: qualitative and quantitative studies in the U.S. from 2007 to 2022 that examined barriers to abortion among minors (under 18). A total of 67 empirical papers met inclusion criteria. Thirty nine percent of these papers included all U.S. states, and the remainder were restricted to certain states, with Texas most represented. The most frequently reported barriers were legal (57%), logistical (24%), financial (18%), cultural (18%), parental pressure (16%), incorrect information (13%) and pressure from a partner (12%). Specific policies assessed in these studies include: waiting periods, Medicaid abortion funding restrictions, parental involvement laws, and judicial bypass. Forty seven (70%) of studies reported the racial composition of their participants, including only 4 (6%) that reported having American Indian/Alaska Native participants. Few papers examined potential differences in barriers to abortion care by race/ethnicity. Adolescents in the U.S. experience barriers in obtaining wanted abortions, especially due to legal restrictions. More population-level research that stratifies by age and examines intersectionality with race is needed to inform policies to protect adolescents’ reproductive rights.