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Can a Minor Consent to Birth Control Without Her Parent’s Consent? It Depends.

January 26, 2022

By Deborah I. Schroeder, Attorney at Law, Staff Counsel, Schroeder &Trahan

Can a Minor Consent to Birth Control Without Her Parent’s Consent? It Depends.
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This issue arose recently based on an insured’s inquiry after a sexually-active 13-year-old appeared in his office seeking birth control pills. The age of the patient was such that the practice manager sought advice from LAMMICO. The first inquiries to be made by any mandatory reporter should be directed to the patient to determine whether the child is engaged in sex with someone over the legal age limit (for a 13-year–old, anyone over 15), whether she is being trafficked, abused or subjected to incest or rape, such that the healthcare provider is required to report child abuse to the authorities.  

In this case the child was sexually active with another child of her own age, was appropriate in her responses and accompanied by her aunt. There was no concern for a mandatory report of minor abuse.  Louisiana law provides for specific scenarios in which a minor (a person under 18 years of age) is able to seek medical care without parental consent. Those situations are:

  1. Where the child is emancipated, married or divorced;
  2. To receive surgical care or health services for any illness or disease the minor believes he or she is suffering;
  3. To receive pregnancy-related care, including care related to labor and delivery;
  4. To receive treatment for sexually transmitted illnesses;
  5. To receive PrEP for HIV prevention
  6. To receive services for treatment and diagnosis of drug or alcohol abuse problems, including preventative counseling or treatment

Contraceptives do not fall into the above permissive areas; however, this does not end the inquiry. A minor can consent to healthcare services without parental or guardian consent pursuant to federal law, if the contraceptive services are provided at a Title X facility, the services are funded by Medicaid or the services are provided at a site funded by Title X.  

Many Louisiana children are enrolled in and receive healthcare through Medicaid, as was the case with this patient. Under Title X the child could be provided contraceptives, family planning services, testing for sexually transmitted diseases and a host of other services. The federal law also provides confidentiality for this type of federally funded care. In this case, the doctor could provide this child with the care she requested without parental/guardian consent.

The Title X family planning program was enacted to allow free or low cost access to reproductive services to eligible individuals, including adolescents. The federal law provides for greater access to confidential family planning than the laws of many states. The program was enacted to achieve, among other goals, a decrease in the number of teenage pregnancies and sexually transmitted diseases. The care is confidential, thus parental involvement is encouraged, but not mandatory. The patient must consent in order for the doctor to include his or her parent, but the patient can choose not to do so. It is acceptable to encourage the child to agree to include a parent in this decision. Leading medical organizations, including ACOG, AAP, AAFP, the Society for Adolescent Medicine, the American Public Health Association and the AMA support providing such reproductive care to teens, without imposing parental notification or consent requirements, believing that access is in the best interest of the adolescent by avoiding teenage pregnancy.

If you are faced with an issue of concern as a healthcare provider, please feel free to contact the LAMMICO Risk Management and Patient Safety Department or the Legal Department at 800.452.2120 for assistance.

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