She came into the Emergency Room alone, wild eyed with fear. When the painful contractions came she would moan and cry, asking for pain medication. This went on for hours and all we could offer her were words of encouragement, but the pain and terror far surpassed whatever comfort our words attempted.
We had failed to help her in her time of need, not because we were unwilling or without the proper supplies, but because at 15 years old she was prohibited from consenting to her own medical care by the state of Rhode Island. Our state is one of only 13 states that does not allow minors to consent for pregnancy-related care. This is unacceptable. This must change.
Every year, pregnant women under the age of 18 in Rhode Island must defer decisions about their prenatal care to a parent or guardian. Regardless of maturity, education, or preparedness, pregnant adolescents are denied the right to make decisions about what is best for their health and the health of their pregnancy. Yet, immediately following delivery, these same young women are entrusted and expected to consent to health care for their newborn. These messages are inconsistent, unfair, and unjust.
Requiring parents or guardians to approve care overlooks that many pregnant teens will present for prenatal care alone, whether it is because their parent or guardian cannot get time off from work, or they do not support the patient’s pregnancy, leaving them without necessary medical care. This could range from failing to receive vital vaccinations to genetic screening or induction of labor, but every denial of care creates unnecessary risk to the patient, her pregnancy, and child.
It’s also not uncommon for a pregnant adolescent to arrive at the hospital in labor and alone. These young women are seeking help. They are often scared and in pain. As labor progresses, they may desire an epidural to manage their pain, but cannot receive it without a parent or guardian present to consent. For some women, this may mean waiting for hours until an appropriate guardian arrives, and for others it may never happen at all. Even still, parents and guardians’ decisions may not always align with the patient’s, and they may refuse an epidural or other care despite the patient’s preference. Requiring these young women to endure the pain of labor, when medication is readily available to anyone else, is inhumane.
Currently, the General Assembly is considering legislation giving these young women the ability to control their prenatal and delivery care. We are grateful to Warwick Representatives Joe McNamara and Camille Vella-Wilkinson and Providence Senator Gayle Goldin and Cranston Senator Josh Miller for leading the charge on this important legislation. They understand pregnant adolescents, who are seeking care may be under-resourced, isolated, and marginalized. And they believe these young women should not have to also worry about being denied necessary medical care. These patients want to access proper care. They want to have healthy pregnancies. And we must do everything in our power to support them.
Recently, over 200 medical professionals at Women and Infants’ Hospital signed a petition in support of H7193 sponsored by Representatives McNamara and Vella-Wilkinson and S2531 sponsored by Senators Goldin and Miller. These are the doctors, midwives, and nurses who routinely care for pregnant adolescents and who experience the heartbreak of denying young women care because of their age. These professionals must be allowed to provide the same medical care that’s readily available to everyone else.
We must work together to empower and support these patients as they navigate making informed decisions. We urge the General Assembly to immediately join Representatives McNamara and Vella-Wilkinson and Senators Goldin and Miller to pass this vital piece of legislation allowing pregnant teens consent for their health care.
Emily White, MD, is Chair of Rhode Island Section of the American College of Obstetricians and Gynecologists (ACOG) and Beth Cronin, MD, is Vice Chair of Rhode Island Section of ACOG. Both Drs. White and Cronin are Assistant Clinical Professors at Brown University, and practicing OB/GYNS at The Providence Community Health Centers and Women & Infants Hospital.