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Teens in Maryland can get birth control without parental permission. Some lawmakers want to change that

Posted January 17, 2020 7:57 a.m. EST

— Maryland is one of 23 states, along with Washington, DC, where minors can get birth control without their parents' knowledge or approval.

A new bill introduced last week by a group of lawmakers in the Maryland House of Delegates could change that for some types of contraception.

Currently, Maryland law states that minors have the "same capacity as an adult" to consent to treatment about venereal disease, pregnancy and contraception, other than sterilization. That means that minors in Maryland can get birth control without their parents' knowledge or approval.

The proposed bill would require minors to have written parental permission before getting certain contraceptive services, including intrauterine devices (IUDs) and implantable rods. Minors could still get other forms of birth control, like pills and patches, without parental permission.

Republican Delegate Neil Parrott told CNN that he proposed the legislation after a mother in Baltimore found out that her daughter had gotten a birth control implant at school that had been improperly inserted.

After the 16-year-old complained of headaches and a pain in her arm, her mother sent her to a pediatrician, according to CNN affiliate WMAR. The doctor told her that her daughter had a Nexplanon implant, a tiny rod meant to be inserted into the upper arm. The rod had been inserted into the back of the arm instead and needed to be removed, the station reported in September.

"Minor surgery should not be performed by public school health care professionals when parents or legal guardians don't even know about the procedure," Parrott wrote in an email to CNN.

The bill is meant to be narrowly tailored, he said, and wouldn't restrict access to other forms of birth control.

If passed and signed into law, the proposed bill would take effect on October 1, 2020.

Republican Delegate Lauren Arikan, a co-sponsor of the bill, said the bill was necessary to "protect minors from unnecessary invasive forms of birth control that carry a higher risk of being improperly placed or implanted."

"Parental rights is vital to be maintained in a world where minors are increasingly targeted by predatory marketing," she wrote in an email to CNN. "Children are not equipped developmentally to make these types of decisions."

IUDs and implants are safe, experts say

Critics say requiring parents to sign off before minors get birth control, even if just for certain types, is misguided.

"This whole discussion around the rights of a teenager to determine her reproductive health are again at issue, which is frustrating and yet redundant," Cora Breuner, a professor of adolescent medicine at Seattle Children's Hospital and past chairwoman of the Committee on Adolescence at the American Academy of Pediatrics, told CNN.

While there are risks and side effects associated for any type of medication, experts generally agree that long-acting reversible contraception, like the implantable rod and the IUD, are very safe.

Incidences of an implantable rod or an IUD being improperly placed like the Baltimore case that inspired the Maryland bill are less than 1%, according to Breuner.

Those types of contraception are also the most effective way of preventing unintended pregnancy, Breuner said.

Other methods like birth control pills leave room for human error, like forgetting to take a pill one day or run out of a prescription and have to miss a day. According to the Merck, the drug's manufacturer, Nexplanon lasts for up to three years before it needs to be replaced.

Requiring parental consent can delay the time between when a young person wants to be on birth control and when they are able to obtain it, Breuner said.

Ideally, adolescents would have an open conversation with their parent about being sexually active and wanting to go on birth control, Breuner said. But some young people may not be comfortable doing that, depending on their relationship with their parents. And if teens are required to have parental consent for some types of birth control, she said, they might just forgo contraception altogether.

"When women aren't able to access effective means of birth control, pregnancies occur," Breuner said. "When that happens, decisions that are tough have to be made."

Planned Parenthood says on its website that it encourages adolescents to communicate with their parents when seeking contraceptive services, though it doesn't require them to.

Many states allow minors to consent

Young people's right to access birth control is protected by the US Supreme Court, according to the Guttmacher Institute, a research and advocacy organization that focuses on reproductive rights.

In 1977, the Supreme Court ruled in favor of minors having access to contraception, striking down a New York law that had prohibited the sale of contraceptives to minors. State laws now supplement that right as 23 states and Washington, DC, explicitly allow all minors to consent to contraceptive services, according to data from the institute.

"Young people can make decisions about contraception and health care," Elizabeth Nash, senior state issues manager at the Guttmacher Institute, wrote in an email to CNN. "What they need, just like adults, is medically accurate information, counseling and affordable services."

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