Can a teen be too immature to choose abortion? This court case shows the complexities

A Florida court effectively blocked a pregnant, parentless 16-year-old from getting an abortion, saying she is not mature enough to make that decision despite her own acknowledgment that "she is not ready for the emotional, physical, or financial responsibility of raising a child."

News of the case blazed a trail of shock and anger across social media this week, the latest high-profile example of a pregnant person being denied access to abortion after the fall of Roe v. Wade. But it also points to another complicated, longer-standing issue: the legal and logistical challenges facing adolescents seeking abortions, especially those without parental support.

Nearly every state requires some form of parental involvement in a minor's decision to obtain an abortion, though to different degrees (Florida is one of just six states that require parents to be notified of their child's intent as well as their consent to the procedure itself).

Through what's known as a judicial bypass procedure, minors can seek court approval to get an abortion without the consent of their parents. To succeed, they must prove "by clear and convincing evidence" that they are "sufficiently mature" to make that decision. It's a fairly vague determination that judges have the freedom to make based on factors like the minor's age, emotional development, overall intelligence and ability to accept responsibility.

In this case, a circuit court ruled there was not enough evidence to prove that the teenager was sufficiently mature to make the decision to end her pregnancy, though left the door open to reevaluating at a later hearing. An appeals court upheld that ruling in an opinion issued on Monday.

Nancy Dowd, a professor emeritus of family law at the University of Florida Levin College of Law, says the process of making the decision and obtaining approval to seek an abortion has always been fraught for teenagers, even during the half-century when Roe was in place. Such consent requirements stem from concerns about parental rights, but have proven difficult to balance in practice.

"For teenagers, this has always been a challenging minefield to walk through if they're in the situation where they, for whatever reasons, feel that they cannot tell their parents, or would make a decision differently if they did tell their parents," Dowd explained to NPR in a phone interview.

Dowd says the unnamed teenager's case isn't substantially exacerbated by the reversal of Roe, except for the fact that she now has fewer options in terms of seeking care in other states (and, as NPR has reported, the end of Roe could spell the end of judicial bypass in abortion ban states). But that doesn't mean it's not significant.

"This would appear like, 'Here's another terrible consequence of this new scenario,' and it's really, 'No, this is what the landscape has looked like for most of the past 50 years if you were a teenager."

After trauma and consideration, she sought an abortion

The opinion issued by Florida's First District Court of Appeal on Monday refers to the girl at the center of the case as "Jane Doe 22-B," and describes her as "almost seventeen years old and parentless."

Doe lives with a relative but has an appointed guardian, who she says "is fine with whatever [she] wants to do," according to court documents. She is pursuing a GED and is involved with a program that aims to provide counseling and educational support to young women who have experienced trauma. The court notes that Doe experienced renewed trauma in the form of a friend's death shortly before deciding to seek an abortion.

Doe petitioned the Escambia County Circuit Court for a waiver when she was 10 weeks pregnant, citing several reasons: The father is unable to assist her, she is "not ready to have a baby," doesn't have a job and is still in school.

Judge Jennifer Frydrychowicz denied that petition, though said Doe "may be able, at a later date, to adequately articulate her request, and the Court may re-evaluate its decision at that time."

Doe challenged that decision, but the appeals court upheld it. Dowd says that's not surprising — because there is such a "deferential standard of review," the higher court would have had to see some sort of "abuse of discretion" by the lower court in order to reach a different conclusion.

The three-judge appellate panel wasn't in complete agreement, however. In a partial dissent, Judge Scott Makar agreed with the overall conclusion but argued they should have ordered the case back to the lower court. Even without that, Dowd says Doe could still return to the lower court to make her case again.

"The hope would be that somehow there's enough communication with this teenager that she understands she can come back to the court and [be] heard again and that this isn't a closed case," she says. "Her other alternative, frankly, is to go out of state, to go to another jurisdiction where she could make this decision and be entitled to terminate her pregnancy."

The judge seems open to hearing her case again

Citing the lower court's hearing transcript and written order, Makar wrote that the first judge "apparently sees this matter as a very close call."

He took care to note that the judge displayed concern for Doe's situation during the hearing, asking questions "in a compassionate manner" and moving quickly to prepare her "thoughtful" written order so she could hand Doe a copy immediately after the hearing.

The transcript shows Doe was knowledgeable about the relevant considerations, having considered the pros and cons, done research online and read a pamphlet from a medical clinic about her medical options and their consequences, Makar added. The judge described Doe as credible and forthcoming with her answers, and acknowledged her "valid concerns about her ability to raise a child."

"Indeed, the minor 'showed, at times, that she is stable and mature enough to make this decision,'" Makar added, quoting the lower court.

So why didn't it grant her request?

"Reading between the lines, it appears that the trial court wanted to give the minor, who was under extra stress due to a friend's death, additional time to express a keener understanding of the consequences of terminating a pregnancy," Makar wrote. "This makes some sense given that the minor, at least at one point, says she was open to having a child, but later changed her view after considering her inability to care for a child in her current station in life."

Dowd says that while the circuit court's ruling may seem harsh, Makar's opinion suggests that the judge was trying to be conscientious given the sensitivities of the case and Doe's circumstances. Perhaps she wanted to give Doe a bit more time and distance — even if just a matter of days — from her friend's death to make such a major decision, she adds.

"This sounds as if it's a young woman who's already had a significant amount of trauma in her life, who is trying to make her life better, but on the day that she was in front of this judge a best friend had died," Dowd says. "It appears that there was concern that that might be affecting her state of mind on the day she was making this decision."

Parental consent laws can be tough for many to navigate

Doe's situation is unique because she has no parents from whom to obtain consent. But in other aspects, it resembles a systemic problem that many other pregnant adolescents face.

Dowd says there has been plenty of criticism over the years about how well-trained and positioned trial court judges are to make determinations about teenagers' maturity.

"What kind of training do trial court judges have in this matter, and to what extent is their own judgement affected by their own feelings about the very difficult issue of termination of pregnancy, and what they know or don't know about teenagers?" Dowd asks. "And do they know about the medical risks to teenagers? Have they had training in the average developmental circumstances of a 16-year-old?"

This past January, a circuit court judge in another part of Florida denied another woman's petition for this same kind of waiver, in part because of questions over her GPA. A higher court ultimately ruled in her favor, though not before the case shed a very public spotlight on the amount of discretion that judges have in making these kinds of determinations and the complexities of navigating parental consent laws in general.

People under age 20 make up 12% of individuals who have abortions in the U.S., and minors ages 17 or younger account for about 4%, according to STAT News — meaning at least 50,000 adolescents seek abortion care each year.

Thirty-six states have laws requiring parental involvement in a minor's decision to obtain an abortion, with most making exceptions for circumstances such as incest and medical emergencies.

According to an American Civil Liberties Union brief, the vast majority of minors who have abortions do so with the knowledge of at least one parent — and the smaller share of those who don't tend to have compelling reasons for not wanting to consult them, including fearing that they would be physically abused (because it had happened before) or kicked out of their house.

Many professional groups — including the American Medical Association and American Academy of Pediatrics — oppose laws that mandate parental involvement in abortion decisions, in large part because they create delays that put teenagers' health and safety at risk. And, the ACLU notes, going through the courts can take even more time, and isn't a feasible option for everyone (especially in small communities where confidentiality is a concern).

While teen pregnancy may conjure up images of Dirty Dancing to some people, Dowd says, data tends to show that once pregnancy occurs, teenagers are pretty responsible about their decision-making process — even though that can be complicated when it comes to parental consent. Society is very protective of parental rights, she adds, sometimes in situations where it is not to the benefit of their kids.

"It may be well-meaning, but we don't always want to look at the realities of family life," she says. "And in this child's situation — very difficult circumstances, trying to do her best — this is not the life circumstances we would choose for any 16, almost 17-year-old."

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