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How one vote separated whether some pregnant teens can get medical care

Posted at 5:38 PM, Jan 31, 2019

INDIANAPOLIS — One vote separated the life of a divisive proposal that would give 16- and 17-year-old pregnant girls the authority to make their own decisions about their care.

A pregnant 16- or 17-year-old girl would no longer need a parent or guardian’s permission to get medical care related to their pregnancy, if Senate Bill 352 passes. Sen. Jean Leising, R-Rushville, said it would help fix a “growing problem” in Indiana. The bill would allow the teenager to receive pre-natal, labor or postpartum care (up to 60 days) even if they did not have a guardian with them.

If a teenager goes to a hospital with an emergency related to her pregnancy, or is in immediate labor, she will get care whether her guardian is there to consent or not. But it’s the non-emergency care for which hospitals need a guardian’s consent.

“A parent has to come and consent for her to get an epidural, or any type of routine care,” said Dr. Mary Pell Abernathy, an IU Health doctor who specializes in maternal and fetal medicine. Abernathy spoke out in favor of the bill in a committee hearing.

The bill failed in the Senate, 24-25. But since 26 senators did not vote against the bill, it is not technically considered “dead.” It can be brought up again in this session.

Leising said the bill would help improve Indiana’s infant mortality rate, which was seventh-worst in the country in 2017. She said there are about 1,000 deliveries each year from 16- or 17-year-old girls.

Abernathy said getting the teenagers into care earlier, before there is an emergency, can help prevent tragic circumstances.

“We know that in this age category, we have higher complications with low birth weight, with prematurity, and the infant death rate,” Abernathy said. “We're trying to identify those earlier in pregnancy. Right now, that's not an emergency and so a teen couldn't give consent for that care."

Sen. Liz Brown, R-Fort Wayne, said the bill wouldn’t necessarily do anything for the infant mortality rate. She spoke out against the bill Tuesday afternoon.

“What [the bill] does, is it takes away the parent’s right to be involved in their 16- to 18-year-old’s pregnancy,” Brown said. “It takes away the parent’s consent. That’s all this bill does. … You may have driven your daughter to school, you may have coached her in soccer since she was in fifth grade, or driven her to dance. You may have kissed her goodnight and you may have taken pictures of her prom. But if she becomes pregnant between the ages of 16 and 18, and this bill passes, then you’re not going to be allowed to be involved with that.”

Leising fought back against Brown’s comments, saying there’s nothing that would prohibit a pregnant teenager from bringing their mother or grandmother to their doctor’s appointment.

“What this does is allows a physician to provide the kind of treatment they would provide if they came with a parent,” Leising said. “I don’t see, in any way, this takes away any parent’s right. A parent that’s engaged with their child is certainly going to be making sure they have appropriate prenatal care, care in delivery and post care.”

Under current law, once the teenager gives birth, she becomes the parent of consent for the infant, which creates a strange loophole, Abernathy said. The teenager still wouldn’t be able to provide consent for her own postpartum care.

“You’re allowing her to consent for this infant, but she can’t consent for her own care,” Abernathy said. “That’s where we’re just trying to correct that situation.”

Leising said the bill was brought to her by the Indiana State Medical Association, the largest physician organization in Indiana. The physicians were concerned about the issue of pregnant teenagers not getting the care they need, she said.

The bill does not allow for an abortion or a Physician Orders for Scope of Treatment (POST) Form.

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