California's Parental Notification Initiative, Prop. 4

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Testimony of
Liz Miller, MD
Member, Physicians for Reproductive Choice and Health September 16, 2008 Joint Hearing on Proposition 4: Waiting Period and Parental Notification Before Termination of Minor’s Pregnancy Initiative Constitutional Amendment Before the Assembly Committee on Health and the Senate Committee on Health
My name is Dr. Liz Miller. I am a mother of two and a physician, and I am deeply concerned about Proposition 4 and the harm it would do to the safety, health, and well-being of California’s teens. I know from experience what effects Prop. 4 would have. As a physician board-certified in internal medicine and pediatrics, I specialize in the care of adolescents and young adults. I provide clinical services for homeless and marginalized youth in Sacramento, treating broken arms as well as prescribing birth control. I also conduct research on the impact of violence on adolescent health. I speak to you today as a member of Physicians for Reproductive Choice and Health, a national organization of doctors firmly committed to safe reproductive healthcare for all. Physicians for Reproductive Choice and Health is united with many other medical organizations against parental notification laws because these laws keep young people from seeking the care they need. Like most doctors in my field, I routinely ask my teen patients about their relationship with their parents. My goal is to include parents in the decision-making process whenever I can but only with my patients’ permission. My staff and I go to great lengths to help parents help their kids. For instance, a 17-year-old girl recently came to our adolescent clinic for a pregnancy test for the third time in the last two months. Her previous tests were negative. Not this one. She burst into tears. She said her 17-yearold boyfriend was a highly controlling young man with a violent streak.
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He refused to use condoms during intercourse; he told her he wanted her to have his baby. But she wanted to finish school and did not want a child. When she spoke with her mother about this relationship, her mother said, “You chose him, so you have to live with that. That’s they way men are.” She feared that if she told her mother—or her boyfriend—she would be forced to keep the pregnancy. Under Prop. 4, she would have had to tell her mother and risk being coerced into becoming a mother, go to court to explain her situation (which would prompt an investigation of her home life), head to Mexico for an abortion, or try something more desperate. As it was, she had a safe abortion with us. Then, with her permission, we were able to bring her mother to the clinic to meet with us about her daughter’s abusive relationship. We helped the mother and our patient obtain a restraining order while ensuring the young woman’s safety and support throughout this tough time. She told us how much she appreciated having a safe and confidential place to get the help she needed. This is what we do every day in our care for adolescents. By guaranteeing confidentiality, we build their autonomy while working to ensure their safety. I share this story with you to underscore how Prop. 4 would interfere with my ability to protect my patients’ health. We use counseling to help improve parent-child communication, which often works. We customize what we say and do according to the patient and her parents’ circumstances. But Prop. 4 would not allow for the variety in teens’ lives. When parents are abusive, addicted to drugs or alcohol, or have disappeared, a letter stating that their daughter wants an abortion isn’t going to help matters. When it comes to confidential care for minors, California now has outstanding statutes. We also have clear mandated reporting laws to fight child abuse. Proposition 4 would throw off the balance we physicians now keep between ensuring minors’ privacy and protecting them from abusers—the teens who need us most would be scared away. I have seen the fear that crosses some of my patients’ faces when I mention their parents. A parental notification law would not eliminate that fear. It would make it worse. A parental notification law would not turn my patients' parents into loving, supportive, and understanding mothers and fathers. No law could do that. We have a preview of the impact Prop. 4 would have on pregnant young women. In 2007 the Program on Access to Care at UC-Berkeley conducted a study of girls ages 12 to 17 in California’s family planning clinics. The researchers asked what the young women would do if they became pregnant and wanted an abortion, were parental notification laws in place. Thirty-seven percent said they would go out of state for an abortion rather than tell their parents; 12% would go to Mexico for an abortion; and 34% would “find a way around the law.” The authors of Prop. 4 forget that when teens are desperate, they create their own options. I do not look forward to seeing the results of their desperation in my examining room.
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The medical community will not stand for Prop. 4’s interference with our adolescent patients’ health. Like all of us, young women need professional medical care and counseling—without delays. In our condemnation of parental notification laws, Physicians for Reproductive Choice and Health joins such medical organizations as the California Medical Association, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Society for Adolescent Medicine. As a profession, we have studied the states that have laws like Prop. 4. We see no advantage to them—not for teens and not for parents. Among other research institutions, the Bixby Center has produced a terrific brief on the many studies, showing that parental notification laws simply do not work. I cannot gamble with teens’ health. Nor should California. We all must say no to Prop. 4.
For more information, or to arrange an interview with Dr. Liz Miller, please contact Libby Benedict, Bay Area Assistant Director for Physicians for Reproductive Choice, at 415-990-6502 (cell). On Thursday, September 17, and after, you can also reach Libby at [email protected]
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