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Most teen girls in the United States live in states with laws that severely limit access to abortion care, according to new research published in JAMA Pediatrics.

Of nearly 11,000,000 females of diverse races aged 13-17 years, two thirds live in states with either a total abortion ban, a gestational limit of 6-22 weeks, or parental involvement laws that require consent or notification of a parent or guardian. 

Roughly a quarter of girls live in states with total abortion bans, another quarter live in states with strict gestational limits, and 42% of girls who live in states that allow abortions must involve their parents if they seek the procedure.

“Too many adolescents face abortion legal restrictions, even in states that are protective of adults’ rights and access,” said Laura Lindberg, PhD, a professor in the Department of Urban-Global Public Health at the Rutgers School of Public Health in New Brunswick, New Jersey, and lead author of the study.

“All people — regardless of age — should have the right and ability to control their own fertility. These abortion restrictions limit their ability to make decisions about their lives and their future,” Lindberg said.

The parental involvement requirement can be especially harmful to girls in unsafe or unsupportive families, said Lindberg.

Theoretically, girls in states with parental involvement laws could apply for a judicial bypass and go before a judge to convince them of their ability to make the decision. “It’s an option that has never been utilized much because it is so difficult and daunting,” said Sarah Prager, MD, an ob-gyn at the University of Washington Medicine in Seattle.

“And I will say I’m a physician, I’m a 54-year-old person, and I don’t know if I would know how to navigate that legal system, at least not in an expeditious way,” Prager said. 

Lindberg and her team sought to examine how abortion in the post–Dobbs v. Jackson Women’s Health Organization era is affecting teens specifically. They obtained data from the Kaiser Family Foundation, 2020 US Census Estimates, and the Guttmacher Institute for the study.

“This gives us, for the first time, a good sense of who’s being impacted by the Dobbs decision in a more precise way than we’ve had so far,” said Lauren Ralph, PhD, MPH, an epidemiologist specializing in young people’s access to abortion care at the University of California, San Francisco.

The researchers found that as of December 2024, 12 states have a total abortion ban and 10 have strict gestational limits. As of September 2023, the parental involvement requirement exists in all of the states with gestational limits and about half of the states without bans or strict gestational limits.

With only 14 states without restrictive laws, teens may need to travel long distances of hundreds or thousands of miles to get an abortion, said Prager. Such travel is both impractical and dangerous for these teens, she said.

“Just a few years ago, I was in high school, and I can’t imagine having to travel across the country at the age of 16 or 17 to access critical healthcare,” said Paz Baum, a research assistant at Northwestern University, Evanston, Illinois and a co-author of the study. “I didn’t have a car or a credit card; I relied on my parents for everything.”

Since 2020, travel for abortion care has doubled from 1 in 10 to 1 in 5 people. 

Having to travel long distances is also problematic given the time-sensitive nature of abortion care, said Prager. And even states with less restrictive laws still have gestational limits, she said. 

Clinics in less restrictive states are already burdened with an excessive number of patients since the Dobbs decision, said Prager. Access in all states that allow for abortion is further limited because not all clinicians are trained to provide abortions beyond a certain number of weeks, she said.

Teens who reside in Idaho face additional barriers due to abortion trafficking laws which criminalize anyone who helps a minor travel for the procedure, said Ralph. In Idaho, abortion “traffickers” face between 2 and 5 years in prison. Other states have been trying to pass similar laws, including Montana and Tennessee. 

“I don’t think that this is going to end with Idaho,” said Ralph.

Teens are already disadvantaged when it comes to abortion care, said Prager, and those with additional marginalizing factors such as minority race or disability are likely to feel the impact of the restrictions more.

The authors reported no relevant financial disclosures. Prager and Ralph reported no relevant disclosures. 

Brittany Vargas is a journalist covering medicine, mental health, and wellness.