The Effect of Parental Involvement Laws on Birth Control and Mental Health: New Evidence from the YRBS

By September 2013, 27 states had enacted and were enforcing parental involvement (PI) laws, which require a pregnant minor contemplating an abortion to notify or obtain the consent of one or more parents before an abortion can legally be performed.  The enactment of these laws can be thought of as raising the expected cost of an abortion to minors, which could impact not only abortion decisions, but also sexual decisions “down the fertility tree” (Levine 2003; Klick and Strattman 2003). 

There is some empirical evidence in support of the hypothesis that PI laws may reduce rates of unprotected sex among minor females.  However, a recent study by Colman, Dee, and Joyce (CDJ, 2013) in the JHE raises new doubts about whether PI laws really affect minors’ sexual behavior.  Using data drawn from the National Youth Risk Behavior Surveys (YRBS) and a difference-in-difference approach, CDJ show that PI laws have no effect on abstinence decisions, condom use, or birth control use of 15-to-17 year-olds.

While intriguing and important, questions remain following CDJ’s work.  Their analysis of the effects of PI laws on sexual behavior relied on the National YRBS, which often provided hundreds, and occasionally only dozens, of observations to the survey in any given year. In addition, over the period 1991-2009, the national YRBS does not include information on a number of smaller states that changed PI laws.  Finally, because the national YRBS contain very few state-by-year observations on those ages 18-to-19, who comprise a natural within-state control group, they are unable to control for within-state trends in non-minor teen sexual behaviors.  This may be problematic if teen sexual behavioral trends differ in states that enact PI laws as compared to those that do not. 

The current study uses data drawn from the 1993 to 2011 State YRBSs—which contain 1000s of observations per state-year for a number of smaller states that changed PI laws—to estimate the relationship between PI laws and adolescent sexual behavior.  Difference-in-difference-in-difference estimates confirm CDJ’s finding that the enactment of PI laws have no effect on abstinence or condom use among minor teen females.  However, we do find that PI laws are associated with an increase in birth control among 13-to-17 year-old females relative to 18-to-19 year-old females.  Falsification tests using PI laws that were passed but enjoined by state courts provide evidence in support of a causal interpretation of our estimates.

Finally, given that PI laws affect birth control use among minor teen females, we next explore whether they produce mental health benefits to affected females via avoidance of unplanned or unwanted pregnancy (Sabia and Rees 2013).  Relative to 18-to-19-year-olds, we find that PI laws are associated with a reduction in the probability that 13-to-17 year-old females report feelings of sadness or hopelessness, and a decline in the probability of considering suicide.  Taken together, our findings suggest that it is too soon to conclude that PI laws have no effect on youth birth control decisions or on the psychological well-being of minor teen females.