Since 2022, Colorado and 10 other states have passed voter initiatives to protect or expand abortion access. Yet, seven of these states, including Colorado, require people under the age of 18 to get consent from or notify a parent prior to receiving abortion services.
In January 2025, my colleagues and I published research using in-depth interviews with 33 people ages 15 to 22 in Colorado who considered or obtained abortion care between 2020 and 2023. Our study suggests that Colorado’s parental notification law delays young people’s access to abortion, complicates already complex family relationships, and forces unwanted disclosure of the pregnancy and abortion.
As a nurse, I have provided health care to young people and their families for more than two decades, and as a researcher, I have spent the past 10 years studying young people’s experiences with parental involvement laws.
Tens of thousands of young people are affected by parental involvement laws each year. By design, these laws threaten their ability to make their own pregnancy decisions.
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Expanding abortion access, but not for adolescents
In the U.S., 38 states allow abortion services at some point in pregnancy. Of those,24 states have parental involvement laws. And of those, 12 states require young people to obtain consent from a parent or guardian; seven require young people to notify a parent or guardian; and five require both notification and consent. Three states – Kansas, Missouri and North Dakota – require involvement of both parents.
In 2024, Colorado passed a constitutional amendment that protects the right to abortion and allows funding through Medicaid. Yet, Colorado still requires parental notification for people under 18 to obtain abortion services. There have been no recent state-led efforts to remove this law.
Proponents of parental involvement laws believe that the laws will foster parent-child communication and improve pregnancy decision-making. Research shows this is wishful thinking: These laws do not improve communication or decision-making, and instead harm adolescents.
We found that even in a state like Colorado that has expanded abortion access, the law creates barriers to services. It takes time for young people to learn the law exists and figure out how to comply with it. That’s true for both young people who can tell their parents and those who cannot. Delays due to parental involvement laws can increase the cost of abortion services, restrict adolescents’ choice of abortion methods and push adolescents past the gestational limit of the clinic or state.
For some Colorado young people, following the law resulted in unwanted disclosure of their pregnancy and abortion to parents and others, which is associated with negative mental health outcomes and exposes some young people to emotional or physical abuse.
Judicial bypass
In states that mandate parental involvement, young people who feel they cannot involve a parent can try to obtain a judicial bypass. The young person must go to court to prove to a judge that they are mature and well informed or that abortion without parental involvement is in their best interest.
Data from Massachusetts, Illinois, Texas and Florida suggests that between 6% and 23% of young people who had an abortion relied on judicial bypass. In some states, such as Florida, up to 13% of young people who requested a bypass were denied.
In our prior research, Texas young people described the judicial bypass process as burdensome, humiliating and traumatizing.
In our new research, young people in Colorado described the judicial bypass process as burdensome. They said it disrupted school, was “embarrassing,” “anxiety” provoking and “nerve wrecking.”
Judicial bypass also delays access to abortion. For one participant in our Colorado study, the two- to three-week delay contributed to her inability to obtain her wanted abortion because it pushed her past the gestational limit of her chosen clinic.
Another participant thought the judicial bypass process would take too long, so she instead tried to end the pregnancy herself. She took vitamin C, which is not effective, and considered but did not take large doses of over-the-counter medications such as ibuprofen, which could have caused organ damage.
The delays and burdens of the judicial bypass process led some study participants’ parents to find out about the pregnancy. This unwanted disclosure breached the privacy that judicial bypass is meant to protect.
Future of abortion restrictions
States such as Colorado, Maryland and Montana provide access for people seeking abortion services who live in the 18 states with bans early in pregnancy. For example, Colorado had a 110% increase in the number of abortions among adolescents from out of state between 2020 and 2022.
However, these states’ parental involvement laws may compound barriers people face when traveling out of state.
Parental involvement laws were the first state-level abortion restriction allowed by the Supreme Court after the Roe v. Wade decision in 1973, which was overturned in 2022. There is a similar pattern today.
Policymakers in some states with abortion bans, such as Idaho, Tennessee and Mississippi, are trying to stop people from traveling out of state for services by targeting young people. These proposed laws would make it a crime to help a young person under 18 leave the state for abortion services without parental consent.
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Some state policymakers are also trying to make it harder to get contraception by targeting young people. For example, federal courts upheld Texas’ refusal to allow minors to confidentially obtain contraception at federally funded clinics.
Young people know who to trust
Our research found that Colorado young people want their parents’ or guardians’ support when considering abortion, yet some felt it was not safe for them to ask for it.
Confirming prior research, we found a number of reasons young people felt unable to disclose their pregnancies to a parent. Those include fearing a parent’s reaction, feeling a parent would not respect their pregnancy decision, and not living with or not having a supportive relationship with a parent.
In addition to those reasons, young people also accurately predicted their parents’ reactions. Young people recounted emotional abuse and abandonment or feeling coerced into either continuing the pregnancy or having an abortion when a parent they did not feel they could tell found out about the pregnancy. Research, including our new study in Colorado, shows we can trust young people to decide who to involve in their pregnancy decision.
