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Four states have no explicit policy in this area; in these states, and other states with very limited policies, the decision of whether to inform parents is typically left to a physician's discretion based on the best interests of the minor (see table, page 8).
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Furthermore, some state courts have adopted the so-called mature minor rule, under which a minor who is deemed sufficiently intelligent and mature to understand the nature and consequences of a proposed treatment may consent to medical treatment without consulting his or her parents or obtaining their permission.
On the basis of scientific findings dating back to the late 1970s that identified the premium that young people place on confidentiality, public policy has long reflected the reality that many minors will not seek important, sensitive health services if required to inform their parents.
Therefore, pregnancies that would have occurred to teenagers within marriage in previous years increasingly occurred before marriage.
At the same time, pregnant teenagers became less likely to marry to "legitimize" their pregnancies and births, and more teens began to terminate their pregnancies following the national legalization of abortion in 1973.
Meanwhile, a growing body of research demonstrated that teenagers who gave birth had worse maternal and child health outcomes than did those who postponed childbearing, and that these young women were more likely to be poor and have reduced educational and workforce achievement.