Most parents in California assume that they have broad rights to know about and consent to their children’s health care treatment. For the most part, this is true: a school nurse cannot even give a child a Tylenol without parental permission.

A major, surprising exception to this rule is in the area reproductive health, contraception, and abortion. We at Right to Life of Central California want to equip parents to understand the ways in which recent changes in California and federal law deny parents their ability to know about and protect their children’s health and innocence:

• Parental consent or notification: In California, healthcare providers can provide children with abortions, contraceptive drugs, and contraceptive devices without parental consent CA (Family Code § 6925). Healthcare providers are required not to disclose to parents any information about their child’s pregnancy, contraceptive use, or abortion, unless and until the child authorizes it (CA Health and Safety Code §§ 123110(a), 121115(a)(1); CA Civic Code §§56.10, 56.11). Once your child turns 12, healthcare providers will ask them questions regarding these issues in private outside of your presence during healthcare appointments.
  
• Abortions with Your Health Insurance: California law allows a minor on their parent’s health insurance plan to receive “sensitive services” such as abortion without the policyholder’s knowledge, to have that policy cover the cost, and to keep information about those services secret from the policyholder (AB 1184 (2021)). Since 2014 the California Department of Managed Healthcare has also required almost every insurance plan in the state to cover abortion (CDPH Letter to Insurers August 22, 2014). As a result, this means that a 13-year-old can get an abortion, have her parents’ insurance pay for it, and the parents would have no indication from their insurance company that the procedure happened. California law also eliminates all out-of-pocket costs for patients accessing abortions, allowing children to access abortion more easily (SB 245 (2022)). 
  
• Transgenderism: Current law in California states that minors must get parental consent before receiving a surgical or hormonal transgender intervention. However, public school districts in California are authorized to participate in a child’s “social transition” from one gender to another (e.g., call the child by a different name, refer to the child using different pronouns, allow the child to use a bathroom or locker room assigned to the opposite sex, etc.). Schools will maintain different records for internal use and for parental use, to keep the child’s “gender identity” hidden from parents. All of this is done at the child’s discretion. While three school districts in California have adopted a policy to inform parents whenever a child socially “transitions,” the Attorney General of California is currently suing one of the districts that adopted this policy, seeking to overturn it.
• The Abortion Pill: First, the Abortion Pill (Mifepristone) is distinct from “Plan B” or “the Morning-After Pill” (Levonorgestrel). Plan B chiefly functions as a contraceptive, by preventing ovulation (and thus pregnancy) within a short timeframe following a sexual encounter. Like most chemical contraceptives, it has a potentially abortifacient backup mechanism of altering the uterine wall so that a new embryo (a living, early-stage human being) cannot implant. Plan B introduces a massive dosage of hormonal contraceptives into the body and can have lots of unhealthy side effects.
  
  The genuine Abortion Pill, Mifepristone, is a drug that induces an abortion up to ten weeks into a pregnancy, per current FDA guidelines (or beyond ten weeks for providers prescribing it off-label). Mifepristone (ingested orally via a pill) inhibits the hormone progesterone, which is critical for pregnancy health. Without progesterone, the lining of the uterine wall is altered so that the embryo/fetus detaches and dies. 48-72 hours later, a woman takes a second drug called Misoprostol either orally or vaginally to induce labor, expelling the fetus. 
  
  The abortion pill has several potentially serious complications, including extreme pain and cramping, excess bleeding or hemorrhaging, and infection. 5-8% of pill abortions are “incomplete,” meaning that the fetus or placenta was not entirely expelled. This requires a follow-up surgical procedure, or else the patient risks serious infection. Our understanding of the risks of the abortion pill is incomplete because the Obama-era FDA issued regulations in 2016 that loosened safety protocols, but also prevented the collection of any data regarding adverse health outcomes other than deaths.
  
  Under new FDA guidelines introduced in 2021 under President Biden, patients can receive a prescription for Mifepristone without an in-person visit with a doctor. Without an in-person visit and an ultrasound, the risks are heightened, particularly for a patient who may have an undetected ectopic pregnancy (embryo/fetus growing in the fallopian tube rather than the uterus, a condition that can be fatal to both mother and baby). Without a follow-up ultrasound, the patient might not detect an incomplete abortion, which brings serious risks of infection.

Without an in-person visit requirement, a minor in California can get a prescription for the abortion pill via a telemedicine appointment over her smartphone, and have the abortion pill mailed to her house or made available at a major pharmacy. And again, California law eliminates any copays or deductibles, and the child can obtain the abortion on her parents’ insurance plan without her parents’ knowledge.

California takes a default assumption that parental involvement in such decisions is harmful rather than hurtful to children. Obviously, in cases of demonstrated abuse, there may be circumstances where the state might need to intervene between a child and her parents, regardless of whatever kinds of services a child is seeking. Nonetheless, we at Right to Life of Central California firmly believe that minor children need the support, love, care, and guidance of their parents or guardians. As in other areas of healthcare, children lack the experience, knowledge, and judgment to make decisions of such far-reaching import. The default presumption should be to include parents, not to exclude them.

We therefore encourage parents: be close to your kids, open up clear and safe lines of communication, monitor their internet and phone usage, and morally guide them. The State of California will not support your parental rights in these critical moments, and you must do what you can to protect your children.