19–006 

112TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 112–671 

CHILD INTERSTATE ABORTION NOTIFICATION ACT 

SEPTEMBER 14, 2012.—Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 

Mr. SMITH of Texas, from the Committee on the Judiciary, 

submitted the following 

R E P O R T 

together with 

DISSENTING VIEWS 

[To accompany H.R. 2299] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on the Judiciary, to whom was referred the bill 

(H.R. 2299) to amend title 18, United States Code, to prohibit taking minors across State lines in circumvention of laws requiring 

the involvement of parents in abortion decisions, having considered 

the same, reports favorably thereon without amendment and recommends that the bill do pass. 

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 2 

Background and Need for the Legislation ............................................................. 4 

Hearings ................................................................................................................... 45 

Committee Consideration ........................................................................................ 45 

Committee Votes ...................................................................................................... 45 

Committee Oversight Findings ............................................................................... 58 

New Budget Authority and Tax Expenditures ...................................................... 58 

Congressional Budget Office Cost Estimate .......................................................... 58 

Performance Goals and Objectives ......................................................................... 59 

Advisory on Earmarks ............................................................................................. 60 

Section-by-Section Analysis .................................................................................... 60 

Changes in Existing Law Made by the Bill, as Reported ..................................... 62 

Dissenting Views ..................................................................................................... 67 


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1 Under 18 U.S.C. § 3559(a)(6) (‘‘An offense that is not specifically classified by a letter grade 

in the section defining it, is classified if the maximum term of imprisonment authorized is 1 

year or less but more than 6 months, as a Class A misdemeanor.’’), CIANA would be classified 

as a Class A misdemeanor. Under the Federal fine statute, the sentence for a Class A misdemeanor that does not result in death is not more than $100,000, and for one that does result 

in death is not more than $250,000. See 18 U.S.C. § 3571(b)(4)-(5). 2Those states are Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, 

Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, 

Missouri, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin 

and Wyoming. 3 Amanda Dennis, Stanley K. Henshaw, Theodore J. Joyce, Lawrence B. Finer, and Kelly 

Blanchard, ‘‘The Impact of Laws Requiring Parental Involvement for Abortion: A Literature Review’’ (Guttmacher Institute: March 2009) at 1. 

Purpose and Summary 

H.R. 2299, the ‘‘Child Interstate Abortion Notification Act’’ 

(‘‘CIANA’’), has two primary purposes. The first is to protect the 

health and safety of young girls by preventing valid and constitutional state parental involvement laws from being circumvented. 

The second is to protect the health and safety of young girls by protecting the rights of parents to be involved in the medical decisions 

of their minor daughters when such decisions involve interstate 

abortions. 

To achieve these purposes, CIANA contains two sections, each of which creates a new Federal crime subject to up to a $100,000 fine, 

or 1 year in jail, or both.1

First, CIANA makes it a Federal crime to transport a minor 

across state lines to obtain an abortion in another state in order 

to avoid a state law requiring parental involvement in a minor’s 

abortion decision. According to the Guttmacher Institute, 34 states 

have laws in effect that require parental involvement in minors’ 

abortions.2 But too often, such laws are circumvented. Indeed, according to ‘‘The Impact of Laws Requiring Parental Involvement for 

Abortion: A Literature Review,’’ published by the Guttmacher Institute in 2009, ‘‘The clearest documented impact of parental involvement laws is an increase in the number of minors traveling outside 

their home states to obtain abortion services in states that do not 

mandate parental involvement or that have less restrictive laws.’’ 3

The purpose of the first section of CIANA is to prevent people— 

including abusive boyfriends and older men who may have committed rape—from pressuring young girls into circumventing their 

state’s parental involvement laws by receiving a secret out-of-state 

abortion. This section of CIANA does not apply to minors themselves, or to their parents. It also does not apply in life-threatening 

emergencies that may require that an abortion be provided immediately. 

Second, CIANA applies when a minor from one state crosses 

state lines to have an abortion in another state that does not have 

a state law requiring parental involvement in a minor’s abortion 

decision, or when a minor from one state crosses state lines to have 

an abortion in another state that does have a state law requiring 

parental involvement in a minor’s abortion decision, but the physician fails to comply with such law. In such a case, CIANA makes 

it a Federal crime for the abortion provider to fail to give one of 

the minor’s parents, or a legal guardian if necessary, 24 hours’ notice (or notice by mail if necessary) of the minor’s abortion decision 

before the abortion is performed. The purpose of this section is to 

protect fundamental parental rights by giving parents a chance to 


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4 Bruce A. Lucero, M.D., ‘‘Parental Guidance Needed,’’ The New York Times (July 12, 1998), 

section 4, at 1. 

help their young daughters through difficult circumstances as best 

they can, including by giving a health care provider their daughter’s medical history to ensure she receives safe medical care and 

any necessary follow-up treatment. 

Dr. Bruce A. Lucero, an abortion provider, has supported this 

legislation because ‘‘parents are usually the ones who can best help 

their teenager consider her options’’ and because ‘‘patients who receive abortions at out-of-state clinics frequently do not return for 

follow-up care, which can lead to dangerous complications.’’ 4 Parental notification also allows parents to assist their daughter in 

the selection of a competent abortion provider. This section of 

CIANA does not apply in the following circumstances: where the 

abortion provider is presented with court papers showing that the 

parental involvement law in effect in the minor’s state of residence 

has been complied with; where the minor states that she has been 

the victim of abuse by a parent and the abortion provider informs 

the appropriate state authorities of such abuse; or where a lifethreatening emergency may require that an abortion be provided 

immediately. 

CIANA supports state laws that provide parents with the necessary information to fulfill their obligation to care for their minor 

children, and it affirms the common-sense notion that parents have 

the legal right to be involved in medical decisions relating to their 

minor children when those decisions involve interstate abortions. 

CIANA does not supercede, override, or in any way alter existing 

state parental involvement laws. CIANA addresses the interstate 

transportation of minors in order to circumvent valid, existing state 

laws, and uses Congress’ authority to regulate interstate activity to 

protect those laws from evasion and to protect parental involvement when minors cross state lines to obtain an abortion. 

The vast majority of States have enacted some form of a parental 

involvement law. Such laws reflect widespread agreement that it is 

the parents of a pregnant minor who are best suited to provide her 

counsel, guidance, and support as she decides whether to continue 

her pregnancy or to undergo an abortion. These laws not only help 

to ensure the health and safety of pregnant young girls, but also 

protect fundamental parental rights. 

Despite widespread support for parental involvement laws and 

clear public policy considerations justifying them, substantial evidence exists that such laws are regularly evaded by adults who 

transport minors to abortion providers in States that do not have 

parental notification or consent laws. CIANA would curb the interstate circumvention of these laws, thereby protecting the rights of 

parents and the interests of vulnerable minors. CIANA ensures 

that State parental involvement laws are not evaded through interstate activity. 

Parental involvement in the abortion decisions of minor girls will 

lead to improved medical care for minors seeking abortions and 

provide increased protection for young girls against sexual exploitation by adult men. When parents are not involved in the abortion 

decisions of a child, the risks to the child’s health significantly increase. Parental involvement will ensure that parents have the opVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00003 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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5http://www.gallup.com/poll/148631/Common-State-Abortion-Restrictions-Spark-Mixed-Reviews.aspx. 

portunity to provide additional medical history and information to 

abortion providers prior to performance of an abortion. The medical, emotional and psychological consequences of an abortion are 

serious and lasting. An adequate medical and psychological case 

history is important to the physician, and parents can provide such 

information for their daughters as well as any pertinent family 

medical history, refer the physician to other sources of medical history, such as family physicians, and authorize family physicians to 

give relevant data. 

Only parents are likely to know a young girl’s allergies to anesthesia and medication or previous bouts with specific medical conditions, including depression. A more complete and thus more accurate medical history of the patient will enable abortion providers 

to disclose not only medical risks that ordinarily accompany abortions but also those risks that may be specific to the pregnant 

minor. 

Parental involvement also improves medical treatment of pregnant minors by ensuring that parents have adequate knowledge to 

recognize and respond to any post-abortion complications that may 

develop. Without the knowledge that their daughters have had 

abortions, parents are unable to ensure that their children obtain 

routine postoperative care and unable to provide an adequate medical history to physicians called upon to treat any complications 

that may arise. These omissions may allow complications such as 

infection, perforation, or depression to continue untreated. Such 

complications may be lethal if left untreated. 

Teenage pregnancies often occur as a result of predatory practices of men who are substantially older than the minor victim, resulting in the transportation of the girl across State lines by an individual who has a great incentive to avoid criminal liability for his 

conduct. Experience suggests that sexual predators recognize the 

advantage of their victims obtaining an abortion. Not only does an 

abortion eliminate critical evidence of the criminal conduct, it allows the abuse to continue undetected. Parental involvement laws 

ensure that parents have the opportunity to protect their daughters 

from those who would victimize them further. 

Background and Need for the Legislation 

H.R. 2299 is much-needed legislation, overwhelmingly supported 

by the American people, that will protect both the health and safety of our minor children and parental rights. 

SUPPORT FOR CIANA

Polls show that the American people overwhelmingly support parental involvement laws by huge majorities. A July 2011 Gallup 

Poll asked ‘‘Do you favor or oppose each of the following proposals? 

. . . A law requiring women under 18 to get parental consent for 

any abortion.’’ 71% responded in favor, 27% opposed.5 An August 

2009 Pew Research Center Survey asked ‘‘Do you strongly favor, 

favor, oppose, or strongly oppose? . . . requiring that women under 

the age of 18 get the consent of at least one parent before they are 

allowed to have an abortion.’’ 76% responded in favor, (45% strongVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00004 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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6The relevant question appears on page 5 of this document: http://www.pewforum.org/ 

uploadedfiles/Topics/Issues/Abortion/abortion09topline.pdf. Also, on p.10 of this Pew report from 

October 2009 there is a comparison of the 2005 & 2009 results of the survey that may be helpful 

(support for parental consent was 73% in 2005, 76% in 2009). See http://www.pewforum.org/ 

uploadedfiles/Topics/Issues/Abortion/abortion09.pdf. 7See page 38 of this appendix of topline data found on the Knights of Columbus website, 

available at http://www.kofc.org/un/en/resources/communications/documents/ 

moralissueslappendix.pdf. 8See USCCB press release, available at http://old.usccb.org/comm/archives/2008/08–206.shtml. 

9Quinnipiac University Poll (conducted March 2–7, 2005, with 1,534 registered voters surveyed; margin of error: +/- 2.5%). 10Wirthlin Worldwide Poll (October 21–23, 2003). 11Wirthlin Worldwide National Poll (October 19–22, 2001). 12Public Opinion Strategies Survey (July 30, 2002). 13Zogby California Poll (June 2002). 14F.S.A. Const. Art. 10 § 22. 15See Jackie Hallifax, ‘‘Group Seeks Parental Notice End,’’ The Brandenton Herald (January 

11, 2005) at 5. 

ly favor, 31% favor), 19% opposed.6 An October 2008 Marist Poll 

National Survey asked ‘‘Except in a medical emergency, which do 

you think is more important: the privacy of a daughter under the 

age of 18 to have an abortion or the right of a parent to know their 

underage daughter is about to have this surgical procedure?’’ 77% 

of registered voters, and 78% of registered Catholic voters supported the parent’s right to know.7 A December 2008 Harris Interactive survey commissioned by the U.S. Conference of Cathlolic 

Bishops also found that ‘‘73 percent favor laws that require giving 

parents the chance to be involved in their minor daughter’s abortion decision.’’ 8

Earlier polls reveal similar results. In March, 2005, 75% of over 

1,500 registered voters surveyed favored ‘‘requiring parental notification before a minor could get an abortion,’’ and only 18% were 

opposed.9 According to another poll conducted in 2003, 73% of nonwhites and 82% of Hispanics support parental notification laws.10

A Wirthlin Worldwide poll conducted in October, 2001, found that 

83% of those surveyed support laws requiring notification to one 

parent before an abortion can be performed on a minor daughter.11

African Americans and Hispanics overwhelmingly support parental notification laws. A Public Opinion Strategies poll surveyed 

1,000 African-American registered voters on the question: ‘‘Would 

you favor or oppose a law that would require a parent or guardian 

to be notified before a minor child, under the age of 18, undergoes 

an abortion procedure?’’ 84% favored such a law (74% ‘‘strongly 

favor’’ and 10% ‘‘somewhat favor’’).12

A Zogby poll of California voters showed that 71% of those surveyed in that state support laws requiring notification to one parent before an abortion can be performed on a minor daughter.13

Moreover, during the November, 2004, elections, Florida overwhelmingly passed an amendment to its state constitution that 

provides that ‘‘the Legislature is authorized to require by general 

law for notification to a parent or guardian of a minor before the 

termination of the minor’s pregnancy.’’ 14 Nearly 65 percent of Florida voters in November, 2004, approved this state constitutional 

amendment.15

Even more rigid requirements of parental consent are overwhelmingly supported by the American public. A Gallup poll conducted in January, 2003, showed that 78% of those surveyed favor 

laws requiring a 24-hour waiting period before an abortion can be 

obtained, and 73% favor laws requiring minors to get parental conVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00005 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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16Lydia Saad, Gallup News Service (January 20, 2003). 17See Los Angeles Times Poll (June 8–13, 2000); CBS News/New York Times Poll (January 

1998). 18See, e.g., CBS News/NY Times Poll (released January 15, 1998) (78% of those polled favor 

requiring parental consent before a girl under 18 years of age could have an abortion); Americans United for Life, Abortion and Moral Beliefs, A Survey of American Opinion (1991); Wirthlin 

Group Survey, Public Opinion, May-June 1989; Life/Contemporary American Family (released 

December, 1981) (78% of those polled believed that ‘‘a girl who is under 18 years of age [should] 

have to notify her parents before she can have an abortion’’). 19Latino Opinions poll (October 5, 2004) (survey of 1,000 national adult Hispanics on the 

question ‘‘[D]o you support or oppose requiring underage teenage girls to get permission from 

their parents before they are allowed to get an abortion?’’ to which 58% reported ‘‘strongly support’’ and 11% reported ‘‘somewhat support’’). 20David Crary, ‘‘Passage of Teen Abortion Bill Called Likely,’’ The Associated Press (January 

31, 2005). 21See Planned Parenthood Federation of America, Inc., Fact Sheets: Teenagers, Abortion, and 

Government Intrusion Laws, at http://www.plannedparenthood.org/library/ABORTION/laws.html 

(last visited February 2, 2005) (‘‘Few would deny that most teenagers, especially younger ones, 

would benefit from adult guidance when faced with an unwanted pregnancy. Few would deny 

that such guidance ideally should come from the teenager’s parents.’’); National Abortion and 

Reproductive Rights Action League, Young Women: Reproductive Rights Issues, at http:// 

www.naral.org/Issues/youngwomen/index.cfm (last visited February 1, 2005) (‘‘Responsible parents should be involved when their young daughters face a crisis pregnancy.’’). 22 Council on Ethical and Judicial Affairs, American Medical Association, ‘‘Mandatory Parental 

Consent to Abortion,’’ 269 JAMA 82, 83 (1993). 23 Carolyn Johnson, ‘‘Abortion Parental Notification Back on Ballot,’’ ABC 7 News (KGO) (November 1, 2006), available at http://abclocal.go.com/kgo/story?section=news/politics&id=4714527. 

sent before an abortion can be obtained.16 These numbers have 

been confirmed in other polls.17 Similar results are found in polls 

that consistently reflect over 70% of the American public support 

parental consent or notification laws,18 including 69% of the Hispanic population.19

As the Associated Press has reported, even ‘‘[o]pponents [of parental notice laws] agree that young women are better off telling 

parents about a pregnancy[.]’’ 20

There is widespread agreement among abortion rights advocates 

and pro-life advocates that it is the parents of a pregnant minor 

who are best suited to provide her counsel, guidance, and support 

as she decides whether to continue her pregnancy or to undergo an 

abortion. Organizations such as Planned Parenthood and the National Abortion and Reproductive Rights Action League all advise 

pregnant minors to consult their parents before proceeding with an 

abortion.21 In addition, the American Medical Association urges 

physicians to ‘‘strongly encourage minors to discuss their pregnancy with their parents’’ and to ‘‘explain how parental involvement can be helpful and that parents are generally very understanding and supportive.’’ 22

THE SCOPE OF THE INTERSTATE PROBLEM CIANA ADDRESSES

There is no serious dispute regarding the fact that the transportation of minors across state lines in order to obtain abortions is 

both a widespread and frequent practice. Even groups opposed to 

this bill acknowledge that large numbers of minors are transported 

across state lines to obtain abortions, in many cases by adults 

other than their parents. As Dr. Anne Foster Rosales, as Medical 

Director of Planned Parenthood Golden Gate in San Francisco, said 

‘‘You may see an artificial decrease in the abortion rate in teens 

in [a] state [that adopts a parental involvement law], but when you 

look at neighboring states, and the origin of patients, you see that 

what’s happening is those young women are just shifting themselves to another state.’’ 23


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24 ‘‘Labor of Love Is Deemed Criminal,’’ The National Law Journal (November 11, 1996) at 

A8. 25See ‘‘Woman Charged in Secret Abortion,’’ Philadelphia Inquirer, (September 16, 1995). 26 Jeff Whelan, ‘‘McGreevey Reveals Latest Abortion Stance,’’ The Star-Ledger (August 30, 

2001). 27 ‘‘Teen-Agers Cross State Lines in Abortion Exodus,’’ The New York Times (December 18, 

1995) at B6. 28See id. 29See id. 30See id. 31 Charles V. Zehren, ‘‘New Restrictive Abortion Law,’’ Newsday (February 22, 1994). 

In 1995, Kathryn Kolbert, then an attorney with the Center for 

Reproductive Law and Policy (a national legal defense organization 

that supports abortion), stated that thousands of adults are helping 

minors cross state lines to get abortions in states whose parental 

involvement requirements are less stringent or non-existent: 

‘‘There are thousands of minors who cross state lines for an abortion every year and who need the assistance of adults to do that.’’ 24

She asked, ‘‘How does a 14-year-old get to New Hampshire from 

Boston without getting a ride?’’ 25 In 2001, New Jersey’s Star-Ledger reported that Laurie Lowenstein, Executive Director of Right to 

Choose, an abortion rights advocacy group, stated that she would 

quit her job to shuttle pregnant young girls to states without parental notification laws if New Jersey enacted a parental notification law.26 Only Congress, with its constitutional authority to regulate interstate commerce, can curb such flagrant disregard of state 

laws. The experience of a number of States illuminates the scope 

of this problem. 

Pennsylvania 

Since Pennsylvania’s current parental consent law took effect in 

March, 1994, news reports have confirmed that many Pennsylvania 

teenagers are going out of state to New Jersey and New York to 

obtain abortions. In 1995, the New York Times reported that 

‘‘Planned Parenthood in Philadelphia has a list of clinics, from New 

York to Baltimore, to which they will refer teenagers, according to 

the organization’s executive director, Joan Coombs.’’ 27 Moreover, 

the New York Times gave accounts of clinics that had seen an increase in patients from Pennsylvania.28 One clinic, in Cherry Hill, 

New Jersey, reported seeing a threefold increase in Pennsylvania 

teenagers coming for abortions.29 Likewise, a clinic in Queens, New 

York, reported that it was not unusual to see Pennsylvania teenagers as patients in 1995, though earlier it had been rare.30

In the period just prior to the Pennsylvania law taking effect, efforts were underway to make it easier for teenagers to go out of 

state for abortions. For instance, Newsday reported that 

‘‘[c]ounselors and activists are meeting to plot strategy and printing 

maps with directions to clinics in New York, New Jersey, Delaware 

and Washington, D.C., where teenagers can still get abortions 

without parental consent . . . ‘We will definitely be encouraging 

teenagers to go out of state,’ said Shawn Towey, director of the 

Greater Philadelphia Woman’s Medical Fund, a nonprofit organization that gives money to women who can’t afford to pay for their 

abortions.’’ 31

Moreover, some abortion clinics in nearby states, such as New 

Jersey and Maryland, and others, use the lack of parental involvement requirements in their own states as a ‘‘selling point’’ in adverVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00007 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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32 Copies of such advertisements are attached at the end of this report. 33See Charlotte Ellertson, Ph.D., ‘‘Mandatory Parental Involvement in Minors’ Abortions: Effects of the Laws in Minnesota, Missouri, and Indiana,’’ American Journal of Public Health (August 1997). 34See id. at 1371. 35See Kevin McDermott and Mark Schauerte, ‘‘Illinois May Tighten Rules on Abortions For 

Teens; Parental Consent Is Not Required; Abortion Bill Targets Illinois as Teen Haven For 

Abortion,’’ St. Louis Post-Dispatch (February 25, 1999). 36The Massachusetts law was changed in 1997 to require the consent of one parent (or judicial authorization), rather than both parents as previously required. 37See Virginia G. Cartoof & Lorraine V. Klerman, ‘‘Parental Consent for Abortion: Impact of 

the Massachusetts Law,’’ American Journal of Public Health 397 (April 1986). 

tising directed at minors in Pennsylvania, stating ‘‘No Parental 

Consent Required.’’ 32 A Rockville, Maryland, abortionist ran a 

similar advertisement in the May 1998–April 1999 Yellow Pages 

for Harrisburg, Pennsylvania. Such advertisements have appeared 

in telephone directories for Wilkes-Barre and Dallas, Scranton, 

Clarks Summit, and Carbondale, Bethlehem, Allentown, York, and 

Erie. 

Missouri 

A study in the American Journal of Public Health reported that 

a leading abortion provider in Missouri refers minors out of state 

for abortions if the girls do not want to involve their parents. Reproductive Health Services, which performs over half of the abortions performed in Missouri, refers minors to the Hope Clinic for 

Women in Granite City, Illinois.33 Research reveals that based on 

the available data the odds of a minor traveling out of state for an 

abortion increased by over 50 percent when Missouri’s parental 

consent law went into effect. Furthermore, compared to older 

women, underage girls were significantly more likely to travel out 

of state to have their abortions.34

A St. Louis Post-Dispatch news report confirms that the Hope 

Clinic in Illinois continues to attract underage girls seeking abortions without parental involvement.35 A clinic counselor estimates 

that she sees two girls each week seeking to avoid their home 

state’s parental involvement law. One example was a 16-year-old 

girl from Missouri who had called abortion clinics in St. Louis and 

learned that parental consent was required before a minor could 

obtain an abortion. According to the report, the Hope Clinic performed 3,200 abortions on out-of-state women in 1998, and the clinic’s executive director estimates that number is 45% of the total 

abortions performed at the clinic. The executive director also estimates that 13% of the clinic’s clients are minors. 

Massachusetts 

Massachusetts has also seen an increase in out-of-state abortions 

performed on its teenage residents since the state’s parental consent law went into effect in April 1981, according to a published 

study.36 A study published in the American Journal of Public 

Health found that in the 4 months prior to implementation of the 

parental consent law, an average of 29 Massachusetts minors obtained out-of-state abortions each month in Rhode Island, New 

Hampshire, Connecticut, and New York.37 After the parental consent law was implemented, however, the average jumped to between 90 and 95 out-of-state abortions per month, using data from 

the five states of Rhode Island, New Hampshire, Connecticut, New 


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38See id. at 398. 39 Id. at 399. 40See M.A.J. McKenna, ‘‘Mass. Abortion Laws Push Teens Over Border,’’ Boston Herald (April 

7, 1991) at A1. 41Stanley K. Henshaw, ‘‘The Impact of Requirements for Parental Consent on Minors’ Abortions in Mississippi,’’ Family Planning Perspectives (June, 1995) at 121. 42 Id. at 122. 43Lisa A. Singh, ‘‘Those Are the People Who Are Being Hurt,’’ Style Weekly (February 11, 

1997). 

York, and Maine, representing one-third of the abortions obtained 

by Massachusetts’ minors.38

The study noted that due to what the authors described as ‘‘astute marketing,’’ one abortion clinic in New Hampshire was able to 

nearly double the monthly average of abortions performed on Massachusetts minors (from 14 in 1981 to 27 in 1982). The abortionist 

‘‘began advertising in the 1982 Yellow Pages of metropolitan areas 

along the northern Massachusetts border, stating ‘consent for minors not required.’ ’’ 39

In April 1991, the Planned Parenthood League of Massachusetts 

estimated that approximately 1,200 Massachusetts minor girls 

travel out of state for abortions each year, the majority of them to 

New Hampshire. Planned Parenthood said that surveys of New 

Hampshire clinics revealed an average of 100 appointments per 

month by Massachusetts minors.40

Mississippi 

A study of the effect of Mississippi’s parental consent law revealed that Mississippi has also experienced an increase in the 

number of minors traveling out of state for abortions. The study, 

published in Family Planning Perspectives, compared data for the 

5 months before the parental consent law took effect in June 1993, 

with data for the 6 months after it took effect, and found that 

‘‘[a]mong Mississippi residents having an abortion in the state, the 

ratio of minors to older women decreased by 13% . . . However, 

this decline was largely offset by a 32% increase in the ratio of minors to older women among Mississippi residents traveling to other 

states for abortion services.’’ 41 Based on the available data, the 

study suggests that the Mississippi parental consent law appeared 

to have ‘‘little or no effect on the abortion rate among minors but 

a large increase in the proportion of minors who travel to other 

states to have abortions, along with a decrease in minors coming 

from other states to Mississippi.’’ 42

Virginia 

Grace S. Sparks, executive director of the Virginia League of 

Planned Parenthood, predicted in February 1997 that if Virginia 

were to pass a parental notification law, teenagers would travel out 

of state for abortions: ‘‘In every state where they’ve passed parental 

notification, . . . there’s been an increase in out-of-state abortions,’’ she said, adding, ‘‘I suspect that that’s what will happen in 

Virginia, that teen-agers who cannot tell their parents . . . will go 

out of state and have abortions . . .’’ 43

Virginia’s parental notification law took effect on July 1, 1997. 

Initial reports indicated that abortions performed on Virginia minors dropped 20 percent during the first 5 months that the law was 

in effect (from 903 abortions during the same time period in 1996 


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44 Ellen Nakashima, ‘‘Fewer Teens Receiving Abortions In Virginia,’’ The Washington Post 

(March 3, 1998). 45See id. 46See id. 47See Child Custody Protection Act: Hearings on H.R. 3682 Before the Subcomm. on the Constitution of the House Comm. on the Judiciary, 105th Cong., (May 21, 1998) (statement of Joyce 

Farley). 48See id. 49See id. 50See id. 51See id. 52See id. 53See id. 54See id. 

to approximately 700 abortions in 1997).44 It appears, however, 

that Virginia teenagers are traveling to the District of Columbia in 

order to obtain an abortion without involving their parents. In fact, 

the National Abortion Federation (‘‘NAF’’), which runs a toll-free 

national abortion hotline, said that calls from Virginia teenagers 

seeking information on how to obtain an abortion out of state were 

the largest source of teenage callers seeking out-of-state abortions, 

at seven to ten calls per day.45 NAF hotline operator Amy Schriefer 

has gone so far as to talk a Richmond area teenage girl through 

the route (involving a Greyhound bus and the Metro’s Red Line) to 

obtain an abortion in the District of Columbia.46

CONGRESSIONAL TESTIMONIALS HIGHLIGHT THE NEED

FOR IMMEDIATE ACTION

At hearings during the 105th, 106th, 107th, and 108th Congresses, the Subcommittee on the Constitution heard testimony 

from two mothers whose daughters were secretly taken for abortions, with devastating consequences. 

Joyce Farley, the mother of a minor girl, recounted how her 12- 

year-old daughter was provided alcohol, raped, and then taken out 

of state by the rapist’s mother for an abortion.47 In the words of 

Joyce Farley, the abortion was arranged to destroy evidence—evidence that her 12-year-old daughter had been raped.48 On August 

31, 1995, her daughter, who had just turned 13, underwent a dangerous medical procedure without anyone present who knew her 

past medical history (as shown by the false medical history that 

was given to the abortionist).49 Following the abortion, the mother 

of the rapist dropped off the child in another town 30 miles from 

the child’s home.50 The child returned to her home with severe 

pain and bleeding which revealed complications from an incomplete 

abortion.51 When Joyce Farley contacted the original clinic that 

performed the abortion, the clinic told her that the bleeding was 

normal and to increase her daughter’s Naprosyn, a medication 

given to her for pain, every hour if needed.52 Fortunately, Ms. Farley, being a nurse, knew this advice was wrong and could be harmful, but her daughter would not have known this.53 Because of her 

mother’s intervention, Ms. Farley’s daughter ultimately received 

further medical care and a second procedure to complete the abortion.54

As Ms. Farley testified before the House Constitution Subcommittee in 2004: 

[I]n 1995, my then 12-year-old daughter, Crystal, was intoxicated and raped by a 19-year-old male . . . On August 

31, 1995, I discovered my 13-year-old daughter, Crystal, 


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55 Child Custody Protection Act: Hearings on H.R. 1755 Before the Subcomm. on the Constitution of the House Comm. on the Judiciary, 108th Cong., 6–7 (July 20, 2004) (statement of Joyce 

Farley). 

was missing from home. An investigation by the police, 

school officials and myself revealed the possibility that 

Crystal had been transported out of State for an abortion. 

I can’t begin to tell you the fear that enveloped me not 

knowing where my daughter was, who she was with, if she 

was in harm’s way, and to learn in this manner that my 

young daughter was pregnant. By early afternoon Crystal 

was home safe with me, but so much had taken place in 

that 1 day. The mother of this 19-year-old male had taken 

Crystal for an abortion in the State of New York. Apparently, this woman decided this was the best solution for 

the situation caused by her son, with little regard for the 

welfare of my daughter. Situations such as this is what the 

Child Custody Act [H.R. 1755 in the 108th Congress, 

which included provisions that are also in CIANA] was designed to help prevent. I am a loving, responsible parent, 

whose parenting was interfered with by an adult unknown 

to me. My child was taken for a medical procedure to an 

unknown facility and physician without my permission. 

When Crystal developed complications from this medical 

procedure, this physician was not available. He refused to 

supply necessary medical records to a physician that was 

available to provide Crystal the medical care she needed. 

I ask you to please, in considering the Child Custody Protection Act, to put aside your personal opinions on abortion. Please just consider the safety of the minor children 

of our Nation whose lives are put at risk when taken out 

of their home State . . . Please allow loving, careful and 

responsible parents the freedom to provide the care their 

adolescent daughters need without interference from criminals or people who think they may be helping, but actually 

cause more harm than good. An abortion is a medical procedure with physical and emotional risks. An adolescent 

who’s had an abortion needs the care and support of family. Crystal, unfortunately, developed both physical and 

emotional side effects. Some of the effects are still present 

today after 9 years have lapsed.55

In the 109th Congress, Marcia Carroll testified before the Constitution Subcommittee and described the following terrifying story 

that CIANA, had it been enacted into law, would have prevented: 

On Christmas Eve 2004, my daughter informed me she 

was pregnant. I assured her I would seek out all resources 

and help that was available. As her parents, her father 

and I would stand beside her and support any decision she 

made. We scheduled appointments with her pediatrician, 

her private counselor, and her school nurse. I followed all 

of their advice and recommendations. They referred us to 

Healthy Beginnings Plus, Lancaster Family Services, and 

the WIC program. They discussed all her options with her. 

I purposefully allowed my daughter to speak alone with 

professionals so that she would speak her mind and not 


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just say what she thought I wanted to hear. My daughter 

chose to have the baby and raise it. My family fully supported my daughter’s decision to keep her baby and offered 

her our love and support. 

Subsequently, her boyfriend’s family began to harass my 

daughter and my family. They started showing up at our 

house to express their desire for my daughter to have an 

abortion. When that did not work, his grandmother started 

calling my daughter without my knowledge. They would 

tell her that if she kept the baby, she couldn’t see her boyfriend again. They threatened to move out of state. 

I told his family that my daughter had our full support 

in her decision to keep the baby. She also had the best doctors, counselors, and professionals to help her through the 

pregnancy. We all had her best interests in mind. 

The behavior of the boy’s family began to concern me to 

the point where I called my local police department for advice. Additionally, I called the number for an abortion center to see how old you have to be to have an abortion in 

our state. 

I felt safe when they told me my minor daughter had to 

be 16 years of age in the state of Pennsylvania to have an 

abortion without parental consent. I found out later that 

the Pennsylvania Abortion Control Act actually says that 

parental consent is needed for a minor under 18 years of 

age. It never occurred to me that I would need to check the 

laws of other states around me. I thought as a resident of 

the state of Pennsylvania that she was protected by Pennsylvania state laws. Boy, was I ever wrong. 

On Feb. 16th, I sent my daughter to her bus stop with $2.00 of lunch money. I thought she was safe at school. 

She and her boyfriend even had a prenatal class scheduled 

after school. 

However, what really happened was that her boyfriend 

and his family met with her down the road from her bus 

stop and called a taxi. The adults put the children in the 

taxi to take them to the train station. His stepfather met 

the children at the train station, where he had to purchase 

my daughter’s ticket since she was only fourteen. They put 

the children on the train from Lancaster to Philadelphia. 

From there, they took two subways to New Jersey. That is 

where his family met the children and took them to the 

abortion clinic, where one of the adults had made the appointment. 

When my daughter started to cry and have second 

thoughts, they told her they would leave her in New Jersey. They planned, paid for, coerced, harassed, and threatened her into having the abortion. They left her alone during the abortion and went to eat lunch. 

After the abortion, his stepfather and grandmother 

drove my daughter home from New Jersey and dropped 

her off down the road from our house. 

My daughter told me that on the way home she started 

to cry, they got angry at her and told her there was nothing to cry about. 


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56 Child Interstate Abortion Notification Act: Hearing Before the Subcomm. on the Constitution 

of the H. Comm. on the Judiciary, 109th Cong. 6–7 (2005) (statement of Marcia Carroll). 57See Sidney Wolfe, M.D., Mary Gabay, Phyllis McCarthy, Alana Bame, and Benita Marcus 

Adler, ‘‘Questionable Doctors: Disciplined by States or the Federal Government’’ (State Listing 

for New Jersey; A Public Citizen Health Research Group Report) (March 1996) at 68. 

Anything could have happened to my daughter at the 

abortion facility or on the ride back home. These people 

did not know my daughter’s medical history, yet they took 

her across state lines to have a medical procedure without 

my knowledge or consent. Our family will be responsible 

for the medical and psychological consequences for my 

daughter as a result of this procedure that was completed 

unbeknownst to me. 

I was so devastated that this could have been done that 

I called the local police department to see what could be 

done. They were just as shocked and surprised as I was 

that there was nothing that could be done in this horrible 

situation. 

The state of Pennsylvania does have a parental consent 

law. Something has to be done to prevent this from happening to other families. This is just not acceptable to me 

and should not happen to families in this country. If your 

child goes to her school clinic for a headache, a registered 

nurse can’t give her a Tylenol or aspirin without a parent’s 

written permission. 

As a consequence of my daughter being taken out of our 

state for an abortion without parental knowledge, she is 

suffering intense grief. My daughter cries herself to sleep 

at night and lives with this everyday. 

I think about what I could or should have done to keep 

her safe. Everybody tells me I did everything I could have 

and should have done. It doesn’t make me feel any better, 

knowing everything I did was not enough to protect my 

daughter. 

It does ease my mind to know with your help that we 

can make a difference and change the law to protect other 

girls and their families. I urge your support for The Child 

Interstate Abortion Notification Act. It is critical that this 

law passes in Congress. The right of parents to protect the 

health and welfare of their minor daughters needs to be 

protected. No one should be able to circumvent state laws 

by performing an abortion in another state on a minor 

daughter without parental consent.56

The physician who performed an abortion on Marcia Carroll’s 

daughter, Dr. Vikram Kaji, had a long history of sexually abusing 

his patients. Marcia Carroll should have been given an opportunity 

to learn about the history of her child’s doctor. Apparently the people who coerced her daughter into having the abortion did not care 

who performed an abortion on her. Dr. Kaji was professionally disciplined by the State of New Jersey on November 1, 1993, and 

given a 12-month suspension for sexually abusing three patients 

and indiscriminately prescribing controlled dangerous substances.57

He was disciplined for having sex with one patient in his office, 

and for performing ‘‘improper’’ rectal and breast exams on two 


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58See American Political Network, ‘‘State Reports Pennsylvania: PA Suspends Abortion Provider’s License,’’ (March 23, 1995) at 6. 59See Kathy Boccella, ‘‘Abortion Doctor Banned One Year,’’ The Philadelphia Inquirer (October 29, 1993) at B1 (‘‘A woman who had been a patient of Kaji’s since 1976 said that ‘numerous 

times (he) made sexual advances toward her and fondled her’ in his office between 1980 and 

1988, the consent order read . . . Kaji knew the woman suffered from severe depression, had 

been sexually abused as a child and had once been hospitalized for psychiatric problems, the 

order read.’’). 60See id. at 68. 61See id. at 68. 62See Child Custody Protection Act: Hearings on H.R. 476 Before the Subcomm. on the Constitution of the House Comm. on the Judiciary, 107th Cong. (Sept. 6, 2001) (statement of Eileen 

Roberts). 63See id. While Ms. Roberts’ daughter was not taken to another state, her story is illustrative 

of the harms involved when a child is secretly taken away from her parents for an abortion. 

After this experience, Ms. Roberts formed an organization called Mothers Against Minor Abortions (MAMA). Ms. Roberts testified: ‘‘I speak today for those parents I know around the country, whose daughters have been taken out of State for their abortions.’’ Id. 64See id. 65See id. 66See id. 

other patients.58 According to a consent order, Dr. Kaji knew the 

woman he had sex with suffered from severe depression, had been 

sexually abused as a child, and had once been hospitalized for psychiatric problems.59 He was also disciplined by the Federal Drug 

Enforcement Agency on February 22, 1994, and made to surrender 

his controlled substance license.60 He was also disciplined by the 

State of Pennsylvania on December 23, 1994, and his license was 

suspended for 36 months.61

When Marcia Carroll was asked why she came to testify on behalf of CIANA, she said, ‘‘[my daughter] does suffer. She has gone 

to counseling for this. I just know that she cries and she wished 

she could redo everything, relive that day over. It’s just sad that 

it had to happen this way and this is what she had to go through. 

But she did want me to come here today and speak on her behalf. 

She said, ‘Mom, just one phone call is all it would have taken to 

stop this from happening . . .’ So she asked me to come here for 

her sake and for other girls’ safety to speak and let you know what 

was happening.’’ That is precisely what CIANA affirms: the right 

of parents to be given the chance to help their children through difficult times. The parents of this Nation want to be given the chance 

to make sure their children’s doctors are not potential sexual abusers and controlled substance pushers, and CIANA would give them 

that chance. 

Eileen Roberts also testified that her 13-year-old daughter was 

encouraged by a boyfriend, with the assistance of his adult friend, 

to obtain a secret abortion.62 The adult friend drove Ms. Roberts’ 

daughter to an abortion clinic 45 miles from her home and paid for 

her daughter to receive the abortion.63 After 2 weeks of observing 

their daughter’s depression, Ms. Roberts and her husband learned 

that the young girl had an abortion from a questionnaire they 

found under her pillow, which their daughter had failed to return 

to the abortion clinic.64

Ms. Roberts’ daughter was then hospitalized as a result of the 

depression, and a physical examination revealed that the abortion 

had been incompletely performed and required surgery to repair 

the damage done by the abortionist.65 The hospital called Ms. Roberts and told her that they could not do reparative surgery without 

a signed consent form.66 The following year, Ms. Robert’s daughter 

developed an infection and was diagnosed with having pelvic inVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00014 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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67See id. 68See id. 

flammatory disease, which again required a 2-day hospitalization 

for antibiotic therapy and a signed consent form.67 Ms. Roberts and 

her family were responsible for over $27,000 in medical costs, all 

of which resulted from this one secret abortion.68

Other examples that illustrate the need for CIANA include the 

following. As reported in LifeNews (which refers to a mother and 

daughter as ‘‘Anna’’ and ‘‘Jane,’’ respectively): 

Anna’s daughter, who the Anchor has identified as ‘‘Jane’’ 

was like many teens. In the winter of 2008, she started 

hanging out with someone her parents didn’t approve of. 

Anna and her husband tried to steer Jane away from the 

young man, but he had become part of her group of 

friends. Months later, Anna took Jane for a drive into the 

Mat-Su Valley in an effort to reach her increasingly distant daughter. Anna could tell something was weighing on 

Jane’s mind. Finally, at lunch, Jane admitted, ‘‘There’s 

something I need to tell you.’’ Jane wrote a message on a 

napkin and slid it across the table. ‘‘I’m pregnant,’’ it 

said . . . 

‘‘I’m going to have this baby,’’ said the resolute teen. 

‘‘Well, good!’’ Anna responded happily. ‘‘She had our love 

and support,’’ Anna said. Anna recalled that over the ensuing weeks, Jane was excited. She returned from an 

ultrasound appointment with images of her unborn daughter—one for every member of the family, each addressed to 

the new grandparents and aunts and uncles. Anna’s read, 

‘‘Hi, Grandma!’’ And the family went shopping for maternity clothes and baby gifts. But not everyone welcomed the 

new baby. Jane told Anna that the boyfriend’s father had 

offered her $5,000 to abort. But Jane was adamant to give 

birth to the baby. When the offer rose to $10,000, Anna 

and her husband were again concerned for their impressionable daughter and reminded her, ‘‘We’re here to support you. We’re here to help you,’’ Anna said. But soon, the 

boyfriend had convinced Jane to move out and in with 

him. Then came the boyfriend’s ‘‘speech.’’ It began with, 

‘‘Don’t tell your family,’’ explained Anna, who with Jane, 

later found the boyfriend’s highly crafted, typewritten 

draft. ‘‘Here is the need for parental notification,’’ Anna 

stressed. ‘‘Manipulative boyfriend. ‘Don’t tell.’ ’’ ‘‘Isn’t that 

what every abuser does to his victim—gets them into a 

‘Don’t tell’ situation?’ ’’ Anna observed . . . ‘‘I finally said, 

‘OK [to the abortion],’ ’’ Jane later explained to her mother. 

‘‘I didn’t say, ‘Yes.’ ’’ The boyfriend flew Jane to Seattle, 

where Alaska abortion clinics often refer late-term pregnant mothers. As with Alaska, Washington does not require abortion practitioners to notify a minor girl’s parent 

before performing an abortion on her. The day of the secret 

abortion, Jane was 17 years old. Her unborn baby daughter was heading into her sixth month. And because of the 


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69Steven Ertelt, ‘‘Alaska Mother Mourns Her Daughter’s Secret Abortion,’’ LifeNews.com (August 6, 2010), available at http://www.lifenews.com/2010/08/06/state-5320/. 70Steven Ertelt, ‘‘Abortion Center Director Admits Out-of-State Teens Go There to Avoid Parents,’’ LifeNews.com (July 30, 2006), available at http://www.lifenews.com/2006/07/30/nat-2461/ 

. 

abortionist’s silence, Anna believes her own rights as a 

mother were sacrificed that day, too.69

Also, as reported by LifeNews: 

Hagerstown, MD—When the Senate approved a bill last 

week prohibiting taking a teenager to another state for an 

abortion without her parents’ knowledge or consent, abortion advocates claimed the practice rarely occurs. However, 

the director of a Maryland abortion business says it routinely gets calls from teens wanting to avoid parental involvement laws. Teenagers in Pennsylvania’s York County 

are apparently heading to the Hagerstown Reproductive 

Health Services abortion business in neighboring Maryland. They appear to be wanting to avoid a Pennsylvania 

state law that requires parental consent for a minor girl 

to have an abortion and requires all women to wait 24 

hours to have an abortion after getting information on 

fetal development and abortion’s medical risks and alternatives. 

The HRHS abortion facility sits just 8–10 miles away 

from the Pennsylvania-Maryland border and it regularly 

advertises in York County’s Yellow Pages. 

‘‘It’s clear to us that we receive calls from young women 

in Pennsylvania who already called a clinic in Pennsylvania, and they want to circumvent the state laws,’’ the 

HRHS abortion center administrator told the York Daily 

Record . . . 

Sheryl Wolf, spokeswoman for Hillcrest Clinic, another 

Maryland abortion business, said 70 young women came 

there from Pennsylvania . . . Missouri teens frequently 

are taken to the Hope Clinic abortion facility in Granite 

City, Illinois, which neighbors St. Louis, Missouri. Though 

Missouri requires parental involvement before an abortion, 

Illinois does not. Last year, Shawn Reagan told Missouri 

state lawmakers about her problems with the Illinois abortion center. 

Reagan said she wept as she talked with staff at Hope 

Clinic who refused to let her talk to her 14-year-old daughter who was inside the facility preparing for an abortion. 

She was eventually arrested trying to find her daughter in 

the abortion facility. The girl was reportedly taken to Hope 

Clinic by the mother of the man who allegedly impregnated the 14-year-old. The woman, posing as the girl’s 

grandmother, had the girl called off from school. When the 

girl left the abortion facility after having an abortion, employees told her, ‘‘No one will ever know you were here, 

we’ll bury your records.’’ 70

As reported in American Medical News, about ‘‘6% of the [Hope] 

clinic’s patients are teens. Of those, 40% are from Missouri, comVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00016 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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71 Amy Lynn Sorrel, ‘‘State High Court Limits Reach of Missouri Abortion Consent Law,’’ 

American Medical News (June 4, 2007), available at http://www.ama-assn.org/amednews/2007/ 

06/04/gvsb0604.htm. 72 Available at http://www.courant.com/media/acrobat/2011–10/65523671.pdf. 73 Vernon’s Annotated Missouri Statutes 188.250. 74Planned Parenthood of Kansas v. Nixon, 220 S.W.3d. 722, 743 (Mo. 2007). 75Planned Parenthood of Kansas v. Nixon, 220 S.W.3d. 722, 742 (Mo. 2007). 76See Ala. Code §§ 26–21–1 to –8 (2003); Alaska Stat. §§ 18.16.010–030 (Michie 2003); Ariz. 

Rev. Stat. § 36–2152 (2004); Ark. Code Ann. §§ 20–16–801 to –808 (Michie 2003); Cal. Health 

& Safety Code § 123450 (West 2004); Colo. Rev. Stat. Ann. §§ 12–37.5–101 to –108 (West 2004); 

Conn. Gen. Stat. Ann. § 19a-601 (West 2003); Del. Code Ann. tit. 24, §§ 1780–1789B (2003); Fla. 

Stat. Ann. ch. 390.01115 (Harrison 2004); Ga. Code Ann. §§ 15–11–110 to –118 (Harrison 2003); 

Idaho Code § 18–609A (2003); 750 Ill. Comp. Stat. Ann. 70/1–99 (West 2004); Ind. Code Ann. 

§§ 16–18–2–267, 16–34–2–4 (West 2004); Iowa Code Ann. §§ 135L.1-.8 (West 2003); Kan. Stat. 

Ann. § 65–6705 (2003); Ky. Rev. Stat. Ann. § 311.732 (Michie 2003); La. Rev. Stat. Ann. 

§ 40:1299.35.5 (West 2004); Me. Rev. Stat. Ann. tit. 22, § 1597–A (West 2003); Md. Code Ann., 

Health-Gen. I § 20–103 (2004); Mass. Gen. Laws Ann. ch. 112, § 12S (West 2004); Mich. Comp. 

Laws Ann. §§ 722.901-.908 (West 2004); Minn. Stat. Ann. § 144.343 (West 2004); Miss. Code 

Ann. §§ 41–41–51 to –63 (2003); Mo. Ann. Stat. §§ 188.015, 188.028 (West 2004); Mont. Code 

Ann. §§ 50–20–201 to –215 (2003); Neb. Rev. Stat. §§ 71–6901 to—6909 (2003); Nev. Rev. Stat. 

§§ 442.255-.257 (2003); N.H. Rev. Stat. Ann. §§ 132:24–28 (2003); N.J. Stat. Ann. §§ 9:17A–1 to 

–1.12 (West 2004); N.M. Stat. Ann. §§ 30–5–1 to –3 (Michie 2003); N.C. Gen. Stat. §§ 90–21.6 

to .10 (2003); N.D. Cent. Code §§ 14–02.1–03.1 (2003); Ohio Rev. Code Ann. §§ 2919.12, 2919.121- 

.122 (West 2004); 18 Pa. Cons. Stat. Ann. § 3206 (West 2004); R.I. Gen. Laws § 23–4.7–6 (2003); 

S.C. Code Ann. §§ 44–41–30 to –37 (Law. Co-op. 2003); S.D. Codified Laws § 34–23A–7 (Michie 

2004); Tenn. Code Ann. § 37–10–301 to –304 (2004); Tex. Fam. Code Ann. §§ 33.001-.004 (Vernon 

2004); Utah Code Ann. § 76–7–304 (2003); Va. Code Ann. § 16.1–241 (Michie 2004); W. Va. Code 

Continued 

pared with 50% from Illinois.’’ 71 CIANA would require Hope Clinic 

to notify a parent of any minor girl who comes from Missouri for 

an abortion. 

Congress must act to maintain the integrity of state parental involvement laws. In October, 2011, the Connecticut Catholic Public 

Affairs Conference prepared this report on the state of abortion in 

Connecticut, relying on data from the Connecticut Department of 

Public Health. Table 3 on page 2 of the report notes that ‘‘of the 

863 abortions performed on minors from out-of-state between 2002 

and 2010, 91% of those cases came from bordering states with parental consent laws [361 teens from Rhode Island and 422 from 

Massachusetts, 53 from New York].’’ 72

Further, in 2005, the State of Missouri enacted a law creating a 

civil cause of action against any person who violates the statutory 

prohibition that ‘‘[n]o person shall intentionally cause, aid, or assist 

a minor to obtain an abortion’’ without the consent (or court order) 

required by Missouri law.73 In 2007, the Missouri Supreme Court 

interpreted this statutory language so that it would not apply to 

out-of-state abortionists. The court held that the statute ‘‘applies to 

in-state conduct and not to wholly out-of-state conduct.’’ 74 The 

court said that ‘‘it is beyond Missouri’s authority to regulate conduct that occurs wholly outside of Missouri, and section 188.250 

cannot constitutionally be read to apply to such wholly out-of-state 

conduct. Missouri simply does not have the authority to make lawful out-of-state conduct actionable here, for its laws do not have 

extraterritorial effect.’’ 75 This is all the more reason why Congress 

needs to exercise its authority and enact CIANA. Congress has the 

constitutional authority to pass CIANA under the Commerce 

Clause of the Constitution, which expressly authorizes Congress to 

regulate interstate activity. 

STATE LAW AND CIANA’S PROTECTION OF STATE LAW

There are currently over 43 states with parental involvement 

statutes on the books.76 Of these statutes, the large majority are 


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§§ 16–2F–1 to –8 (2004); Wis. Stat. Ann. § 48.375 (West 2003); Wyo. Stat. Ann. § 35–6–118 

(Michie 2003). 77See Planned Parenthood v. Heed, 390 F.3d 53 (1st Cir. 2004) (unconstitutional for lack of 

health exception); Planned Parenthood of Idaho, Inc. v. Wasden, 376 F.3d 908 (9th Cir. 2004) 

(concluding that the Idaho statute’s definition of Amedical emergency@ is unconstitutionally 

narrow and that, without an adequate medical exception, the parental consent statute is invalid); Glick v. McKay, 937 F.2d 434 (9th Cir. 1991) (judicial bypass procedure rendered statute 

unconstitutional); Zbaraz v. Ryan, No. 84 CV771, 1996 WL 33293423 (N.D. Ill. Feb. 8, 1996) 

(the Illinois Supreme Ct. refused to issue rules implementing the Illinois statute); Planned Parenthood of Alaska, Inc. v. State, No. 3AN–97–6014 CI (Alaska Super. Ct. Oct. 13, 2003) (decision 

on remand from State v. Planned Parenthood of Alaska, 35 P.3d 30 (Alaska 2001)) (parental consent law with judicial waiver violates state constitution); American Acad. of Pediatrics v. Lungren, 940 P.2d 797, 800 (Cal. 1997) (parental consent statute violated state constitutional right 

to privacy); N. Fla. Women’s Health and Counseling Services, Inc. v. State, 866 So. 2d 612 (Fla. 

2003) (state supreme court held that law violated state right to privacy; however, the state constitution was amended in November 2004 to allow parental notification); Wicklund v. State, No. 

ADV–97–671 (Mont. Dist. Ct. Feb. 11, 1999) available at http://www.mtbizlaw.com/1stjd99/ 

WICKLUNDl2l11.htm (parental notification law violated state constitution); Planned Parenthood of Central New Jersey v. Farmer, 762 A.2d 620 (N.J. 2000) (parental notification law with 

judicial waiver violates state constitution); N.M. A.G. Op. No. 90–19 (Oct. 3 1990) (State attorney general holds law unenforceable due to lack of judicial bypass procedure). In addition, Ohio’s 

parental notification law is in effect because a subsequently enacted parental consent statute 

was enjoined. See Cincinnati Women’s Services v. Voinovich, No. C–1–98–289 (S.D. Ohio Apr. 

29, 1998) (preliminary injunction preventing enforcement of the law). 78 A 1989 memo prepared by the Minnesota Attorney General regarding Minnesota’s experience with its parental involvement law states that ‘‘after some 5 years of the statute’s operation, 

the evidence does not disclose a single instance of abuse or forceful obstruction of abortion for 

any Minnesota minor.’’ Testimony before the Texas House of Representatives on Massachusetts’ 

experience with its parental consent law revealed a similar absence of unintended, but harmful, 

consequences. Ms. Jamie Sabino, chair of the Massachusetts Judicial Consent for Minors Lawyer 

Referral Panel, could identify no case of a Massachusetts’ minor being abused or abandoned as 

a result of the law. See Hearing on Tex. H.B. 1073 Before the House State Affairs Comm., 76th 

Leg., R.S. 21 (Apr. 19, 1999) (statement by Jamie Sabino). 79See Hearing on Tex. H.B. 1073 Before the House State Affairs Comm., 76th Leg., R.S. 21 

(Apr. 19, 1999) (statement by Jamie Sabino, testifying that there had been no increase in the 

number of illegal abortions in Massachusetts since the enactment of the statute in 1981). 80Parental Notification of Abortion: Hearings on H. 218 Before the House Comm. on Judiciary, 

2001–2002 Legis. (Vt. 2001) (Lori Burris, representative of Vermont Academy of Pediatrics). 

in effect today.77 Despite widespread support for parental involvement laws and clear public policy considerations justifying such 

laws, there exists substantial evidence, outlined above, that they 

are frequently circumvented by adults who transport minors to 

abortion providers in states that do not have parental notification 

or consent laws. One purpose of CIANA is to curb the interstate 

circumvention of these laws, thereby protecting the rights of parents and the interests of vulnerable minors. 

Parental involvement laws have been in force for decades, and 

there is no case where it has been established that these laws led 

to parental abuse or to self-inflicted injury.78 Similarly, there is no 

evidence that these laws have led to an increase in illegal abortions.79

Despite these critical benefits of better-informed selection of 

abortion providers, improved medical histories, appropriate post-operative care, and the affirmation of parental rights, opponents of 

CIANA argue that mandatory parental involvement results in girls’ 

delaying their decisions to obtain abortions, thus increasing the 

risks attendant to the procedure.80 There is no evidence, however, 

that parental involvement laws result in medically significant 

delays in obtaining abortions. A study of Minnesota’s parental notification law found that, ‘‘Regardless [of the reason], the claim that 

the law caused more minors to obtain late abortions is unsubstantiated. In fact, the reverse is true. For ages 15–17, the number of 

late abortions per 1,000 women decreased following the enactment 


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81 Rogers, James L., Boruch, Robert F., Stoms, George B. & DeMoya, Dorothy, ‘‘Impact of the 

Minnesota Parental Notification Law on Abortion and Birth,’’ 81 Amer. J. Pub. Health 294, 297 

(Mar. 1991). Cf. Ellertson, Charlotte, ‘‘Mandatory Parental Involvement in Minors’ Abortions: 

Effects of the Laws in Minnesota, Missouri, and Indiana,’’ 87 Am. J. Pub. Health 1367, 1372 

(August 1997) (‘‘Evidence concerning delay is mixed.’’). See also id. at 1374 (‘‘During periods of 

the laws’ enforcement in Minnesota and Indiana, the two states with gestational age at abortion, 

in-state abortions for minors were probably delayed into the second month of pregnancy, although probably not into the second trimester.’’). 82 In 2001, 853,485 legal induced abortions were reported to CDC. See Lilo T. Strauss, M.A., 

Joy Herndon, M.S., Jeani Chang, M.P.H., Wilda Y. Parker Sonya, V. Bowens, M.S., Suzanne 

B. Zane, D.V.M., Cynthia J. Berg, M.D., ‘‘Abortion Surveillance—United States, 2001,’’ Centers 

for Disease Control, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (November 26, 2004). 83See, e.g., William D. Valente, 2 Education Law: Public and Private § 19.23 at 212 (acknowledging ‘‘[t]he common school practice of obtaining written parental consents or waivers . . . for 

designated [school field trip] activities’’); Cal. Educ Code Ann § 49302 (requiring parental consent before pupils can be transported). 84See, e.g., Ala. Code § 22–17A2; Alaska Stat. § 08.13.217; Del. Code Ann. tit. 11, § 1114; 720 

Ill. Comp. Stat. Ann. 5/12–10.1; Kan. Stat. Ann. § 65–1953; Me. Rev. Stat. Ann. tit. 32, § 4323; 

Mich. Comp. Laws Ann. § 333.13102; Mo. Ann. Stat. § 324.520; N.C. Gen. Stat. § 14–400; Okla. 

Stat. Ann. tit. 21, § 842.1; Tenn. Code Ann. § 62–38–302; Tex. Health & Safety Code Ann. 

§ 146.012. 85See, e.g., Ariz. Rev. Stat. Ann. § 13–3721; La. Rev. Stat. Ann. § 14:93.2; R.I. Gen. Laws § 23– 

1–39; Utah Code Ann. § 76–10–2201; Va. Code Ann. § 18.2–371.3. 86See, e.g., Cal. Penal Code § 652; Fla. Stat. Ann. § 381.0075(7); Ind. Code Ann. § 35–42–2– 

7; S.C. Code Ann. § 44–32–120. 87 Ala. Code 22–17A–2 (prohibits anyone from performing a tattoo, brand or body piercing on 

a minor unless prior written informed consent is obtained from the minor’s parent or legal 

guardian); Ariz. Rev. Stat. Ann. § 13–3721 (establishes that it is unlawful to either tattoo or 

body pierce anyone under age 18 without the physical presence of the parent or legal guardian; 

violators are guilty of a Class 6 felony; allows anyone to avoid prosecution if he or she requested 

the ID and relied on the accuracy of the information contained in the ID); Ark. Stat. Ann. § 5– 

27–228 (prohibits anyone from tattooing, body piercing or branding a minor without the written 

consent of one of the minor’s parents, a guardian or a custodian; violators are guilty of a misdemeanor and, upon conviction, will be fined between $20 and $200); Cal. Penal Code § 652 (establishes that it is unlawful to tattoo or offer to tattoo anyone under age 18; violators are guilty 

of a misdemeanor; prohibits anyone from performing or offering to perform body piercing upon 

anyone under age 18 unless the piercing is performed in the presence of a parent or guardian 

or as directed by and notarized by the minor’s parent or guardian; does not apply to emancipated minors and does not include pierces of the ear); Col. Rev. Stat. Ann. § 25–4–2103 (prohibits anyone from performing a body art procedure on a minor unless the artist has received 

express consent from the minor’s parent or guardian; failure to obtain permission before performing the procedures on a minor shall constitute a petty offense punishable by a fine of $250); 

Conn. Gen. Stat. § 19a-92g (establishes that it is illegal to tattoo an unemancipated minor under 

age 18 without the written consent of the minor’s parent or guardian; requires written consent 

of the minor’s parent in order to perform body piercing on an unemancipated minor under age 

18); Del. Code Ann. Title 11, Ch 5 § 1114(a) (it is illegal for a person to either knowingly or 

negligently tattoo or body pierce a minor without the prior written consent of the parent or legal 

guardian who must be over age 18); Fla. Stat. § 381.0075 (requires written, notarized consent 

of a minor’s parent or legal guardian in order to tattoo a minor; prohibits body piercing of a 

minor without the written, notarized consent of the parent or legal guardian or if he or she is 

Continued 

of the law. Therefore, an increased medical hazard due to a rising 

number of late abortions was not realized.’’ 81

OTHER PARENTAL NOTICE STATUTES

CIANA will strengthen the effectiveness of state laws designed 

to protect children from the health and safety risks associated with 

abortion.82 Across the country, officials must obtain parental consent before performing even routine medical services such as providing aspirin and before including children in certain activities 

such as field trips and contact sports.83 Regarding body piercing, 

states require written parental consent,84 a parent to be present 

when a minor is pierced,85 and written permission or a parent’s 

physical presence.86 The large majority of states have laws prohibiting adolescents from getting tattoos without parental consent, 

and a majority of states have laws against body piercing without 

parental consent and laws that prohibit both without parental consent.87 Also, in Maryland, for example, as the Washington Post reVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00019 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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accompanied by a parent or legal guardian); Ga. Code § 16–5–71.1 (prohibits the tattooing of 

anyone under age 18 by anyone other than a licensed osteopath or technician acting under the 

direct supervision of a licensed physician or osteopath; violators are guilty of a misdemeanor; 

prohibits anyone from body piercing anyone under age 18 without prior written consent of the 

custodial parent or guardian; violators are guilty of a misdemeanor); Idaho Chapter No. 127 

2004 (effective July 1, 2004) (prohibits the tattooing, branding or body piercing of minors under 

the age of 14; prohibits the tattooing, branding or body piercing on anyone between the ages 

of 14 and 18 without the written informed consent of the minor’s parent or legal guardian; written informed consent must be executed in the presence of the person performing the act or an 

employee or agent of that person; violators are guilty of a misdemeanor and will be fined up 

to $500 and subsequent violations within 1 year will be fined between $500 and $1,000; piercing 

of the ear lobes and piercing for medical purposes are exempted from this legislation) Ill. Compiled Stat. 5/12–10.1 (it is a Class C misdemeanor for anyone, other than a person licensed to 

practice medicine in all branches, to tattoo or offer to tattoo a person under age 21; establishes 

that anyone who pierces the body of a minor under age 18 without written consent of the parent 

or legal guardian commits a Class C misdemeanor; does not apply to emancipated or married 

minors; Ind. Code Ann. § 35–42–2–7 (requires a minor’s parent or legal guardian to be present 

on order to either tattoo or perform body piercing on a minor under age 18; requires the parent 

or guardian to also provide written permission for the minor to receive the tattoo or body piercing); Iowa Code § 135.37 (prohibits anyone from tattooing an unmarried minor under age 18; 

upon conviction, violators are guilty of a serious misdemeanor); Ky. Rev. Stat. § 211.760 (prohibits anyone from tattooing or body piercing minors without the written, notarized consent of 

a parent or guardian); La. Rev. Stat. Ann. § 14:93.2 (it is unlawful for anyone to tattoo or body 

pierce a minor under age 18 without the consent of the minor’s accompanying parent or legal 

custodian; upon conviction, violators shall be fined between $100 and $500 or imprisoned between 30 and 100 days, or both); Me. Rev. Stat. Ann. Title 32, Ch. 64 § 4323 (establishes that 

it is illegal to tattoo anyone under age 18; requires prior written consent of a minor’s parent 

or legal guardian to perform body piercing on anyone under age 18); Mich. Comp. Laws Ann. 

§ 333.13102 (prohibits anyone from either tattooing or performing body piercing on a minor without prior written, informed consent of the minor’s parent or legal guardian; requires the parent 

or legal guardian to execute the consent in the presence of either the person performing the 

body piercing or tattooing on the minor or in the presence of an employee or agent of the individual; does not include emancipated minors); Minn. Stat. § 609.2246 (it is unlawful for anyone 

under age 18 to receive a tattoo without written parental consent); Miss. Laws § 73–61–3 (prohibits anyone from tattooing or body piercing a minor under age 18; violators are guilty of a 

misdemeanor and will be fined a maximum of $500); Mo. Rev. Stat. § 324.520 (prohibits anyone 

from knowingly tattooing or body piercing a minor without prior written, informed consent of 

the minor’s parent or legal guardian; requires the parent or legal guardian to execute the written consent in the presence of either the person performing the tattooing or body piercing or 

an employee or agent of that person; violators are guilty of a misdemeanor and will be fined 

a maximum of $500; subsequent violations within 1 year of the initial violation will be subject 

to a fine of between $500 and $1,000); Mont. Code Ann. § 45–5–623 (prohibits anyone from 

knowingly tattooing a child under the age of majority without the explicit in-person consent of 

the child’s parent or guardian; upon conviction, violators will be either fined a maximum of 

$500, imprisoned for up to 6 months, or both; those convicted of a second offense will either 

be fined a maximum of $1,000, imprisoned for up to 6 months, or both); N.C. Gen. Stat. § 14– 

400 (prohibits anyone from tattooing a minor under age 18; violators are guilty of a Class 2 

misdemeanor; prohibits anyone from piercing any part of a minor under age 18 other than the 

ears without the prior consent of the custodial parent; violators are guilty of a Class 2 misdemeanor); Ohio Rev. Code Ann. § 3730.06 (it is illegal to tattoo, body pierce or pierce the ears 

of anyone under age 18 without the consent of the minor’s parent, guardian or custodian; requires the consenting individual to appear in person at the business at the time the procedure 

is performed and sign a document that provides informed consent); Okla. Stat. Title 21 §§ 841 

and 842.1 (prohibits anyone other than a licensed practitioner of the healing arts in the course 

of their practice from tattooing or offering to tattoo anyone; it is unlawful for anyone to perform, 

or offer to perform, body piercing on a child under age 18 unless the parent or legal guardian 

gives written consent for and is present during the procedure; penalties for violations include 

imprisonment for up to 90 days and a fine of up to $500, or both); Pa. Cons. Stat. Title 18 § 6311 

(it is unlawful to provide tattoo services to anyone under age 18 without the consent of the parent or guardian; violators are guilty of a misdemeanor of the third degree and, upon conviction, 

will be sentenced to either pay a maximum fine of $100 or be imprisoned a maximum of 3 years, 

or both); R.I. General Laws §§ 11–9–15; 23–1–39 (prohibits tattooing or body piercing a minor 

who is unaccompanied by his or her consenting parent or guardian; violators are guilty of a misdemeanor and, upon conviction, will either be imprisoned a maximum of 1 year or fined a maximum of $300); S.D. Codified Laws Ann. § 26–10–19 (requires anyone who is tattooing a minor 

under age 18 to obtain a signed consent form from the minor’s parents authorizing a tattoo; 

violators are guilty of a Class 2 misdemeanor); Tenn. Code Ann. §§ 62–38–207; 62–38–305 and 

306 (establishes that a minor age 16 or older may be tattooed with the written consent of the 

parent or legal guardian to cover up an existing tattoo and requires the parent or legal guardian 

to be present during the procedure; it is a Class C misdemeanor for anyone to tattoo a person 

under age 18; allows a minor age 18 or younger to undergo body piercing with the written consent of the parent, legal guardian or legal custodian and requires them to be present during 

the procedure; they must sign a document that explains the procedure and methods for proper 

care, present proof of age and attest in writing that they are the minor’s parent, legal guardian 

or legal custodian; violators will be charged with a Class C misdemeanor and will be imprisoned 

for up to 30 days or pay a fine of up to $50); Texas Health and Safety Code Ann. §§ 146.012; 

146.0125 (prohibits anyone from performing a tattoo on anyone under age 18 without the conVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00020 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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sent of a parent or guardian who believes it is in the best interest of the minor to cover an 

obscene of offensive tattoo; required consent may be the physical presence of the individual’s 

parent or guardian or the provision of evidence that he or she is the parent or guardian of the 

person who is getting the tattoo; prohibits anyone from performing body piercing on an individual under age 18 without the consent of the individual’s parent, managing conservator or 

guardian; consent must specify the part of the body to be pierced. Required consent is the physical presence of the individual’s parent or guardian and the provision of evidence stating their 

parental or guardian status); Utah Code Ann. § 76–10–2201 (prohibits anyone from performing 

or offering to perform a tattoo or body piercing upon a minor without receiving the consent of 

the minor’s parent or legal guardian; establishes that a person is not guilty of a violation if he 

or she (a) had no actual knowledge of the minor’s age and (b) reviewed, recorded and maintained 

a personal identification number for the minor prior to performing the body piercing or tattoo; 

violators are guilty of a Class C misdemeanor and the owner or operator of the establishment 

where the act takes place is subject to a civil penalty of $750 for each violation); Vt. Stat. Ann. 

Title 26 § 4102 (prohibits anyone from tattooing a minor without the written consent of his or 

her parent or guardian); Va. Code § 18.2–371.3 (prohibits anyone from tattooing or performing 

body piercing on a person under age 18, knowing or having reason to believe that the person 

is under 18 except (a) in the presence of the person’s parent or guardian or (b) when done by 

or under the supervision of a medical doctor, registered nurse, or other medical services personnel in the performance of their duties; violators are guilty of a Class 2 misdemeanor. A second or subsequent violation shall be punished as a Class 1 misdemeanor; excludes ear piercing 

as a form of body piercing); Wash. Rev. Code § 26.28.085 (applying a tattoo to a minor under 

age 18 is illegal and violators are guilty of a misdemeanor; prohibits anyone from stating that 

he or she did not know the minor’s age as a defense to prosecution, unless he or she establishes 

that by a preponderance of evidence he or she made a reasonable attempt to determine the true 

age of the minor by requiring a driver’s license or other picture ID card and did nor rely solely 

on oral allegations); W. Va. Code § 16–38–3 (requires prior written consent from a parent or 

guardian for the tattooing of a minor); Wis. Stat. § 948.70 (prohibits anyone other than a physician in the course of his or her professional practice from tattooing or offering to tattoo a child; 

violators are subject to a Class D forfeiture); Wyo. Stat. § 14–3–107 Chapter 47 2004 (Effective 

July 1, 2004) (prohibits anyone from tattooing a person under the age of majority, except with 

the consent of the person’s parent or legal guardian who is present at the time the procedure 

is performed; violators are guilty of a misdemeanor and punishable by imprisonment for a maximum of 6 months, a fine of a maximum of $750, or both; prohibits performing body art on anyone who had not reached the age of majority without the consent of the parent or legal guardian 

and who is present at the time of the procedure; violators are guilty of a misdemeanor and punishable by imprisonment for a maximum of 6 months, a fine of a maximum of $750, or both; 

body art is defined as the practice of body piercing, branding scarification, sculpting or 

tattooing). 88See Daniel de Vise, ‘‘Bill Would Legislate Maryland Students’ Use of Sunscreen,’’ The Washington Post (March 29, 2005). 89 443 U.S. 622 (1979) (Bellotti II). 90 Id. at 644. 91 Id. Factors that may be considered in determining ‘‘immaturity’’ include work and personal 

experience, appreciation of the gravity of the procedure, and judgment. See Hodgson v. Minnesota, 497 U.S. 417 (1990). Under the ‘‘best interests’’ analysis, judges often consider medical 

risks to the minor as a result of the time, place, or type of procedure to be performed, medical 

risks particular to the girl, evidence of physical, sexual, or emotional abuse by parents or guardians, and abortion alternatives such as marriage, adoption, and single motherhood. 

ports, eleven school systems require a parent’s note before sunscreen can be applied to a minor student.88 Notwithstanding the 

extensive body of State law requiring parental consent before 

minor children can engage in a range of less consequential activity, 

people other than parents can secretly take children across state 

lines without the consent of their parents for abortions. 

STATE JUDICIAL BYPASS PROCEDURES

In Bellotti v. Baird,89 a plurality of the United States Supreme 

Court set forth the basic test by which judicial bypass proceedings 

pursuant to a parental consent statute, if judicial bypass provisions 

are enacted at all, must be reviewed. Bypass procedures must allow 

the minor to show that she possesses maturity and information to 

make the abortion decision, in consultation with her physician, 

without regard to her parents’ wishes; allow the minor to show 

that, even if she cannot make the decision by herself, the ‘‘desired 

abortion would be in her best interests’’ 90 ; be confidential; and be 

conducted ‘‘with expedition to allow the minor an effective opportunity to obtain the abortion.’’ 91


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92See Child Custody Protection Act: Hearings on H.R. 1218 Before the Subcomm. on the Constitution of the House Comm. on the Judiciary, 106th Cong. (May 27, 1999) (statement of Billie 

Lominick). 93 Bellotti v. Baird, 443 U.S. 622, 644 (1979) (plurality opinion). 94 868 F.2d 459 (1st Cir. 1989). 95 Id. at 469 (quoting Hodgson v. Minnesota, 648 F. Supp. 756, 777 (D. Minn. 1986)). 96 Id. at 463. 97 Id. at 461 n.6. 98See Cleveland Surgi-Center, Inc. v. Jones, 2 F.3d 686, 690 (6th Cir. 1993). 99Planned Parenthood v. Lawall, 180 F.3d 1022 (9th Cir. 1999). 100 Id. at 1027. 

Critics of CIANA claim that the measure endangers the health 

of young girls who are forced to travel out of state to obtain abortions because the judges in their home states either refuse to hear 

judicial bypass petitions or deny them arbitrarily. In support of 

this argument, the critics cite cases like that of Ms. Billie 

Lominick, who testified before the Constitution Subcommittee regarding her experience with South Carolina’s judicial bypass procedures. According to Ms. Lominick, who assisted her grandson’s 

girlfriend in obtaining an out-of-state abortion, only two judges in 

the state of South Carolina would hear a judicial bypass petition, 

and one of those judges, according to Ms. Lominick, would hear petitions only from girls residing in his county.92

Such examples ignore the fact that CIANA provides assistance 

only in the enforcement of constitutional state parental notice and 

consent laws. If there are only two judges in an entire state willing 

to hear judicial bypass proceedings, that state’s parental involvement laws are likely unconstitutional under Supreme Court precedent, which requires the state to provide a minor the opportunity 

to seek a judicial bypass with ‘‘sufficient expedition to provide an 

effective opportunity for an abortion to be obtained.’’ 93

This fact is illustrated by the First Circuit’s decision in Planned 

Parenthood League v. Bellotti (‘‘Bellotti II’’). 94 In that case, the 

court held that the plaintiffs could successfully challenge the state’s 

judicial bypass procedures if they could present ‘‘proof of ‘a systemic failure to provide a judicial bypass option in the most expeditious, practical manner.’ ’’ 95 The court of appeals remanded the 

case to the lower court so that the plaintiffs could present evidence 

that, among other things, judges were ‘‘‘defacto unavailable’ to hear 

minors’ abortion petitions,’’ 96 and many judges were avoided ‘‘for 

reasons of hostility.’’ 97 The Sixth Circuit has also recognized that 

a constitutional challenge may be brought for a state’s systemic 

failure to provide an expeditious judicial bypass.98

Not only must states provide access to judges who are willing to 

hear judicial bypass petitions, states must also ensure that the 

judges who do hear bypass petitions render their decisions in an 

expedited fashion. For example, in Planned Parenthood v. 

Lawall, 99 the Court of Appeals for the Ninth Circuit struck down 

an Arizona parental consent statute on the grounds that its judicial 

bypass provision lacked specific time limits and was therefore in 

violation of the Bellotti II expediency requirement. The court 

reached this conclusion even though the Arizona statute stated 

that such proceedings were to be given priority and required that 

‘‘the court shall reach the decision [on a bypass request] promptly 

and without delay to serve the best interests of a pregnant 

minor.’’ 100 The court’s rationale in adopting a strict interpretation 

of the Supreme Court’s timeliness requirement was that ‘‘[o]penVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00022 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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101 Id. at 1030. 102See Causeway Medical Suite v. Ieyoub, 109 F.3d 1096 (5th Cir. 1997). 103 Id. at 1110–11. 104 Child Custody Protection Act: Hearings on H.R. 1755 Before the Subcomm. on the Constitution of the House Comm. on the Judiciary, 108th Cong., 41 (2004) (testimony of Rev. Lois M. 

Powell). 105 Id. at 37 (statement of Teresa Collett). 106See Orr v. Knowles, 337 N.W.2d 699, 706 (Neb. 1983) (‘‘This statute does not provide that 

the state or anyone else will contest the minor’s claim that she is mature enough to make the 

abortion decision herself. Rather, she will present evidence, and the judge will then make the 

decision as to her maturity. Since there is no adversarial aspect to these proceedings, we find 

that no petitioning minor, indigent or otherwise, is entitled to free court-appointed counsel as 

a matter of right in proceedings under § 28–347(2).’’). Accord Joseph W. Moylan, ‘‘No Law Can 

Give Me the Right to Do What Is Wrong,’’ in LIFE AND LEARNING V: PROCEEDINGS OF THE FIFTH

UNIVERSITY FACULTY FOR LIFE CONFERENCE at 234, 235 (1995) (explaining Judge Moylan’s decision to resign from a bench in the juvenile court he had occupied for more than 20 years) 

(‘‘When the bill, taken from a Minnesota law, did get passed, it stated that at the hearing the 

pregnant minor is entitled to have an attorney appointed for her and even a guardian ad litem. 

There is nobody on the other side, unless a judge takes it on himself. Now I know of no other 

case that is like that, where it is truly one-sided. If after that one-sided hearing, the judge finds 

that the girl is mature and can give an informed consent, then the judge is required to authorize 

the abortion physician to perform the abortion.’’). 

ended bypass provisions engender substantial possibilities of delay 

for minors seeking abortions.’’ 101

The Fifth Circuit employed essentially identical reasoning in 

striking down a Louisiana judicial bypass procedure having indefinite time limits.102 The court found that ‘‘not only do [the bypass 

procedures] fail to provide any specific time within which a minor’s 

application will be decided, but they give no assurances (assurances 

required by Bellotti II) that the proceedings will conclude expeditiously.’’ 103

As these cases illustrate, judicial bypass procedures must be 

readily accessible and efficient in order to pass constitutional muster. CIANA will assist in the enforcement of only those State parental involvement laws that meet the relevant constitutional criteria. 

In any case, the minority’s own witness at a hearing on H.R. 

1755, the ‘‘Child Custody Protection Act,’’ which contained the 

same provision in CIANA regarding judicial bypass laws, admitted 

that ‘‘I am personally not aware of cases where [a judicial bypass 

procedure] hasn’t worked.’’ 104 Furthermore, testimony received by 

the Constitution Subcommittee indicates that, where judicial bypass procedures are in place, they are not needed in the overwhelming number of cases because a parent’s involvement is obtained. In 2002, 852 girls received abortions in Alabama with a 

parent’s approval and 12 with a judge’s approval, according to state 

health department records. Idaho similarly reported less than 5 

percent of minors using judicial bypass to avoid that state’s parental consent law (64 minors with parental consent, 3 with judicial 

bypass) in 2002. South Dakota reported 14 of 76 minors obtained 

judicial bypasses, rather than parental consent. In Texas where 

3,654 minors obtained abortions, the Texas Department of Health 

paid for assistance in 284 judicial bypass proceedings. In Wisconsin, less than 10% of the minors obtaining abortions did so with 

the use of an order obtained through judicial bypass (727 with parental involvement, 63 with judicial bypass).105

And far from being too complicated or too intrusive, the judicial 

bypass procedure has been described as ‘‘remarkably simple’’ by the 

Nebraska Supreme Court in Orr v. Knowles.106 In fact, the average 

judicial bypass hearing lasts only 12 minutes, and ‘‘more than 92 


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107 Id. at 648. 108 Robert H. Mnookin, ‘‘Bellotti v. Baird, A Hard Case’’ in IN THE INTEREST OF CHILDREN: ADVOCACY, LAW REFORM, AND PUBLIC POLICY 149, 239 (Robert H. Mnookin ed., 1985). 109Susanne Yates & Anita J. Pliner, ‘‘Judging Maturity in the Courts: the Massachusetts Consent Statute,’’ 78 Am. J. Pub. Health 646, 647 (1988). 110 Hodgson v. Minnesota, 648 F.Supp. 756, 765 (D. Minn. 1986). 111See Ellen Nakashima, ‘‘Fewer Teens Receiving Abortions in Virginia: Notification Law to 

Get Court Test,’’ Washington Post (March 3, 1998) at A1 (‘‘In Virginia, since the law took effect, 

18 teenagers have gone to a judge, who determines whether the girl is mature enough to make 

her own decision about abortion. All but one of the requests were granted eventually.’’) 112 450 U.S. 398, 424 (1981) (Stevens, J., concurring). 

percent of the hearings [were] less than or equal to 20 minutes.’’ 107

The young girl is not subjected to an adversarial process. She is not 

‘‘on trial.’’ A young girl must merely present evidence only about 

her maturity level, not intimate details of her personal life, to the 

court. Then the judge will make his decision. 

Indeed, judicial bypass procedures are overwhelmingly granted 

by the courts. Judicial bypasses provide a safe and effective means 

of insuring the well-being of young girls seeking to abort their 

pregnancies. A survey of Massachusetts cases found that every 

minor who sought judicial authorization to bypass parental consent 

received it.108 Another Massachusetts study found that only 1 of 

477 girls was refused judicial authorization.109 A Minnesota study 

cited that a Federal trial court determined that of the 3,573 bypass 

petitions filed, six were withdrawn, nine were denied, and 3,558 

were granted.110 A survey of the Virginia statute requiring parental notification found that out of 18 requests for judicial bypass, 

‘‘all but one of the requests were granted eventually.’’ 111

CIANA IS BASED ON THE PROPOSITION THAT PARENTS SHOULD BE

GIVEN A CHANCE TO PLAY A ROLE IN THE LIVES OF THEIR MINOR

CHILDREN

Children’s feelings should not trump parental authority. Parents 

are not simply placeholders in a child’s life. They are the 

foundational pillars of civilization. The family unit has provided 

the comfort, stability, and safety necessary to sustain civilization, 

and it has done so for millennia. Parents must be given a chance 

to work with their own children through difficult situations. There 

is no guarantee that parents will be successful in that endeavor, 

and unfortunately there will, no doubt, be a few parents who will 

be indifferent when they are made aware of their daughter’s pregnancy. But that is surely the rare case, and even in that rare case 

nothing in this legislation will bar an abortion. What this legislation affirms is the proposition that parents deserve a chance. Opponents of CIANA must rest their objections on the notion that most 

parents do not deserve that simple chance. But parents do deserve 

that chance, and CIANA would give that chance to parents who 

have not abused or neglected their child. Even famously liberal 

Justice Stevens wrote in his concurring opinion in H.L. v. Matheson 

that ‘‘[t]he possibility that some parents will not react with compassion and understanding upon being informed of their daughter’s 

predicament or that, even if they are receptive, they will incorrectly 

advise her, does not undercut the legitimacy of the State’s attempt 

to establish a procedure that will enhance the probability that a 

pregnant young woman exercise as wisely as possible her right to 

make the abortion decision.’’ 112


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113See, e.g., H.R. Rep. No. 107–397 (2002) at 56 (‘‘It seems to me what this bill is, is really 

akin to the Fugitive Slave Act of the 1850’s where you’re enabling one State in the South, which 

had slavery, to reach over into another State . . . and say, ‘We want our slave back.’ ’’) (remarks 

of Mr. Nadler D–NY). 114Troxel v. Granville, 530 U.S. 57, 65 (2000) (overturning Washington visitation statute 

which unduly interfered with parental rights). 

Nothing in this bill requires a minor who was abused by her parents to notify an abusive parent before having an abortion. And all 

state judicial bypass provisions that are protected by this bill are 

both the product of state law and required to conform to the Supreme Court’s own standards for judicial bypass provisions. Furthermore, all the various additional exceptions opponents have proposed be added to CIANA are simply legislative excuses to deny 

parents that chance. Those who oppose giving parents a chance 

claim life is hopelessly confusing and therefore Congress should not 

act to protect parental rights. But a sister or a brother, or a minister, or some other third party, is not a parent. Sisters and brothers, and ministers, can of course provide their own counseling if a 

minor girl seeks it. But parents are special, and parents deserve 

unique protections when it comes to their ability to protect the 

health and safety of their children. That much is clear. 

Anyone who is truly interested in the best interests of a pregnant 

girl—be they a minister, a sibling, a friend, or anyone else—will 

encourage her to inform her parents and give them the chance of 

helping her address her situation appropriately. It is beyond dispute that it is not in a pregnant girl’s best interests to allow anyone to assist her in circumventing state laws providing for parental 

involvement or to allow anyone to give a pregnant girl who has 

crossed state lines a secret abortion that could have serious medical consequences without notifying a parent. 

Unfortunately, during consideration of this legislation, some opponents of this legislation have equated parents with slave owners.113 Parental rights are not those of a slave owner. They are the 

rights of caring people who deserve a chance to work with their 

children through difficult times and should be provided a chance to 

express their love to their children in their children’s moments of 

greatest need. 

THE FUNDAMENTAL NATURE OF PARENTAL RIGHTS

The United States Supreme Court has described parents’ right to 

control the care of their children as ‘‘perhaps the oldest of the fundamental liberty interests recognized by this Court.’’ 114 In addressing the right of parents to direct the medical care of their children, 

the Supreme Court has stated: 

Our jurisprudence historically has reflected Western civilization concepts of the family as a unit with broad parental 

authority over minor children. Our cases have consistently 

followed that course; our constitutional system long ago rejected any notion that a child is ‘‘the mere creature of the 

State’’ and, on the contrary, asserted that parents generally ‘‘have the right, coupled with the high duty, to recognize and prepare [their children] for additional obligations.’’ Surely, this includes a ‘‘high duty’’ to recognize 

symptoms of illness and to seek and follow medical advice. 

The law’s concept of the family rests on a presumption 


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115Parham v. J.R., 442 U.S. 584, 602 (1979) (emphasis added) (citations omitted) (rejecting 

claim that minors had right to adversarial proceeding prior to commitment by parents for treatment related to mental health). 116 262 U.S. 390, 399 (1923). 117Pierce v. Society of the Sisters, 268 U.S. 510, 535 (1925). 118See Prince v. Massachusetts, 321 U.S. 158, 166 (1944). 119 Unauthorized medical examinations of minors have resulted in liability. See van Emrik v. 

Chemung County Dep’t of Soc. Servs., 911 F.2d 863, 867 (2d Cir. 1990) (parental consent required for x-ray); Tenebaum v. Williams, 193 F.3d 581, 597–99 (2d Cir. 1999)(parental consent 

required for gynecological exam). 120Meyer, 262 U.S. at 400. 121Parham, 442 U.S. at 602–04. See also Hodgson v. Minnesota, 497 U.S. 417 (1990) (a parent 

is ‘‘presumed to act in the minor’s best interest and thereby assures that the minor’s decision 

to terminate her pregnancy is knowing, intelligent, and deliberate’’). 122Parharm, 442 U.S. at 602. 

that parents possess what a child lacks in maturity, experience, and capacity for judgment required for making life’s 

difficult decisions.115

The parents of a minor child have a fundamental right to direct 

the upbringing and education of that child. The Supreme Court 

first recognized the right to ‘‘establish a home and bring up children’’ as a ‘‘privilege[] long recognized at common law as essential 

to the orderly pursuit of happiness by free men’’ in the 1923 case 

of Meyer v. Nebraska in which it struck down as unconstitutional 

a Nebraska law forbidding all schools within its boundaries from 

teaching pupils in any language other than English.116 Two years 

later, striking down an Oregon statute requiring all children, under 

compulsory education laws, to attend public schools, the Court affirmed this principle stating, ‘‘The child is not the mere creature 

of the state; those who nurture him and direct his destiny have the 

right, coupled with the high duty, to recognize and prepare him for 

additional obligations.’’ 117

Coupled with this right, however, is the duty of parents to provide for the care and safety of their children, including their physical and medical well-being. A parent’s duty to provide medical care 

to his or her child is a duty arising from the relationship of parent 

and child. Indeed, the Court has described the ‘‘care and nurture’’ 

of a child as being a ‘‘primary function’’ of parents.118 Ignoring or 

violating a parent’s legal right to direct the upbringing of their children, including the right to direct the medical care received by 

those children, can result in liability.119 In Meyer, the Court stated, 

‘‘Corresponding to the right of control, it is the natural duty of the 

parent to give his children education suitable to their station in life 

[.]’’ 120Certainly this duty to educate includes instructing one’s children on how to best make decisions concerning their health. 

Holding that the State of Georgia’s commitment procedures for 

minor children did not violate the due process rights of minors, the 

Court recognized ‘‘the traditional presumption that the parents act 

in the best interests of their child’’ and warned against discarding 

‘‘wholesale those pages of human experience that teach that parents generally do act in the child’s best interests.’’ 121 The Court 

added, ‘‘Surely, this includes a ‘high duty’ to recognize symptoms 

of illness and to seek and follow medical advice.’’ 122

The Supreme Court has consistently recognized that parents 

have a legal right to be involved in their minor daughter’s decision 

to seek medical care, which includes the abortion procedure. Therefore, the Court has consistently affirmed a state’s right to restrict 

the circumstances under which a minor may obtain an abortion in 


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123 428 U.S. 52, 74 (1976). 124 Bellotti v. Baird, 443 U.S. 622, 633–34 (1979) (Bellotti II). 125 H.L. v. Matheson, 450 U.S. 398, 411 (1981). 126Planned Parenthood v. Danforth, 428 U.S. 52, 91 (1976). 127 505 U.S. 833, 895 (1992). 128 428 U.S. 52 (1976). 129Planned Parenthood v. Danforth, 428 U.S. 52, 91 (1976) (Stewart, J., concurring). 130 443 U.S. 622, 640 (1979) (Bellotti II) (plurality opinion). 

ways in which adult women seeking abortions may not be restricted. Holding that a state may not grant to a third party an absolute, and possibly arbitrary, veto over a minor’s decision to have 

an abortion in Planned Parenthood v. Danforth, the Court added 

‘‘the State has somewhat broader authority to regulate the activities of children than of adults.’’ 123 Indeed, ‘‘the status of minors 

under the law is unique in many respects’’ and the ‘‘unique role in 

our society of the family, the institution by which ‘we inculcate and 

pass down many of our most cherished values, moral and cultural,’ 

requires that constitutional principles be applied with sensitivity 

and flexibility to the special needs of parents and children.’’ 124

SUPREME COURT PRECEDENT SUPPORTS GIVING PARENTS A CHANCE

TO PLAY A ROLE IN THEIR CHILDREN’S ABORTION DECISIONS

Supreme Court precedents support CIANA. The Supreme Court 

has observed that ‘‘[t]he medical, emotional, and psychological consequences of an abortion are serious and can be lasting,’’ 125 and 

that ‘‘[i]t seems unlikely that [the minor] will obtain adequate 

counsel and support from the attending physician at an abortion 

clinic, where abortions for pregnant minors frequently take 

place.’’ 126 Parental involvement in such a decision will lead to improved medical care for minors seeking abortions and provide increased protection for young girls against sexual exploitation by 

adult men. 

On an issue as contentious and divisive as abortion, it is both remarkable and instructive that there is such firm and long-standing 

support for laws requiring parental involvement. Various reasons 

underlie this broad and consistent support. As the Supreme Court, 

including Justices O’Connor, Kennedy, and Souter, observed in 

Planned Parenthood v. Casey,127 parental consent and notification 

laws related to abortions ‘‘are based on the quite reasonable assumption that minors will benefit from consultation with their parents and that children will often not realize that their parents have 

their best interests at heart.’’ 

In Planned Parenthood of Central Missouri v. Danforth,128 noted 

liberal Justice Stewart wrote, ‘‘There can be little doubt that the 

State furthers a constitutionally permissible end by encouraging an 

unmarried pregnant minor to seek the help and advice of her parents in making the very important decision whether or not to bear 

a child.’’ 129 Three years later, in Bellotti v. Baird,130 a plurality of 

the Court acknowledged that parental consultation is critical for 

minors considering abortion because minors often lack the experience, perspective, and judgment to avoid choices that could be detrimental to them. The Bellotti plurality also observed that parental 

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131 Id. at 635. 132See H.L. v. Matheson, 450 U.S. 398, 411 (1981) (‘‘The Utah Statute gives neither parents 

nor judges a veto power over the minor’s abortion decision.’’). 133Ohio v. Akron Center for Reproductive Health, 497 U.S. 502, 511 (1992). 134Planned Parenthood of the Blue Ridge v. Camblos, 155 F.3d 352, 363 (4th Cir. 1998). 135 Bellotti v. Baird, 428 U.S. 132, 147 (1976) (Bellotti I). 136 Bellotti II, 443 U.S. at 635 (quotations and citations omitted). 137 Id. at 635. 138See id. at 637. 139 Id. at 648. 140 Id. 141 450 U.S. 398 (1981). 

sion since, for some, the situation raises profound moral and religious concerns.131

Significantly, the Supreme Court has already concluded that notice statutes do not give parents any ‘‘veto power’’ 132 over the minor’s abortion decision. As the Court reiterated in Akron II, ‘‘notice 

statutes are not equivalent to consent statutes because they do not 

give anyone a veto power over a minor’s abortion decision.’’ 133 A 

one-parent notification law such as one containing CIANA’s abuse 

and life-endangerment exception does not require a judicial bypass. 

As the Fourth Circuit Court of Appeals recognized in Planned Parenthood of the Blue Ridge v. Camblos, ‘‘In contrast to its assessment of parental consent statutes, the [Supreme] Court has consistently recognized that the same potential for absolute veto over 

the abortion decision that inheres in a parental consent statute 

does not inhere in a parental notice statute, and therefore that notice statutes are fundamentally different from—and less burdensome than—consent statutes.’’ 134

Parental involvement in a pregnant minor girl’s abortion decision 

is supported by the common-sense realization that minors often 

lack the maturity to fully comprehend the significance and consequences of their actions. In 1976, when it first addressed Massachusetts’ parental consent statute, the Supreme Court recognized 

that with minors, ‘‘there are unquestionably greater risks of inability to give an informed consent.’’ 135 During its second review of 

Massachusetts’ parental consent law, the Court stated, ‘‘Viewed together, our cases show that although children generally are protected by the same constitutional guarantees against governmental 

deprivations as are adults, the State is entitled to adjust its legal 

system to account for children’s vulnerability and their needs for 

concern, . . . sympathy, and . . . paternal attention.’’ 136 The 

Court continued to describe its previous rulings to allow states to 

‘‘limit the freedom of children to choose for themselves in the making of important, affirmative choices with potentially serious consequences’’ as being ‘‘grounded in the recognition that, during the 

formative years of childhood and adolescence, minors often lack the 

experience, perspective, and judgment to recognize and avoid 

choices that could be detrimental to them.’’ 137

The Supreme Court has pointed to the ‘‘guiding role of parents 

in the upbringing of their children’’ as the basis for its rulings preserving for parents a unique legal authority over the conduct of 

their children.138 The Court has reasoned that ‘‘parents naturally 

take an interest in the welfare of their children[.]’’ 139 This, in the 

Court’s view, creates ‘‘an important state interest in encouraging a 

family rather than a judicial resolution of a minor’s abortion decision.’’ 140 In H.L. v. Matheson, 141 the Court upheld a Utah statute 


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142 Id. at 409–10. 143 505 U.S. 833, 899–900 (1992). 144 Bellotti, 443 U.S. at 637. 145Parham v. J.R., 442 U.S. 584, 602 (1979)(emphasis added). See also Prince v. Commonwealth of Massachusetts, 321 U.S. 158, 166 (1944) (‘‘It is cardinal with us that the custody, care 

and nurture of the child reside first in the parents, whose primary function and freedom include 

preparation for obligations the state can neither supply nor hinder.’’); Wisconsin v. Yoder, 406 

U.S. 205, 232 (1972) (‘‘The history and culture of Western civilization reflect a strong tradition 

of parental concern for the nurture and upbringing of their children. This primary role of the 

parents in the upbringing of their children is now established beyond debate as an enduring 

American tradition.’’). 146Troxel v. Granville, 530 U.S. 57 (2000). 147 Id. at 68–69. 148 Id. at 69. 

requiring a physician to notify, if possible, parents of a minor upon 

whom an abortion is to be performed and stated: 

There can be little doubt that the State furthers a constitutionally permissible end by encouraging an unmarried 

pregnant minor to seek the help and advice of her parents 

in making the very important decision whether or not to 

bear a child. That is a grave decision, and a girl of tender 

years, under emotional stress, may be ill-equipped to make 

it without mature advice and emotional support. It seems 

unlikely that she will obtain adequate counsel and support 

from the attending physician at an abortion clinic, where 

abortions for pregnant minors frequently take place.142

In Planned Parenthood v. Casey, the Court upheld the parental 

consent provisions of Pennsylvania’s Abortion Control Act of 1982, 

stating that they ‘‘provide the parent or parents of a pregnant 

young woman the opportunity to consult with her in private, and 

to discuss the consequences of her decision in the context of the 

values and moral or religious principles of their family.’’ 143 It continued, ‘‘The State commonly protects its youth from adverse governmental action and from their own immaturity by requiring parental consent to or involvement in important decisions by minors.’’ 144

It is instructive that the Court has always held that this important duty to ensure and provide for the care and nurture of minor 

children lies only with parents—a conclusion that arises from the 

traditional legal recognition ‘‘that natural bonds of affection lead 

parents to act in the best interests of their children.’’ 145

Significantly for CIANA, the Court recently struck down a Washington State visitation law under which grandparents were granted 

visitation to their grandchildren over the objection of the children’s 

mother precisely because it failed to provide special protection for 

the fundamental right of parents to control with whom their children associate.146 The Court concluded that the lower court ‘‘gave 

no special weight at all’’ to a mother’s conclusion that excessive 

grandparent visitation was not in her minor children’s best interests, and continued, ‘‘so long as a parent adequately cares for his 

or her children (i.e., is fit), there will normally be no reason for the 

State to inject itself into the private realm of the family to further 

question the ability of that parent to make the best decisions concerning the rearing of that parent’s children.’’ 147 This failure, the 

Court stated, ‘‘directly contravened the traditional presumption 

that a fit parent will act in the best interest of his or her child.’’ 148


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149 Bellotti v. Baird, 443 U.S. 622, 641 n.21 (1979) (Bellotti II). 150See National Abortion and Reproductive Rights Action League, Minors’ Issues: Reproductive Choice Issues, at http://www.naral.org/issues/issueslminors.html (last visited Aug. 30, 

2001). 

CIANA PROTECTS THE HEALTH OF MINOR GIRLS

Young girls face serious risks to their health and well-being 

when they are secretly taken for abortions without their parents’ 

knowledge. When an abortion is performed on a girl without the 

physician having full knowledge of her medical history—which is 

usually available only from a parent—the risks greatly increase. 

Moreover, minor girls who do not involve their parents usually do 

not return for follow-up treatment, which can lead to dangerous 

complications. In many cases, only a girl’s parents know of her 

prior psychological and medical history, including allergies to medication and anesthesia. Also, parents are usually the only people 

who can provide authorization for post-abortion medical procedures 

or the release of pertinent data from family physicians. None of 

these precautions can be taken when a pregnant girl is taken to 

have an abortion without her parents’ knowledge. Consequently, 

when parents are not involved, the risks to the minor girl’s health 

significantly increase. CIANA is designed to safeguard minor girls’ 

physical and emotional health by helping to ensure parental involvement in their interstate abortion decisions. 

The medical care that minors seeking abortions receive is improved when their parents are involved in three ways. 

First, parental involvement allows parents to assist their daughter in the selection of a competent abortion provider. With all medical procedures, one of the most reliable means of guaranteeing patient safety is the professional competence of the physician performing the procedure. In Bellotti v. Baird, the United States Supreme Court acknowledged that parents possess a much greater 

ability to evaluate and select competent healthcare providers than 

their minor children often do: 

In this case . . . we are concerned only with minors who, 

according to the record, range in age from children of 12 

years to 17-year-old teenagers. Even the latter are less 

likely than adults to know or be able to recognize ethical, 

qualified physicians, or to have the means to engage such 

professionals. Many minors who bypass their parents probably will resort to an abortion clinic, without being able to 

distinguish the competent and ethical from those that are 

incompetent or unethical.149

The Supreme Court’s concern for that ability of minors to distinguish competent and ethical abortion providers is particularly justified in states where non-physicians are allowed, by statute, to perform abortions. The National Abortion and Reproductive Rights Action League recommends that patients seeking an abortion confirm 

that the abortion will be performed by a licensed physician in good 

standing with the state Board of Medical Examiners, and that he 

or she have admitting privileges at a local hospital not more than 

20 minutes away from the location where the abortion is to 

occur.150 A well-informed parent seeking to guide her child is more 

likely to inquire into the qualifications of the person performing the 

abortion, and the availability of a physician with local admitting 


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151 H.L. v. Matheson, 450 U.S. 398, 411 (1981). Accord Ohio v. Akron Ctr. for Reproductive 

Health, 497 U.S. 502, 518–19 (1990). 152See Edison v. Reproductive Health Services, 863 S.W.2d 621 (Mo. App. E.D. 1993). 153See id. at 624. 154See id. at 628. 155 Edison v. Reproductive Health Services, 863 S.W.2d 621 (Mo. App. E.D. 1993). 156See Ohio v. Akron Ctr. for Reproductive Health, 497 U.S. 502, 519 (1990). 157Stanley K. Henshaw, ‘‘Unintended Pregnancy and Abortion: A Public Health Perspective,’’ 

in A Clinician’s Guide to Medical and Surgical Abortions 20 (Maureen Paul et al., eds. 1999). 

privileges, than an emotionally vulnerable young girl faced with 

pregnancy. 

Second, parental involvement will ensure that parents have the 

opportunity to provide additional medical history and information 

to abortion providers prior to performance of the abortion. As the 

Supreme Court has stated: 

The medical, emotional, and psychological consequences of 

an abortion are serious and can be lasting . . . An adequate medical and psychological case history is important 

to the physician. Parents can provide medical and psychological data, refer the physician to other sources of medical 

history, such as family physicians, and authorize family 

physicians to give relevant data.151

Take, for example, the story of Sandra, a 14-year-old girl who 

committed suicide shortly after obtaining an abortion.152 Sandra’s 

mother, who learned of her daughter’s abortion only after her suicide, sued the abortion provider at which Sandra’s abortion was 

performed, asserting that her daughter’s death was due to the failure of the abortion provider to obtain a psychiatric history or monitor Sandra’s mental health.153 The court concluded that Sandra 

was not insane at the time she committed suicide and, therefore, 

her actions broke the chain of causation required for recovery.154

Yet evidence was presented that Sandra had a history of psychological illness and that her behavior was noticeably different after 

the abortion.155 If Sandra’s mother had been aware of her daughter’s abortion, she would have had the opportunity to notify the 

abortion provider of Sandra’s psychological history, and steps could 

have been taken to minimize the psychological effect of the abortion on Sandra’s already fragile mental state. 

A more complete and thus more accurate medical history of the 

patient will enable abortion providers to disclose not only medical 

risks that ordinarily accompany abortions but also those risks that 

may be specific to a pregnant minor. Parental involvement provides 

adults with the opportunity to advise and assist the girl in giving 

her informed consent to the procedure. 

Third, parental involvement will improve medical treatment of 

pregnant minors by ensuring that parents have adequate knowledge to recognize and respond to any post-abortion complications 

that may develop.156 The rate of many of the complications associated with abortion are unknown. As a clinician’s guide states, ‘‘The 

abortion reporting systems of some counties and states in the 

United States include entries about complications, but these systems are generally considered to underreport infections and other 

problems that appear some time after the procedure was performed.’’ 157 Furthermore, women typically have no pre-existing reVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00031 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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158See Florida Dep’t of Health v. North Florida Women’s Health and Counseling Service, 852 

So.2d 254, 264 n.3 (Fla. App. 1 Dist., 2001): [E]vidence at trial showed, the physician-patient 

relationship is often attenuated in the abortion context, almost to the point of non-existence. 

Cf. Planned Parenthood v. Danforth, 428 U.S. 52, 91, 96 S.Ct. 2831, 49 L.Ed.2d 788 (1976) (‘‘It 

seems unlikely that [the minor] will obtain adequate counsel and support from the attending 

physician at an abortion clinic, where abortions for pregnant minors frequently take place.’’). 

Abortion patients ordinarily see their physicians only once or twice, very briefly. Most of their 

interaction is with the clinic’s staff. Physicians performing abortions often perform several in 

the space of a single hour. Id. 159Stanley K. Henshaw, ‘‘Unintended Pregnancy and Abortion: A Public Health Perspective,’’ 

in A Clinician’s Guide to Medical and Surgical Abortions 20 (Maureen Paul et al., eds. 1999). 

Cf. Richard S. Moon, Why I Don’t Do Abortions Anymore, Medical Economics 61(Mar. 4, 1985). 160Parental Notification of Abortion: Hearings on H. 218 Before the House Comm. on Health 

and Welfare, 2001–2002 Legis. (Vt. 2001) (Nancy Mosher, President and CEO of Planned Parenthood of Northern New England on April 16, 2001) (estimating that two-thirds of Vermont 

women keep their follow up appointments, although ‘‘teenagers are notorious for ‘no-showing’ ’’). 161Reynier v. Delta Women’s Clinic, 359 So.2d 733, 738 (La. Ct. App. 1978) (‘‘All the medical 

testimony was to the effect that a perforated uterus was a normal risk, but the statistics given 

by the experts indicated that it was an infrequent occurrence and it was rare for a major blood 

vessel to be damaged.’’). Frequent injuries from incomplete abortions are discussed in Swate v. 

Schiffers, 975 S.W.2d 70 (Tex. App.-San Antonio 1998) (abortionist’s unsuccessful claim of libel 

against journalist for reports based in part upon one disciplinary order that doctor had failed 

to complete abortions performed on several patients and had failed to repair lacerations which 

occurred during abortion procedures). Cf. Sherman v. District of Columbia Bd. of Medicine, 557 

A.2d 943, 944 (D.C. 1989) (‘‘Dr. Sherman placed his patients’ lives at risk by using unsterile 

instruments in surgical procedures and by intentionally doing incomplete abortions (using septic 

instruments) to increase his fees by making later surgical procedures necessary. His practices 

made very serious infections (and perhaps death) virtually certain to occur. Dr. Sherman does 

not challenge our findings that his misconduct was willful nor that he risked serious infections 

in his patients for money.’’). 162Phillip G. Stubblefield and David A. Grimes, ‘‘Current Concepts: Septic Abortions,’’ New 

Eng. J. Med. 310 (August 4, 1994). 

lationship with an abortion provider,158 which likely accounts for 

the fact that only about one-third return to the provider for their 

post-operative exam.159 Teenagers are even less likely to return for 

follow-up appointments.160 This failure to return for post-operative 

exams precludes discovery of post-abortion complications by abortion providers and subsequent reporting of these complications. 

Other healthcare providers may be reluctant to report any complications for fear of compromising the secrecy that often surrounds 

abortions. 

At least one American court has held that a perforated uterus is 

a ‘‘normal risk’’ associated with abortion.161 Untreated, a perforated uterus may result in an infection, complicated by fever, endometritis, and parametritis. According to one study, ‘‘[t]he risk of 

death from post-abortion sepsis [infection] is highest for young 

women, those who are unmarried, and those who undergo procedures that do not directly evacuate the contents of the uterus . . . 

A delay in treatment allows the infection to progress to bacteremia, 

pelvic abscess, septic pelvic thrombophlebitis, disseminated 

intravascular coagulophy, septic shock, renal failure, and 

death.’’ 162 Evidence about these dangers presented at trial persuaded a Florida appellate court to uphold that State’s parental notification law: 

The State proved that appropriate aftercare is critical in 

avoiding or responding to post-abortion complications. 

Abortion is ordinarily an invasive surgical procedure attended by many of the risks accompanying surgical procedures generally. If post-abortion nausea, tenderness, swelling, bleeding, or cramping persists or suddenly worsens, a 

minor (like an adult) may need medical attention. A guardian unaware that her ward or a parent unaware that his 

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163Florida Dep’t of Health v. North Florida Women’s Health and Counseling Service, 852 So.2d 

254, 262–63 (Fla. App. 1 Dist. 2001), quashed by North Florida Women’s Health and Counseling 

Services, Inc. v. State, 866 So.2d 612 (Fla. 2003) (striking down state law under state constitution’s ‘‘right to privacy’’). The Florida Constitution was subsequently amended to state ‘‘Notwithstanding a minor’s right to privacy . . . the Legislature is authorized to require by general law 

for notification to a parent or guardian of a minor before the termination of the minor’s pregnancy.’’ Fla. Stat. Ann. Const. Art. 10 § 22. 164See Willard Cates, Jr., M.D., M.P.H., Kenneth F. Schulz, M.B.A. & David A. Grimes, M.D., 

The Risks Associated With Teenage Abortion, New Eng. J. of Med., Sept. 15, 1983, at 621–24. 165See Burkman et al., Morbidity Risk Among Young Adolescents Undergoing Elective Abortion, Contraception, vol. 30 (1984), at 99–105. 166 Bruce A. Lucero, M.D., ‘‘Parental Guidance Needed,’’ The New York Times (July 12, 1998), 

section 4, at 1. 167 Id. 168 Id. 

rious disadvantage in caring for her if complications develop. An adult who has been kept in the dark cannot, 

moreover, assist the minor in following the abortion provider’s instructions for post-surgical care. Failure to follow 

such instructions can increase the risk of complications. As 

the plaintiffs’ medical experts conceded, the risks are significant in the best of circumstances. While abortion is less 

risky than some surgical procedures, abortion complications can result in serious injury, infertility, and even 

death.163

Young adolescent girls are particularly at risk of certain adverse 

medical consequences from an abortion. For instance, there is a 

greater risk of cervical injury associated with suction-curettage 

abortions (at 12 weeks’ gestation or earlier) performed on girls 17 

years old or younger.164 Cervical injury is of serious concern because it may predispose the young girl to adverse outcomes in future pregnancies. Girls 17 years old or younger also face a two and 

a half times greater risk of acquiring endometriosis following an 

abortion than do women 20-29 years old.165

The particular risks faced by minors upon whom abortions are 

performed were articulated by Dr. Bruce A. Lucero. Dr. Lucero, 

who supported the Child Custody Protection Act (federal legislation 

similar to CIANA) in 1998, wrote in The New York Times about his 

own experience with minor girls seeking abortions. ‘‘In almost all 

cases,’’ Dr. Lucero wrote, ‘‘the only reason that a teen-age girl 

doesn’t want to tell her parents about her pregnancy is that she 

feels ashamed and doesn’t want to let her parents down.’’ 166 However, according to Dr. Lucero, ‘‘parents are usually the ones who 

can best help their teen-ager consider her options. And whatever 

the girl’s decision, parents can provide the necessary emotional 

support and financial assistance.’’ 167 Moreover, Dr. Lucero explained that ‘‘patients who receive abortions at out-of-state clinics 

frequently do not return for follow-up care, which can lead to dangerous complications. And a teen-ager who has an abortion across 

state lines without her parents’ knowledge is even more unlikely to 

tell them that she is having complications.’’ 168

Opponents also argue that the bill needs a broader ‘‘health exception.’’ It does not. CIANA specifically provides that its notification 

requirements would not apply if ‘‘the abortion is necessary to save 

the life of the minor because her life was endangered by a physical 

disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy 

itself.’’ If the concern is about health risks of a non life-threatening 


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169 Hodsgon v. Minnesota, 497 U.S. 417, 426 n.7 (1990) (citing Minnesota statute § 144.343, 

subd. 4(a)). 170 American Academy of Pediatrics Committee on Adolescence, ‘‘Adolescent Pregnancy—Current Trends and Issues: 1998,’’ 103 Pediatrics 516, 519 (1999). 171Mike A. Males, ‘‘Adult Involvement in Teenage Childbearing and STD,’’ 346 Lancet 64 

(July 8,1995) (emphasis added). 172See id. (citing HP Boyer and D. Fine, ‘‘Sexual Abuse as a Factor in Adolescent Pregnancy 

and Child Maltreatment,’’ 24 Fam. Plan. Perspectives 4 (1992)); See also HP Gershenson, et al. 

‘‘The Prevalence of Coercive Experience Among Teenage Mothers,’’ 24 J. Interpersonal Violence 

4 (1989); American Academy of Pediatrics Committee on Adolescence, ‘‘Adolescent Pregnancy— 

Current Trends and Issues: 1998,’’ 103 Pediatrics 516, 516 (1999) (‘‘Younger teenagers are especially vulnerable to coercive and nonconsensual sex. Involuntary sexual activity has been reported in 74% of sexually active girls younger than 14 years and 60% of those younger than 

15 years.’’). 

nature, then the best course of action, of course, is involving the 

parents. Finally, the Supreme Court has upheld as constitutional 

a state parental notification statute that did not contain a health 

exception. That state statute provided only for a ‘‘judicial bypass’’ 

exception, which would of course take some time for a minor to utilize, and an exception for cases in which emergency treatment prior 

to notice ‘‘is necessary to prevent the woman’s death.’’ 169

Without the knowledge that their daughters have had abortions, 

parents are incapable of ensuring that their children obtain routine 

post-operative care or of providing an adequate medical history to 

physicians called upon to treat any complications that may arise. 

The first omission may allow complications such as infection, perforation, or depression, to continue untreated. The second omission 

may be lethal. When parents do not know that their daughter had 

an abortion, ignorance prevents swift and appropriate intervention 

by emergency room professionals responding to a life-threatening 

condition. 

In short, the physical and psychological risks of abortions to minors are great, and laws requiring parental involvement in such 

abortions reduce that risk. The widespread practice of evading such 

laws by transporting minors across State lines through interstate 

commerce may be prevented only through Federal legislation. 

CIANA PROTECTS MINOR GIRLS FROM SEXUAL ASSAULT

In addition to improving the medical care received by young girls 

dealing with an unplanned pregnancy, parental involvement will 

provide increased protection against sexual exploitation of minors 

by adult men. National studies reveal that ‘‘[a]lmost two thirds of 

adolescent mothers have partners older than 20 years of age.’’ 170

In a study of over 46,000 pregnancies by school-age girls in California, researchers found that ‘‘71%, or over 33,000, were fathered 

by adult post-high-school men whose mean age was 22.6 years, an 

average of 5 years older than the mothers . . . Even among junior 

high school mothers aged 15 or younger, most births are fathered 

by adult men 6-7 years their senior. Men aged 25 or older father 

more births among California school-age girls than do boys under 

age 18.’’ 171 Other studies have found that most teenage pregnancies are the result of predatory practices by men who are substantially older.172

A 1989 study of coercive sexual experiences among teenage mothers found that of the pregnant teens who had unwanted sexual experiences, only 18% of the perpetrators were within the victim’s 

age group. Another 18% were three to 5 years older than the victim. Seventeen percent were six to 10 years older, and 40% were 


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173See Gershenson, et al. ‘‘The Prevalence of Coercive Experience Among Teenage Mothers,’’ 

24 J. Interpersonal Violence 4 (1989). 174See Stanley Henshaw & Kathryn Post, Parental Involvement in Minors’ Abortion Decisions, 

Family Planning Perspectives, Sept./Oct. 1992, at 206. 175See Department of Health and Human Services, ‘‘Report to Congress on Out-of-Wedlock 

Childbearing’’ (September 1995) at x (‘‘Evidence also indicates that among unmarried teenage 

mothers, two-thirds of the fathers are age 20 or older, suggesting that differences in power and 

status exist between many sexual partners.’’). 176 Child Custody Protection Act: Hearings on H.R. 1755 Before the Subcomm. on the Constitution of the House Comm. on the Judiciary, 108th Cong., 22 (July 20, 2004) (statement of Teresa 

Collett). 177On June 14, 2000, a 36-year-old Omaha man who impersonated the father of his teen-age 

victim in order to assist her in obtaining an abortion was sentenced to 11⁄2-2 years in prison 

for felony child abuse. See Angie Brunkow, ‘‘Man Who Said He Was Girl’s Dad Sentenced,’’ 

Omaha World-Herald (June 14, 2000) at 20. A similar attempt to hide the consequences of statutory rape is reflected in the testimony of Joyce Farley before the United States House of Representatives, Committee on the Judiciary, Subcommittee on the Constitution. See, e.g., Child 

Custody Protection Act: Hearings on H.R. 3682 Before the Subcomm. on the Constitution of the 

House Comm. on the Judiciary, 105th Congress, May 21, 1998 (statement of Joyce Farley). 

http://www.house.gov/judiciary/222460.htm. 178See Commonwealth v. Sasville, 616 N.E.2d 476 (Mass. 1993) (destruction of aborted fetus 

precluded prosecution for forcible rape of a child under the age of sixteen). Compare Smith v. 

Commonwealth, 432 S.E.2d 2 (Va. App. 1993) (prosecution for rape of 14-year-old girl), with 

Hampton v. State, 1987 WL. 28223 (Ark. App. 1987) (prosecution for incest), and State v. Khong, 

502 N.E.2d 682 (Ohio App. 1985) (prosecutor subject to contempt order for failure to comply with 

discovery orders). 179Dee Dee Alonzo testified before the Texas Senate Human Services Committee in support 

of Senate Bill 30, the bill enacting the Texas Parental Notification Act. At age sixteen, she was 

seduced by her high school teacher. When she became pregnant, he persuaded her to have a 

secret abortion. She went to the clinic alone, obtained the abortion her abuser had paid for, and 

returned to continue the abusive relationship for another year. Ms. Alonzo testified ‘‘No matter 

what their reaction would have been, they were my parents and they were adults, and they did 

love me, it would not have been a secret and the man would have been exposed.’’ Testimony 

of Dee Dee Alonzo, Hearing on Tex. S.B. 30 Before the Senate Human Servs. Comm., 76th Leg., 

R.S. 4–5 (Mar. 10, 1999) (tapes available from the Senate Staff Servs. Office and content is from 

private transcripts of those tapes). A similar incident involved another high school student impregnated by her teacher. This is revealed in the settlement related to injuries she suffered during the abortion of her pregnancy. See Clement v. Riston, No.B–131,033, settlement reported in 

Jury Verdict Research, Research, LRP Pub. No. 65904 available on Lexis-Nexis; cf. Patterson 

v. Planned Parenthood, 971 S.W.2d 439, 447 (Tex. 1998) (Gonzales, J., concurring) (describing 

the sexual abuse of a young girl that resulted in two pregnancies and two secret abortions). 

more than 10 years older than their victims.173 Another study reports that when a minor’s parents have not been told about her 

pregnancy, 58 percent of the time it is the girl’s boyfriend who accompanies her for an abortion, and the minor’s boyfriend helped 

pay for the abortion 76 percent of the time.174

As Professor Teresa Stanton Collett testified before the House 

Constitution Subcommittee: 

[A]s this Congress learned through a congressional report 

from the Center for Disease Control, two-thirds of the fathers of teenage mothers are age 20 years or older, suggesting that there is in fact differences in power and status between the sexual partners.175 In addition to that, a 

survey of 1,500 unmarried minors having abortions revealed that among the minors who reported that neither 

parent knew of the abortion, 89 percent said that a boyfriend was involved in deciding or arranging the abortion, 

and 93 percent of those 15 and under said that the boyfriend was involved.176

Experience suggests that sexual predators recognize the advantage of their victims’ obtaining an abortion.177 Not only does an 

abortion eliminate a critical piece of evidence of the criminal conduct,178 but it also allows the abuse to continue undetected.179 As 

a recent presentation given at a U.S. Department of Health and 

Human Services Conference on the Sexual Exploitation of Teens 


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180Kristin Moore, Ph.D. and Jennifer Manlove, Ph.D., ‘‘A Demographic Portrait of Statutory 

Rape,’’ Presentation given at the United States Department of Health and Human Services’ Conference on the Sexual Exploitation of Teens (March 23–24, 2005) (defining statutory rape as occurring when teens aged 15 or younger have sex with a partner 3 or more years older). 181 Id. 182 Id. (of those younger than 14, 18%; of those age 15–16, 10%; and of those age 17–19, 5%). 183 Id. (Hispanic, 17%, black, 16%, white, 11%). 184See, e.g., Heart of Atlanta Motel, Inc. v. United States, 379 U.S. 241 (1964) (upholding enactment of Title II of the Civil Rights Act under Congress’ commerce clause power). 185See, e.g., Caminetti v. United States, 242 U.S. 470 (1917). 186There is therefore no need to address the scope of Congress’ power to regulate activity that 

is not, but that affects, commerce among the States. See, e.g., A.L.A. Schechter Poultry Corp. 

v. United States, 295 U.S. 495 (1935); Wickard v. Filburn, 317 U.S. 111 (1942); Katzenbach v. 

McClung, 379 U.S. 294 (1964); United States v. Lopez, 514 U.S. 549 (1995). 187See United States v. Darby, 312 U.S. 100 (1941). 188 U.S. Const., art. I, § 8, cl. 3. 189 18 U.S.C. § 2421 (1970). As amended, the statute prohibits the knowing transportation of 

any individual across state lines ‘‘with intent that such individual engage in prostitution, or in 

any sexual activity for which any person can be charged with a criminal offense, or attempts 

to do so . . .’’ 18 U.S.C. § 2421 (1999). 

showed, of minor girls’ first sexual experiences, 13% constitute 

statutory rape.180 Further, the younger a sexually experienced teen 

is, the more likely they are to experience statutory rape. Of sexually experienced teens age 13 or younger, 65% experienced statutory rape. Of those age 14, 53% experienced statutory rape. And of 

those age 15, 41% experienced statutory rape.181 And young girls 

who are younger at their first sexual experience are more likely to 

say their first sexual experience was non-voluntary.182 Also, blacks 

and Hispanics are more likely to experience statutory rape.183 Parental involvement laws help ensure that parents have the opportunity to protect their daughters from those who would victimize 

them further. Secret abortions protect and perpetuate the illegal 

conduct of these adult male predators. 

CONGRESS HAS CLEAR CONSTITUTIONAL AUTHORITY TO ENACT CIANA

CIANA is a regulation of commerce among the several states.184

Commerce, as that term is used in the Constitution, includes travel 

whether or not that travel is for reasons of business.185 To transport another person across state lines is to engage in commerce 

among the states.186 Under current Supreme Court precedents, 

Congress can enact legislation concerning interstate commerce, 

such as CIANA, for reasons related primarily to local activity rather than commerce itself.187

The interstate transportation of minors for the purpose of securing an abortion is clearly a form of interstate commerce which the 

Constitution expressly empowers Congress to regulate.188 CIANA 

regulates only conduct which involves interstate movement, activity which the national government alone is expressly authorized by 

the Constitution to address. 

The Federal Government has long exercised its interstate commerce authority to prohibit interstate activity harmful to minors 

and their families. In 1910, Congress used its Commerce Clause 

power to enact the Mann Act,189 which, before its amendment in 

1986, prohibited the interstate transportation of women or minors 

for purposes of ‘‘prostitution or debauchery, or for any other immoral purpose.’’ The Supreme Court upheld the enactment of this 

law as a constitutional exercise of Congress’ power over transportation among the several states. The Court reasoned that if men 

and women employ interstate transportation to facilitate a wrong, 


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190See Hoke v. United States, 227 U.S. 308, 323 (1913) (noting, in upholding the constitutionality of the Mann Act, ‘‘that Congress has power over transportation ‘among the several 

states;’ that the power is complete in itself, and that Congress, as an incident to it, may adopt 

not only means necessary but convenient to its exercise, and the means may have the quality 

of police regulations.’’). 191See United States v. Pelton, 578 F.2d 701 (8th Cir. 1978). 192 Caminetti, 242 U.S. at 491. 193 United States v. Edge Broadcasting Co., 509 U.S. 418, 421 (1993). 194See 18 U.S.C.A. § 1302 (prohibiting the mailing of lottery tickets or letters, circulars, and 

other materials regarding a lottery). 195See 18 U.S.C. § 1301. 196 188 U.S. 321 (1903). 197 410 U.S. 113 (1973). 

then their right to interstate travel can be restricted.190 That statute was upheld as applied to the transportation of a person to Nevada for purposes of engaging in prostitution, even though prostitution was legal in Nevada.191 The Mann Act flatly prohibited the 

interstate transportation of women for ‘‘prostitution’’ or for ‘‘any 

other immoral purpose.’’ In upholding the law as a valid exercise 

of Congress’ commerce power, the Court stated: 

The transportation of passengers in interstate commerce, 

it has long been settled, is within the regulatory power of 

Congress, under the commerce clause of the Constitution, 

and the authority of Congress to keep the channels of 

interstate commerce free from immoral and injurious uses 

has been frequently sustained, and is no longer open to 

question.192

Just as it was appropriate for Congress to use its constitutional 

authority to keep the channels of interstate commerce free from 

‘‘immoral’’ conduct, so it is also appropriate for Congress to exercise 

that authority to keep the channels of interstate commerce free 

from those who transport minors across state lines in order to circumvent state parental involvement laws, or from physicians who 

might not otherwise notify a minor’s parents. 

The Mann Act is not the only example of a Federal law that prohibit interstate activities that might be legal in the state to which 

the activity is directed. Indeed, as long ago as 1876, Congress 

‘‘made it a crime to deposit in the mails any letters or circulars 

concerning lotteries, whether illegal or chartered by state legislatures.’’ 193 A statute to this effect is still in force.194 Congress later 

prohibited the transportation of lottery tickets in interstate commerce, whether or not lotteries are legal in the state to which the 

tickets are transported.195 That provision was upheld by the Supreme Court in Champion v. Ames 196 and is still in effect. 

CIANA does not supercede, override, or alter existing state laws 

regarding minors’ abortions. Rather, CIANA is predicated on Congress’ authority to regulate interstate activity. The bill does nothing to regulate purely local activity, and it does not impose any 

new rules regarding conduct that occurs solely within one state. 

CIANA embodies rules to regulate interstate activities that involve 

two or more states, as is entirely appropriate under the Commerce 

Clause. In short, CIANA does not encroach on state powers. 

CIANA IS CONSISTENT WITH SUPREME COURT PRECEDENT

In Roe v. Wade, 197 a majority of the Supreme Court found that 

the Fourteenth Amendment’s Due Process Clause, which provides 


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198See Planned Parenthood v. Casey, 505 U.S. 833, 985 (1992) (Scalia, J., dissenting). 199 505 U.S. 833 (1992). 200For the articulation of the ‘‘undue burden’’ standard in Casey, see id. at 874–80. While the 

‘‘undue burden’’ standard as expressed in Casey appeared only to be the views of the three-person plurality, Justice Scalia predicted that ‘‘undue burden’’ would henceforward be the relevant 

standard, see id. at 984–95 (Scalia, J., dissenting). It now appears that the lower Federal courts 

understand that the ‘‘undue burden’’ standard is the correct one to be applied in abortion cases 

involving babies that are not viable. See, e.g., Manning v. Hunt, 119 F.3d 254, 260 (4th Cir. 

1997) (‘‘The trend does appear to be a move away from the strict scrutiny standard toward the 

so-called ‘undue burden’ standard of review.’’). 201 410 U.S. 113 (1973). 202 428 U.S. 52 (1976). 203 Id. at 74. 204 Id. at 74, 75. 

that no state shall deprive any person of ‘‘life, liberty, or property’’ 

without due process of law, includes within it a ‘‘substantive’’ component that bars a state from prohibiting abortions under some circumstances. This substantive component of the Due Process 

Clause, also described in that case as including a ‘‘right to privacy,’’ 

was construed to forbid virtually all state prohibitions on abortion 

during the first trimester of pregnancy.198 In Planned Parenthood 

v. Casey, 199 the scope of permissible state regulation of abortion 

and the standards to be applied in evaluating the constitutionality 

of the regulation were significantly changed. Instead of declaring 

that the right to seek an abortion was a ‘‘fundamental right’’ requiring a ‘‘compelling state interest’’ in order to be regulated, the 

new holding was that state regulation of abortion was permissible 

so long as such regulation did not place an ‘‘undue burden’’ on a 

woman’s exercise of her constitutional rights with regard to abortion.200

CIANA does not place an undue burden upon a woman’s right to 

an abortion. To the extent that a state rule is inconsistent with the 

Court’s doctrine, that rule is ineffective and CIANA would not 

make it effective. Regarding the bill’s provisions that govern interstate abortions conducted in States without parental involvement 

laws, a requirement that a parent simply be notified is not an 

undue burden. 

Following the Court’s decision in Roe v. Wade, 201 many states 

enacted parental notice or consent statutes requiring minors to notify or seek the consent of their parents before undergoing an abortion. Parental consent laws generally require one or both parents 

to give actual consent to the minor’s decision to have an abortion. 

Parental notification laws typically require the physician, or in 

some statutes another health care provider, to notify one or both 

of the parents of the minor female at some time prior to the abortion. 

The Court first considered parental involvement in a minor 

daughter’s abortion in Planned Parenthood of Central Missouri v. 

Danforth. 202 The Missouri statute gave a minor girl’s parent an absolute veto over her decision to have an abortion. The majority, led 

by Justice Blackmun, concluded that such a veto power was unconstitutional.203 The majority noted, however, that the Court ‘‘long 

has recognized that the State has somewhat broader authority to 

regulate the activities of children than of adults’’ and ‘‘emphasized’’ 

that its holding in the case ‘‘does not suggest that every minor, regardless of age . . . may give effective consent for termination of 

her pregnancy.’’ 204


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205 428 U.S. 132 (1976). 206 In doing so the Court recognized minors bear ‘‘unquestionably greater risks of inability to 

give an informed consent.’’ Id. at 147. 207 443 U.S. 622 (1979). 208 Id. at 638. 209 Id. at 634. 210 450 U.S. 398 (1981). 211 Id. at 409–10. 212 462 U.S. 476 (1983). 213 497 U.S. 502 (1990). 

The Court next addressed state parental involvement laws in 

Bellotti v. Baird, 205 remanding a parental consent statute that was 

unclear as to whether the parents had authority to veto the abortion and as to the availability of a judicial bypass procedure.206 The 

statute returned to the Supreme Court in Bellotti v. Baird (Bellotti 

II).207 The statute in Bellotti II required a minor to obtain the consent of her parents or circumvent this requirement through a judicial bypass proceeding that did not take into account whether the 

minor was sufficiently mature to make an informed decision regarding the abortion. The Supreme Court invalidated the statute 

without a majority opinion. 

Justice Powell stated in his plurality opinion, ‘‘constitutional interpretation has consistently recognized that the parents’ claim to 

authority in their own household to direct the rearing of their children is basic in the structure of our society’’ and that ‘‘[p]roperly 

understood, then, the tradition of parental authority is not inconsistent with our tradition of individual liberty; rather, the former 

is one of the basic presuppositions of the latter.’’ 208 This has become the de facto constitutional standard for parental consent and 

notification laws. In upholding parental involvement laws, the plurality found three reasons why the constitutional rights of minors 

were not identical to the constitutional rights of adults: ‘‘[t]he peculiar vulnerability of children; their inability to make critical decisions in an informed, mature manner; and the importance of the 

parental role in child rearing.’’ 209 Thus, the plurality sought to design guidelines for a judicial bypass proceeding that allowed states 

to address these interests in a parental consent statute. 

In H.L. v. Matheson, 210 a minor girl challenged the constitutional validity of a state statute that required a physician to give 

notice to the parents of a minor girl whenever possible before performing an abortion on her. By a vote of six to three, the statute 

was held constitutional. The Court held that a state could require 

notification of the parents of a minor girl because the notification 

‘‘furthers a constitutionally permissible end by encouraging an unmarried pregnant minor to seek the help and advice of her parents 

in making the very important decision whether or not to bear a 

child.’’ 211

In Planned Parenthood Association of Kansas City, Missouri, Inc. 

v. Ashcroft, 212 the Court upheld the constitutionality of a State law 

that required a minor to obtain the consent of one of her parents 

before obtaining an abortion or, in the alternative, to obtain the 

consent of a juvenile court judge. While there was no majority opinion, this case marked the first time the Court directly upheld a parental consent requirement. 

In Ohio v. Akron Center for Reproductive Health, 213 the Supreme 

Court upheld a statute that required a physician to give notice to 


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214See id. at 514–15. 215 497 U.S. 417 (1990). 216 428 U.S. 52 (1976). 217Planned Parenthood v. Danforth, 428 U.S. 52, 91 (1976) (Stewart, J., concurring). 218Lambert v. Wicklund, 520 U.S. 292, 295 (1997). 

one of the minor’s parents or, under some circumstances, another 

relative, before performing an abortion on the minor. The statute 

permitted the physician and the minor to avoid the requirement by 

a judicial bypass. Justice Kennedy, writing for the majority, held 

that the bypass proceeding did not unconstitutionally impair a minor’s rights by the creation of unnecessary delay.214 The Court established in this case that it will not invalidate state procedures so 

long as they seem to be reasonably designed to provide the minor 

with an expedited process. 

In Hodgson v. Minnesota, 215 the Court invalidated a state statute that required notification of both parents prior to a minor girl’s 

abortion without the option of a judicial bypass. The Court, however, upheld statutory requirements that both parents be notified 

of the abortion and a 48 hour waiting period between notification 

and the performance of the abortion, if such requirements were accompanied by a judicial bypass procedure that met constitutional 

standards. 

CIANA, consistent with these Supreme Court precedents, requires—in cases in which a minor from one state seeks to obtain 

an abortion in another state without a parental involvement law— 

that before an abortion can be obtained, either (1) the physician is 

presented with documentation showing with a reasonable degree of 

certainty that a court in the minor’s state of residence has waived 

any parental notification required by the laws of that state, or has 

otherwise authorized that the minor be allowed to procure an abortion; (2) the minor declares in a signed written statement that she 

is the victim of sexual abuse, neglect, or physical abuse by a parent, and, before an abortion is performed on the minor, the physician notifies the authorities specified to receive reports of child 

abuse or neglect by the law of the State in which the minor resides 

of the known or suspected abuse or neglect; or (3) the abortion is 

necessary to save the life of the minor because her life was endangered by a physical disorder, physical injury, or physical illness, including a life endangering physical condition caused by or arising 

from the pregnancy itself. 

In Planned Parenthood of Central Missouri v. Danforth,216 the 

first of a series of Supreme Court cases dealing with parental consent or notification laws, noted liberal Justice Stewart wrote, 

‘‘There can be little doubt that the State furthers a constitutionally 

permissible end by encouraging an unmarried pregnant minor to 

seek the help and advice of her parents in making the very important decision of whether or not to bear a child.’’ 217

While the Supreme Court has, to date, ‘‘declined to decide whether a parental notification statute must include some sort of bypass 

provision to be constitutional,’’ 218 it is of note that even famously 

liberal Justice Stevens wrote in his concurring opinion in H.L. v. 

Matheson, that ‘‘[t]he fact that certain members of the class of unmarried minor women who are suffering unwanted pregnancies 

and desire to terminate the pregnancies may actually be emancipated or sufficiently mature to make a well-reasoned abortion deciVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00040 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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219 H.L. v. Matheson, 450 U.S. 398, 424–25 (1981) (Stevens, J., concurring) (citations and 

quotations omitted). 220 497 U.S. 417 (1990). 221 Hodgson v. Minnesota, 497 U.S. 417, 448–49 (1990). 222 Id. at 449 (emphasis added). 223Planned Parenthood v. Casey, 505 U.S. 833, 874 (1992). 224 Id. at 877 (1992) (emphasis added). 225 Hodgson v. Minnesota, 497 U.S. 417, 449 (1990) (emphasis added). 226The Supreme Court elaborated that ‘‘Some guiding principles should emerge. What is at 

stake is the woman’s right to make the ultimate decision, not a right to be insulated from all 

others in doing so. Regulations which do no more than create a structural mechanism by which 

Continued 

sion does not, in my view, undercut the validity of the [state] statute [in question] . . . [A] state legislature has constitutional power 

to utilize, for purposes of implementing a parental-notice requirement, a yardstick based upon the chronological age of unmarried 

pregnant women. That this yardstick will be imprecise or even unjust in particular cases does not render its use by a state legislature impermissible under the Federal Constitution.’’ 219

Furthermore, the Court in Hodgson v. Minnesota,220 wrote that: 

We think it is clear that a requirement that a minor wait 

48 hours after notifying a single parent of her intention to 

get an abortion would reasonably further the legitimate 

state interest in ensuring that the minor’s decision is 

knowing and intelligent . . . The brief waiting period provides the parent the opportunity to consult with his or her 

spouse and a family physician, and it permits the parent 

to inquire into the competency of the doctor performing the 

abortion, discuss the religious or moral implications of the 

abortion decision, and provide the daughter needed guidance and counsel in evaluating the impact of the decision 

on her future.’’ 221

The Supreme Court has clearly indicated that a parental notification requirement does not impose an undue burden on a minor’s 

ability to obtain an abortion, finding that ‘‘[a] 48-hour delay imposes only a minimal burden on the right of the minor to decide 

whether or not to terminate her pregnancy.’’ 222

The Court then stated in Planned Parenthood v. Casey that: 

Numerous forms of state regulation might have the incidental effect of increasing the cost or decreasing the availability of medical care, whether for abortion or any other 

medical procedure. The fact that a law which serves a 

valid purpose, one not designed to strike at the right itself, 

has the incidental effect of making it more difficult or 

more expensive to procure an abortion cannot be enough to 

invalidate it. Only where state regulation imposes an 

undue burden on a woman’s ability to make this decision 

does the power of the State reach into the heart of the liberty protected by the Due Process Clause.223

The Court continued that ‘‘[a] finding of an undue burden is a 

shorthand for the conclusion that a state regulation has the purpose or effect of placing a substantial obstacle in the path of a 

woman seeking an abortion of a nonviable fetus.’’ 224 A parental notice requirement, which the Supreme Court has described as a 

‘‘minimal burden’’ 225 is clearly not a ‘‘substantial obstacle’’ 226 to 

receiving an abortion. 


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the State, or the parent or guardian of a minor, may express profound respect for the life of 

the unborn are permitted, if they are not a substantial obstacle to the woman’s exercise of the 

right to choose.’’ Planned Parenthood v. Casey, 505 U.S. 833, 877 (1992). 227Planned Parenthood v. Casey, 505 U.S. 833, 878, 895 (1992). 228 450 U.S. 398 (1981). 

The Supreme Court continued: ‘‘We reject the rigid trimester 

framework of Roe v. Wade. To promote the State’s profound interest in potential life, throughout pregnancy the State may take 

measures to ensure that the woman’s choice is informed, and measures designed to advance this interest will not be invalidated as 

long as their purpose is to persuade the woman to choose childbirth 

over abortion. These measures must not be an undue burden on 

the right . . . As with any medical procedure, the State may enact 

regulations to further the health or safety of a woman seeking an 

abortion . . . [P]arental notification or consent requirements . . . 

and our judgment that they are constitutional, are based on the 

quite reasonable assumption that minors will benefit from consultation with their parents and that children will often not realize 

that their parents have their best interests at heart.’’ 227

Even famously liberal Justice Stevens wrote in his concurring 

opinion in H.L. v. Matheson,228 that: 

In my opinion, the special importance of a young woman’s 

abortion decision . . . provides a special justification for 

reasonable state efforts intended to ensure that the decision be wisely made. Such reasonable efforts surely may 

include a requirement that an abortion be procured only 

after consultation with a licensed physician. And, because 

the most significant consequences of the [abortion] decision 

are not medical in character, the State unquestionably has 

an interest in ensuring that a young woman receive other 

appropriate consultation as well. In my opinion, the quality of that interest is plainly sufficient to support a state 

legislature’s determination that such appropriate consultation should include parental advice . . . [T]he State may 

legitimately decide that such consultation should be made 

more probable by ensuring that parents are informed of 

their daughter’s decision: If there is no parental-[notice] 

requirement, many minors will submit to the abortion procedure without ever informing their parents. An assumption that the parental reaction will be hostile, disparaging, 

or violent no doubt persuades many children simply to bypass parental counsel which would in fact be loving, supportive, and, indeed, for some indispensable. It is unrealistic, in my judgment, to assume that every parent-child 

relationship is either (a) so perfect that communication 

and accord will take place routinely or (b) so imperfect 

that the absence of communication reflects the child’s correct prediction that the parent will . . . [act] arbitrarily to 

further a selfish interest rather than the child’s interest. 

A state legislature may conclude that most parents will be 

primarily interested in the welfare of their children, and 

further, that the imposition of a parental-[notice] requirement is an appropriate method of giving the parents an 

opportunity to foster that welfare by helping a pregnant 


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229 H.L. v. Matheson, 450 U.S. 398, 422–24 (1981) (Stevens, J., concurring) (citations and 

quotations omitted). 230 Id. at 413 (citations and quotations omitted). 231 Contrary to claims by some opponents of CIANA, Saenz v. Roe, 526 U.S. 489 (1999) does 

not in any way impugn the constitutionality of CIANA. In Saenz, the Supreme Court addressed 

‘‘the citizen’s right to be treated equally in her new State of residence.’’ Id. at 505 (emphasis 

added). A minor who is a resident of one state and who crosses state lines to obtain an abortion 

in another state is by definition not a resident of the state in which such abortion is performed. 

Both operative sections of CIANA specifically restrict its applications to situations in which a 

minor resides in one state and seeks an abortion in another state. 232Saenz v. Roe, 526 U.S. 489, 502 (1999). 233See id. at 500. 234 United States v. Guest, 383 U.S. 745, 759 n.17 (1966). 

distressed child to make and to implement a correct decision.229

Even earlier, the Court stated in H.L. v. Matheson that ‘‘[t]he 

Constitution does not compel a state to fine-tune its statutes so as 

to encourage or facilitate abortions. To the contrary, state action 

encouraging childbirth except in the most urgent circumstances is 

rationally related to the legitimate governmental objective of protecting potential life.’’ 230

THE RIGHT TO TRAVEL IS PRESERVED UNDER CIANA

Opponents also argue that CIANA violates the rights of residents 

of each of the United States and of the District of Columbia to travel to and from any state of the Union for lawful purposes. Those 

opposed to CIANA on these grounds argue that the legislation will 

hold a pregnant minor ‘‘hostage’’ to the laws of her home state. 

As an initial matter, it does not appear that the Supreme Court 

has ever held that Congress’ power to regulate interstate commerce 

is ever limited by the ‘‘right to travel.’’ Even assuming, however, 

that Congress’ authority under the Commerce Clause is limited by 

the right to travel doctrine,231 the Supreme Court has recognized 

that the right to travel is ‘‘not absolute,’’ and is not violated so long 

as there is a ‘‘substantial reason for the discrimination beyond the 

mere fact that they are citizens of other States.’’ 232 Congress obviously has a substantial interest in protecting the health and wellbeing of minor girls and in protecting the rights of parents to raise 

their children. 

However, the notion that CIANA is inconsistent with the constitutional right to travel is not supportable under the Supreme 

Court’s jurisprudence. Neither a state nor the Federal Government 

can interfere with a citizen’s ability to leave a state for the purpose 

of visiting another State or prevent its citizens from returning; either would violate ‘‘the right of a citizen of one State to enter and 

to leave another State.’’ 233 CIANA does not even implicate this 

limitation, for it does not preclude the minor from traveling. The 

minor’s right to travel to another state is wholly unimpeded by 

CIANA. 

In addition, the Court has recognized that the right to interstate 

travel ‘‘may be regulated or controlled by the exercise of a State’s 

police power’’ and by the Federal Government as well.234 Protecting 

the health and well-being of minor girls and the rights of parents 

to raise their children are substantial, indeed compelling, reasons 

for restricting minors from obtaining an abortion without parental 

involvement. First, young adolescent girls who undergo abortions 

face a heightened risk of suffering from long-term physical and psyVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00043 Fmt 6659 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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235 Bellotti v. Baird, 443 U.S. 622, 638 (1979) (Bellotti II). 236 Id. at 639. 237 Id. at 634. 238 Id. at 635. 239 Id. 240 Id. 241 Id. at 638–39. 

chological complications. Second, ‘‘[c]onstitutional interpretation 

has consistently recognized that the parents’ claim to authority in 

their own household to direct the rearing of their children is basic 

in the structure of our society,’’ and that ‘‘[p]roperly understood, 

then, the tradition of parental authority is not inconsistent with 

our tradition of individual liberty; rather, the former is one of the 

basic presuppositions of the latter.’’ 235 Thus, ‘‘[u]nder the Constitution, the State can properly conclude that parents . . . who have 

[the] primary responsibility for children’s well-being are entitled to 

the support of laws designed to aid discharge of that responsibility.’’ 236 Third, the fundamental rights of minors, including the 

right to travel, are not equal to those of adults. Although the Court 

has previously concluded that the fundamental rights of a child are 

‘‘virtually coextensive with that of an adult,’’ 237 it also has recognized that ‘‘[t]hese rulings have not been made on the uncritical assumption that the constitutional rights of children are indistinguishable from those of adults.’’ 238 Thus, ‘‘the State is entitled to 

adjust its legal system to account for children’s vulnerability and 

their needs for ‘concern, . . . sympathy, and . . . paternal attention.’ ’’ 239

Based upon this reasoning, the Court has allowed States to enact 

laws that ‘‘account for children’s vulnerability’’ and that protect the 

unique role of parents: 

[T]he Court has held that the States validly may limit the 

freedom of children to choose for themselves in the making 

of important, affirmative choices with potentially serious 

consequences. These rulings have been grounded in the 

recognition that, during the formative years of childhood 

and adolescence, minors often lack the experience, perspective, and judgment to recognize and avoid choices that 

could be detrimental to them.240

Therefore, ‘‘[l]egal restrictions on minors, especially those supportive of the parental role, may be important to the child’s 

chances for the full growth and maturity that make eventual participation in a free society meaningful and rewarding.’’ 241 Consequently, a State may properly subject minors to more stringent 

limitations than are permissible with respect to adults. Examples 

include laws that prohibit the sale of cigarettes and alcoholic beverages to minors, laws that prohibit the sale of firearms and deadly 

weapons to minors without parental consent, and laws that prohibit third parties from exposing minors to certain types of literature. Similarly, Congress may restrict the right of minors to 

travel across state lines to a greater extent than it may adults. 

CIANA’s opponents sometimes also argue that CIANA violates 

the rights of states to enact and enforce their own laws governing 

conduct within their territorial boundaries. This contention is clearly specious because CIANA does not attempt to regulate conduct 

occurring solely within the territorial boundaries of a state. Rather, 


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CIANA regulates interstate commerce, and Congress has the exclusive authority to regulate such activity. 

Hearings 

The Committee’s Subcommittee on the Constitution held 1 day of 

hearings on H.R. 2299 on March 8, 2012. Testimony was received 

from Professor Teresa Collett, Professor of Law, University of St. 

Thomas School of Law; The Very Rev. Dr. Katherine Hancock 

Ragsdale, President and Dean, Episcopal Divinity School; and Dr. 

Michael New, Department of Social Sciences, University of Michigan—Dearborn. 

Committee Consideration 

On March 27, 2012, the Committee met in open session and ordered the bill H.R. 2299 favorably reported without amendment, by 

a rollcall vote of 20 to 13, a quorum being present. 

Committee Votes 

In compliance with clause 3(b) of rule XIII of the Rules of the 

House of Representatives, the Committee advises that the following 

rollcall votes occurred during the Committee’s consideration of H.R. 

2299. 

1. An amendment offered by Mr. Nadler that provides an exemption for grandparents and adult siblings, provided that such grandparent or adult sibling did not have sexual contact with the minor. 

Failed by a vote of 7-16. 

ROLLCALL NO. 1 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa .................................................................................................. X 

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King ................................................................................................. X 

Mr. Franks .............................................................................................. X 

Mr. Gohmert ........................................................................................... X 

Mr. Jordan .............................................................................................. X 

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ...........................................................................................

Mr. Griffin .............................................................................................. X 

Mr. Marino ..............................................................................................

Mr. Gowdy .............................................................................................. X 

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 


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ROLLCALL NO. 1—Continued 

Ayes Nays Present 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt .................................................................................................

Ms. Lofgren ............................................................................................

Ms. Jackson Lee .....................................................................................

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu ..................................................................................................

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ...........................................................................................

Mr. Polis .................................................................................................

Total ..................................................................................... 7 16 

2. An amendment offered by Mr. Scott that provides an exemption for taxicab drivers, and others in the business of professional 

transport, unless the individual had sexual contact with the minor. 

Failed by a vote of 10-14. 

ROLLCALL NO. 2 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa ..................................................................................................

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King .................................................................................................

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy .............................................................................................. X 

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle ..............................................................................................

Mr. Amodei ............................................................................................. X 


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ROLLCALL NO. 2—Continued 

Ayes Nays Present 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee .....................................................................................

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu ..................................................................................................

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 10 14 

3. An amendment offered by Mr. Watt that provides an exemption for persons transporting a minor if delay endangers the physical health of the minor seeking the abortion. Failed by a vote of 

11-13. 

ROLLCALL NO. 3 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa ..................................................................................................

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King .................................................................................................

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan ..............................................................................................

Mr. Poe ...................................................................................................

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy .............................................................................................. X 

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle ..............................................................................................

Mr. Amodei ............................................................................................. X 


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ROLLCALL NO. 3—Continued 

Ayes Nays Present 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee ..................................................................................... X 

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu ..................................................................................................

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 11 13 

4. An amendment offered by Mr. Watt that provides an exemption for cases where the abortion is necessary to protect the health 

or save the life of the abortion-seeking minor. Failed by a vote of 

12-15. 

ROLLCALL NO. 4 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa ..................................................................................................

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King .................................................................................................

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy .............................................................................................. X 

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 


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ROLLCALL NO. 4—Continued 

Ayes Nays Present 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee ..................................................................................... X 

Ms. Waters .............................................................................................

Mr. Cohen ............................................................................................... X 

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu ..................................................................................................

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 12 15 

5. An amendment offered by Ms. Jackson Lee that provides an 

exemption for clergy, godparents, aunts, uncles, or first cousins, unless the individual had sexual contact with the minor. Failed by a 

vote of 11-16. 

ROLLCALL NO. 5 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa ..................................................................................................

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King .................................................................................................

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy .............................................................................................. X 

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 


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ROLLCALL NO. 5—Continued 

Ayes Nays Present 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee ..................................................................................... X 

Ms. Waters .............................................................................................

Mr. Cohen ............................................................................................... X 

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu ..................................................................................................

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 11 16 

6. An amendment offered by Ms. Jackson Lee that provides an 

exemption for cases where pregnancy is a result of sexual contact 

with parent, guardian, or other household member. Failed by a 

vote of 11-17. 

ROLLCALL NO. 6 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa .................................................................................................. X 

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King .................................................................................................

Mr. Franks .............................................................................................. X 

Mr. Gohmert ........................................................................................... X 

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy .............................................................................................. X 

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 


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ROLLCALL NO. 6—Continued 

Ayes Nays Present 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee ..................................................................................... X 

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu ..................................................................................................

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 11 17 

7. An amendment offered by Ms. Jackson Lee that changes the 

effective date from 45 days to 120 days after enactment. Failed by 

a vote of 11-17. 

ROLLCALL NO. 7 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa .................................................................................................. X 

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King .................................................................................................

Mr. Franks .............................................................................................. X 

Mr. Gohmert ........................................................................................... X 

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy .............................................................................................. X 

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 

Mr. Conyers, Jr., Ranking Member .........................................................


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ROLLCALL NO. 7—Continued 

Ayes Nays Present 

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee ..................................................................................... X 

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu ..................................................................................................

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 11 17 

8. An amendment by Mr. Johnson that provides an exception to 

the disclosure requirement if the minor’s home poses a threat to 

physical safety. Failed by a vote of 11-18. 

ROLLCALL NO. 8 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa .................................................................................................. X 

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King ................................................................................................. X 

Mr. Franks .............................................................................................. X 

Mr. Gohmert ........................................................................................... X 

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy .............................................................................................. X 

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................ X 


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ROLLCALL NO. 8—Continued 

Ayes Nays Present 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee .....................................................................................

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu .................................................................................................. X 

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 11 18 

9. An amendment offered by Mr. Quigley that provides an exemption for cases of rape or incest. Failed by a vote of 11-15. 

ROLLCALL NO. 9 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa .................................................................................................. X 

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King ................................................................................................. X 

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin ..............................................................................................

Mr. Marino .............................................................................................. X 

Mr. Gowdy ..............................................................................................

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 


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ROLLCALL NO. 9—Continued 

Ayes Nays Present 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee .....................................................................................

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu .................................................................................................. X 

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 11 15 

10. An amendment offered by Ms. Chu that provides an exemption in Section 2 of the bill for those who have transported a minor 

in order to protect the life and health of the minor. Failed by a vote 

of 9-15. 

ROLLCALL NO. 10 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa .................................................................................................. X 

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King .................................................................................................

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy ..............................................................................................

Mr. Ross .................................................................................................

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 


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ROLLCALL NO. 10—Continued 

Ayes Nays Present 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................

Ms. Jackson Lee .....................................................................................

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu .................................................................................................. X 

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 9 15 

11. An amendment offered by Mr. Nadler that provides for a 

Federal judicial bypass. Failed by a vote of 8-16. 

ROLLCALL NO. 11 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa .................................................................................................. X 

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King .................................................................................................

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan ..............................................................................................

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy ..............................................................................................

Mr. Ross .................................................................................................

Ms. Adams ............................................................................................. X 

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 

Mr. Conyers, Jr., Ranking Member .........................................................

Mr. Berman ............................................................................................

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................


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ROLLCALL NO. 11—Continued 

Ayes Nays Present 

Ms. Jackson Lee .....................................................................................

Ms. Waters .............................................................................................

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley .............................................................................................

Ms. Chu .................................................................................................. X 

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis .................................................................................................

Total ..................................................................................... 8 16 

12. An en bloc amendment offered by Mr. Scott that restricts 

prosecution to offenders in the first degree and provides that no 

Federal notification is required if both the minor’s home state, and 

the state in which she is seeking an abortion, do not require parental involvement in the minor’s decision. Failed by a vote of 14-17. 

ROLLCALL NO. 12 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa ..................................................................................................

Mr. Pence ...............................................................................................

Mr. Forbes ..............................................................................................

Mr. King ................................................................................................. X 

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan .............................................................................................. X 

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy ..............................................................................................

Mr. Ross ................................................................................................. X 

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 

Mr. Conyers, Jr., Ranking Member ......................................................... X 

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 


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ROLLCALL NO. 12—Continued 

Ayes Nays Present 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee .....................................................................................

Ms. Waters ............................................................................................. X 

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu .................................................................................................. X 

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis ................................................................................................. X 

Total ..................................................................................... 14 17 

13. H.R. 2299 was favorably reported without amendment, by a 

rollcall vote of 20 to 13, a quorum being present. 

ROLLCALL NO. 13 

Ayes Nays Present 

Mr. Smith, Chairman ............................................................................. X 

Mr. Sensenbrenner, Jr. ........................................................................... X 

Mr. Coble ................................................................................................ X 

Mr. Gallegly ............................................................................................ X 

Mr. Goodlatte ......................................................................................... X 

Mr. Lungren ............................................................................................ X 

Mr. Chabot ............................................................................................. X 

Mr. Issa .................................................................................................. X 

Mr. Pence ...............................................................................................

Mr. Forbes .............................................................................................. X 

Mr. King ................................................................................................. X 

Mr. Franks .............................................................................................. X 

Mr. Gohmert ...........................................................................................

Mr. Jordan .............................................................................................. X 

Mr. Poe ................................................................................................... X 

Mr. Chaffetz ........................................................................................... X 

Mr. Griffin .............................................................................................. X 

Mr. Marino .............................................................................................. X 

Mr. Gowdy ..............................................................................................

Mr. Ross ................................................................................................. X 

Ms. Adams .............................................................................................

Mr. Quayle .............................................................................................. X 

Mr. Amodei ............................................................................................. X 

Mr. Conyers, Jr., Ranking Member ......................................................... X 

Mr. Berman ............................................................................................ X 

Mr. Nadler .............................................................................................. X 

Mr. Scott ................................................................................................ X 

Mr. Watt ................................................................................................. X 

Ms. Lofgren ............................................................................................ X 

Ms. Jackson Lee .....................................................................................


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ROLLCALL NO. 13—Continued 

Ayes Nays Present 

Ms. Waters ............................................................................................. X 

Mr. Cohen ...............................................................................................

Mr. Johnson, Jr. ...................................................................................... X 

Mr. Pierluisi ............................................................................................ X 

Mr. Quigley ............................................................................................. X 

Ms. Chu .................................................................................................. X 

Mr. Deutch ............................................................................................. X 

Ms. Sa ́ nchez ........................................................................................... X 

Mr. Polis ................................................................................................. X 

Total ..................................................................................... 20 13 

Committee Oversight Findings 

In compliance with clause 3(c)(1) of rule XIII of the Rules of the 

House of Representatives, the Committee advises that the findings 

and recommendations of the Committee, based on oversight activities under clause 2(b)(1) of rule X of the Rules of the House of Representatives, are incorporated in the descriptive portions of this report. 

New Budget Authority and Tax Expenditures 

Clause 3(c)(2) of rule XIII of the Rules of the House of Representatives is inapplicable because this legislation does not provide new 

budgetary authority or increased tax expenditures. 

Congressional Budget Office Cost Estimate 

In compliance with clause 3(c)(3) of rule XIII of the Rules of the 

House of Representatives, the Committee sets forth, with respect to 

the bill, H.R. 2299, the following estimate and comparison prepared 

by the Director of the Congressional Budget Office under section 

402 of the Congressional Budget Act of 1974: 

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, April 9, 2012. 

Hon. LAMAR SMITH, CHAIRMAN, Committee on the Judiciary, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 2299, the ‘‘Child Interstate Abortion Notification Act.’’ 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Mark Grabowicz, who 

can be reached at 226–2860. 

Sincerely, 

DOUGLAS W. ELMENDORF, 

DIRECTOR. 

Enclosure 

cc: 


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Honorable John Conyers, Jr. 

Ranking Member 

H.R. 2299—Child Interstate Abortion Notification Act. 

As ordered reported by the House Committee on the Judiciary on 

April 9, 2012. 

CBO estimates that implementing H.R. 2299 would have no significant cost to the Federal Government. Enacting the bill could affect direct spending and revenues; therefore, pay-as-you-go procedures apply. However, CBO estimates that any effects would be insignificant for each year. 

H.R. 2299 would establish new Federal crimes relating to the 

transporting of minors across State lines without parental notification to obtain abortions. Because the legislation would establish 

new offenses, the government would be able to pursue cases that 

it otherwise would not be able to prosecute. We expect that H.R. 

2299 would apply to a relatively small number of offenders, so any 

increase in costs for law enforcement, court proceedings, or prison 

operations would not be significant. Any such costs would be subject to the availability of appropriated funds. 

Because those prosecuted and convicted under H.R. 2299 could 

be subject to criminal fines, the Federal Government might collect 

additional fines if the legislation is enacted. Criminal fines are recorded as revenues, deposited in the Crime Victims Fund, and later 

spent. CBO expects that any additional revenues and direct spending would not be significant because of the small number of cases 

likely to be affected. 

H.R. 2299 contains an intergovernmental and a private-sector 

mandate as defined in the Unfunded Mandates Reform Act 

(UMRA) by requiring doctors, in certain cases, to provide parental 

notification in person or by certified mail before performing an 

abortion on a minor who is not a resident of the State in which the 

abortion would be performed. CBO estimates the cost for doctors in 

publicly owned or private medical facilities to comply with that 

mandate would be minimal. The bill also contains a private-sector 

mandate by prohibiting the transport of a minor across State lines 

with the intent to obtain an abortion in a State that does not require parental notification or consent. CBO estimates that the aggregate costs of the intergovernmental and private-sector mandates 

would be small and well below the annual thresholds established 

in UMRA ($73 million for intergovernmental mandates and $146 

million for private-sector mandates in 2012, adjusted annually for 

inflation). 

The CBO staff contacts for this estimate are Mark Grabowicz (for 

Federal costs) and Melissa Merrell and Marin Randall (for mandates). The estimate was approved by Peter H. Fontaine, Assistant 

Director for Budget Analysis. 

Performance Goals and Objectives 

The Committee states that pursuant to clause 3(c)(4) of rule XIII 

of the Rules of the House of Representatives, H.R. 2299 is designed 


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to prohibit taking minors across State lines in circumventions of 

laws requiring the involvement of parents in abortion decisions. 

Advisory on Earmarks 

In accordance with clause 9 of rule XXI of the Rules of the House 

of Representatives, H.R. 2299 does not contain any congressional 

earmarks, limited tax benefits, or limited tariff benefits as defined 

in clause 9(e), 9(f), or 9(g) of Rule XXI. 

Section-by-Section Analysis 

The following discussion describes the bill as reported by the 

Committee. 

Sec. 1. Short title. 

Section 1 provides this Act may be cited as the ‘‘Child Interstate 

Abortion Notification Act.’’ 

Sec. 2. Transportation of Minors in Circumvention of Certain Laws 

Relating to Abortion. 

Subsection (a) of Section 2 provides that, unless one of the exceptions listed below is met, whoever knowingly transports a minor 

across a State line, with the intent that such minor obtain an abortion, and thereby abridges the right of a parent under a law (in 

force in the minor’s state of residence) requiring parental involvement in a minor’s abortion decision, shall be fined or imprisoned 

not more than 1 year, or both. An abridgement of a parent’s right 

occurs if an abortion is performed or induced on the minor, in a 

State other than the State where the minor resides, without the 

parental consent or notification, or the judicial authorization, that 

would have been required by that law had the abortion been performed in the State where the minor resides. 

Subsection (b) of Section 2 provides for the following exceptions 

to prosecuting or suing someone under this section: (1) the prohibition does not apply if the abortion was necessary to save the life 

of the minor because her life was endangered by a physical disorder, physical injury, or physical illness, including a life endangering physical condition caused by or arising from the pregnancy 

itself; (2) the bill exempts from prosecution or suit the minor herself (the girl being transported) and any parent of that minor. 

Subsection (c) of Section 2 provides that a defendant can present 

an affirmative defense to a prosecution for an offense, or to a lawsuit, based on a violation of this section if the defendant: (1) reasonably believed, based on information the defendant obtained directly from a parent of the minor, that before the minor obtained 

the abortion, the parental consent or notification took place that 

was required under State law had the abortion been performed in 

the State where the minor resides; or (2) was presented with documentation showing with a reasonable degree of certainty that a 

court in the minor’s State of residence waived any parental notification required by the laws of that State, or otherwise authorized 

that the minor be allowed to obtain an abortion. 

Subsection (d) of Section 2 provides that any parent who suffers 

harm from a violation of subsection (a) may obtain appropriate relief in a civil action. 


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Subsection (e) of Section 2 provides, among other, the following 

definitions. The term a ‘‘law requiring parental involvement in a 

minor’s abortion decision’’ means a law requiring, before an abortion is performed on a minor, either: (1) notification to, or consent 

of, a parent of that minor; or (2) proceedings in a State court. A 

‘‘law requiring parental involvement in a minor’s abortion decision’’ 

does not include a law that allows notification or consent to be 

given by anyone other than a ‘‘parent’’ as defined in the bill. The 

term ‘‘minor’’ means an individual who is not older than the maximum age requiring parental notification or consent, or proceedings 

in a State court, under the State law requiring parental involvement in a minor’s abortion decision. The term ‘‘parent’’ means: (1) 

a parent or guardian; (1) a legal custodian; or (3) a person with the 

requisite legal status to have care and control of the minor, and 

with whom the minor regularly resides, who is designated by the 

law requiring parental involvement in the minor’s abortion decision 

as a person to whom notification, or from whom consent, is required. 

Sec. 3. Child Interstate Abortion Notification. 

Subsection (a) of Section 3 provides that a physician who knowingly performs or induces an abortion on a minor in violation of the 

requirements of this section shall be fined under this title or imprisoned not more than 1 year, or both. Subsection (a) further provides that, unless one of the exceptions described below is met, a 

physician who knowingly performs or induces an abortion on a 

minor who is a resident of a State other than the State in which 

the abortion is performed must provide at least 24 hours actual notice to a parent of the minor before performing the abortion. If actual notice to such parent is not possible after a reasonable effort 

has been made, 24 hours constructive notice must be given to a 

parent. 

Subsection (b) of Section 3 provides that subsection (a) does not 

apply if: (1) the abortion is performed or induced in a State that 

has a law in force requiring parental involvement in a minor’s 

abortion decision and the physician complies with the requirements 

of that law; (2) the physician is presented with documentation 

showing with a reasonable degree of certainty that a court in the 

minor’s State of residence has waived any parental notification required by the laws of that State, or has otherwise authorized that 

the minor be allowed to procure an abortion; (3) the minor declares 

in a signed written statement that she is the victim of sexual 

abuse, neglect, or physical abuse by a parent, and, before an abortion is performed on the minor, the physician notifies the authorities specified to receive reports of child abuse or neglect by the law 

of the State in which the minor resides of the known or suspected 

abuse or neglect; (4) the abortion is necessary to save the life of the 

minor because her life was endangered by a physical disorder, 

physical injury, or physical illness, including a life endangering 

physical condition caused by or arising from the pregnancy itself; 

or (5) the minor is physically accompanied by a person who presents the physician or his agent with documentation showing with 

a reasonable degree of certainty that he or she is in fact the parent 

of that minor. 


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Subsection (c) of Section 3 provides that any parent who suffers 

harm from a violation of subsection (a) may obtain appropriate relief in a civil action. 

Subsection (d) of Section 3 defines the following terms, among 

others. The term ‘‘actual notice’’ means the giving of written notice 

directly, in person. The term ‘‘constructive notice’’ means notice 

that is given by certified mail, return receipt requested, restricted 

delivery to the last known address of the person being notified, 

with delivery deemed to have occurred 48 hours following noon on 

the next day subsequent to mailing on which regular mail delivery 

takes place, days on which mail is not delivered excluded. The term 

a ‘‘law requiring parental involvement in a minor’s abortion decision’’ is given the same meaning as in Section 2. The term ‘‘minor’’ 

means an individual who is not older than 18 years and who is not 

emancipated under State law. The term ‘‘parent’’ means a parent 

or guardian; a legal custodian; or a person standing in loco parentis 

who has care and control of the minor, and with whom the minor 

regularly resides, as determined by State law. The term ‘‘physician’’ means a doctor of medicine legally authorized to practice 

medicine by the State in which such doctor practices medicine, or 

any other person legally empowered under State law to perform an 

abortion. 

Sec. 4. Severability and Effective Date. 

Subsection (a) of Section 4 provides that if any provision of this 

Act, or any application thereof, is found unconstitutional, that finding shall not affect any provision or application of the Act not so 

adjudicated. 

Subsection (b) of Section 4 provides that the provisions of this 

Act shall take effect upon enactment. 

Changes in Existing Law Made by the Bill, as Reported 

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (new matter is printed in italics 

and existing law in which no change is proposed is shown in 

roman): 

TITLE 18, UNITED STATES CODE 

* * * * * * * 

PART I—CRIMES 

Chapter. Sec. 

1. General Provisions ................................................................................. 1 

* * * * * * * 

117A. Transportation of minors in circumvention of certain laws relating to abortion ............................................................... 2431 

117B. Child interstate abortion notification ................................................ 2435 

* * * * * * * 


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CHAPTER 117A—TRANSPORTATIONOF MINORS IN CIRCUMVENTION OF CERTAIN LAWS RELATING TO ABORTION 

Sec. 

2431. Transportation of minors in circumvention of certain laws relating to abortion. 

2432. Transportation of minors in circumvention of certain laws relating to abortion. 

§ 2431. Transportation of minors in circumvention of certain 

laws relating to abortion 

(a) OFFENSE.— (1) GENERALLY.—Except as provided in subsection (b), whoever knowingly transports a minor across a State line, with the 

intent that such minor obtain an abortion, and thereby in fact 

abridges the right of a parent under a law requiring parental 

involvement in a minor’s abortion decision, in force in the State 

where the minor resides, shall be fined under this title or imprisoned not more than one year, or both. 

(2) DEFINITION.—For the purposes of this subsection, an 

abridgement of the right of a parent occurs if an abortion is 

performed or induced on the minor, in a State or a foreign nation other than the State where the minor resides, without the 

parental consent or notification, or the judicial authorization, 

that would have been required by that law had the abortion 

been performed in the State where the minor resides. 

(b) EXCEPTIONS.— (1) The prohibition of subsection (a) does not apply if the 

abortion was necessary to save the life of the minor because her 

life was endangered by a physical disorder, physical injury, or 

physical illness, including a life endangering physical condition 

caused by or arising from the pregnancy itself. 

(2) A minor transported in violation of this section, and 

any parent of that minor, may not be prosecuted or sued for a 

violation of this section, a conspiracy to violate this section, or 

an offense under section 2 or 3 of this title based on a violation 

of this section. 

(c) AFFIRMATIVE DEFENSE.—It is an affirmative defense to a 

prosecution for an offense, or to a civil action, based on a violation 

of this section that the defendant— 

(1) reasonably believed, based on information the defendant 

obtained directly from a parent of the minor, that before the 

minor obtained the abortion, the parental consent or notification took place that would have been required by the law requiring parental involvement in a minor’s abortion decision, 

had the abortion been performed in the State where the minor 

resides; or 

(2) was presented with documentation showing with a reasonable degree of certainty that a court in the minor’s State of 

residence waived any parental notification required by the laws 

of that State, or otherwise authorized that the minor be allowed 

to procure an abortion. 

(d) CIVIL ACTION.—Any parent who suffers harm from a violation of subsection (a) may obtain appropriate relief in a civil action 

unless the parent has committed an act of incest with the minor 

subject to subsection (a). 

(e) DEFINITIONS.—For the purposes of this section— 


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(1) the term ‘‘abortion’’ means the use or prescription of any 

instrument, medicine, drug, or any other substance or device intentionally to terminate the pregnancy of a female known to be 

pregnant, with an intention other than to increase the probability of a live birth, to preserve the life or health of the child 

after live birth, to terminate an ectopic pregnancy, or to remove 

a dead unborn child who died as the result of a spontaneous 

abortion, accidental trauma or a criminal assault on the pregnant female or her unborn child; 

(2) the term a ‘‘law requiring parental involvement in a minor’s abortion decision’’ means a law— 

(A) requiring, before an abortion is performed on a 

minor, either— 

(i) the notification to, or consent of, a parent of 

that minor; or 

(ii) proceedings in a State court; and 

(B) that does not provide as an alternative to the requirements described in subparagraph (A) notification to or 

consent of any person or entity who is not described in that 

subparagraph; 

(3) the term ‘‘minor’’ means an individual who is not older 

than the maximum age requiring parental notification or consent, or proceedings in a State court, under the law requiring 

parental involvement in a minor’s abortion decision; 

(4) the term ‘‘parent’’ means— 

(A) a parent or guardian; 

(B) a legal custodian; or 

(C) a person standing in loco parentis who has care 

and control of the minor, and with whom the minor regularly resides, who is designated by the law requiring parental involvement in the minor’s abortion decision as a person 

to whom notification, or from whom consent, is required; 

and 

(5) the term ‘‘State’’ includes the District of Columbia and 

any commonwealth, possession, or other territory of the United 

States, and any Indian tribe or reservation. 

§ 2432. Transportation of minors in circumvention of certain 

laws relating to abortion 

Notwithstanding section 2431(b)(2), whoever has committed an 

act of incest with a minor and knowingly transports the minor 

across a State line with the intent that such minor obtain an abortion, shall be fined under this title or imprisoned not more than one 

year, or both. For the purposes of this section, the terms ‘‘State’’, 

‘‘minor’’, and ‘‘abortion’’ have, respectively, the definitions given 

those terms in section 2435. 

CHAPTER 117B—CHILDINTERSTATE ABORTION 

NOTIFICATION 

Sec. 

2435. Child interstate abortion notification. 

§ 2435. Child interstate abortion notification 

(a) OFFENSE.— 


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(1) GENERALLY.—A physician who knowingly performs or 

induces an abortion on a minor in violation of the requirements 

of this section shall be fined under this title or imprisoned not 

more than one year, or both. 

(2) PARENTAL NOTIFICATION.—A physician who performs or 

induces an abortion on a minor who is a resident of a State 

other than the State in which the abortion is performed must 

provide, or cause his or her agent to provide, at least 24 hours 

actual notice to a parent of the minor before performing the 

abortion. If actual notice to such parent is not possible after a 

reasonable effort has been made, at least 24 hours constructive 

notice must be given to a parent before the abortion is performed. 

(b) EXCEPTIONS.—The notification requirement of subsection 

(a)(2) does not apply if— 

(1) the abortion is performed or induced in a State that 

has, in force, a law requiring parental involvement in a minor’s 

abortion decision and the physician complies with the requirements of that law; 

(2) the physician is presented with documentation showing 

with a reasonable degree of certainty that a court in the minor’s 

State of residence has waived any parental notification required 

by the laws of that State, or has otherwise authorized that the 

minor be allowed to procure an abortion; 

(3) the minor declares in a signed written statement that 

she is the victim of sexual abuse, neglect, or physical abuse by 

a parent, and, before an abortion is performed on the minor, the 

physician notifies the authorities specified to receive reports of 

child abuse or neglect by the law of the State in which the 

minor resides of the known or suspected abuse or neglect; 

(4) the abortion is necessary to save the life of the minor because her life was endangered by a physical disorder, physical 

injury, or physical illness, including a life endangering physical 

condition caused by or arising from the pregnancy itself, but an 

exception under this paragraph does not apply unless the attending physician or an agent of such physician, within 24 

hours after completion of the abortion, notifies a parent in writing that an abortion was performed on the minor and of the circumstances that warranted invocation of this paragraph; or 

(5) the minor is physically accompanied by a person who 

presents the physician or his agent with documentation showing 

with a reasonable degree of certainty that he or she is in fact 

the parent of that minor. 

(c) CIVIL ACTION.—Any parent who suffers harm from a violation of subsection (a) may obtain appropriate relief in a civil action 

unless the parent has committed an act of incest with the minor 

subject to subsection (a). 

(d) DEFINITIONS.—For the purposes of this section— 

(1) the term ‘‘abortion’’ means the use or prescription of any 

instrument, medicine, drug, or any other substance or device intentionally to terminate the pregnancy of a female known to be 

pregnant, with an intention other than to increase the probability of a live birth, to preserve the life or health of the child 

after live birth, to terminate an ectopic pregnancy, or to remove 

a dead unborn child who died as the result of a spontaneous 


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abortion, accidental trauma, or a criminal assault on the pregnant female or her unborn child; 

(2) the term ‘‘actual notice’’ means the giving of written notice directly, in person, by the physician or any agent of the physician; 

(3) the term ‘‘constructive notice’’ means notice that is given 

by certified mail, return receipt requested, restricted delivery to 

the last known address of the person being notified, with delivery deemed to have occurred 48 hours following noon on the 

next day subsequent to mailing on which regular mail delivery 

takes place, days on which mail is not delivered excluded; 

(4) the term a ‘‘law requiring parental involvement in a minor’s abortion decision’’ means a law— 

(A) requiring, before an abortion is performed on a 

minor, either— 

(i) the notification to, or consent of, a parent of 

that minor; or 

(ii) proceedings in a State court; 

(B) that does not provide as an alternative to the requirements described in subparagraph (A) notification to or 

consent of any person or entity who is not described in that 

subparagraph; 

(5) the term ‘‘minor’’ means an individual who is not older 

than 18 years and who is not emancipated under the law of the 

State in which the minor resides; 

(6) the term ‘‘parent’’ means— 

(A) a parent or guardian; 

(B) a legal custodian; or 

(C) a person standing in loco parentis who has care 

and control of the minor, and with whom the minor regularly resides; 

as determined by State law; 

(7) the term ‘‘physician’’ means a doctor of medicine legally 

authorized to practice medicine by the State in which such doctor practices medicine, or any other person legally empowered 

under State law to perform an abortion; and 

(8) the term ‘‘State’’ includes the District of Columbia and 

any commonwealth, possession, or other territory of the United 

States, and any Indian tribe or reservation. 


srobinson on DSK4SPTVN1PROD with HEARING
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1See, e.g., Jessica Valenti, Republicans Wage War on Women: Latest Paternalistic Efforts 

to Control Female Sexuality Are Part of a Long Pattern, BALTIMORE SUN, Feb. 28, 2012, available at http://articles.baltimoresun.com/2012-02-28/news/bs-ed-war-on-women-20120228l1l 

democratic-women-republicans-contraception. 2 No Taxpayer funding for Abortion Act: Hearing on H.R. 3 Before the Subcomm. on the Const. 

of the H. Comm. on the Judiciary, 112th Cong. (2011); Markup of H.R. 3, the No Taxpayer Funding for Abortion Act, by the H. Comm. on the Judiciary, 112th Cong. (Mar. 3, 2011); The State 

of Religious Liberty in the United States: Hearing Before the Subcomm. on the Const. of the H. 

Comm. on the Judiciary, 112th Cong. (2011); Susan B. Anthony and Frederick Douglass Prenatal Nondiscrimination Act (PRENDA) of 2011: Hearing on H.R. 3541 Before the Subcomm. on 

the Const. of the H. Comm. on the Judiciary, 112th Cong. (2011); Markup of H.R. 3541, the 

Susan B. Anthony and Frederick Douglass Prenatal Nondiscrimination Act of 2011 by the H. 

Comm. on the Judiciary, 112th Cong. (Feb. 7, 8, 16, 2012); Child Interstate Abortion Notification 

Act: Hearing on H.R. 2299 Before the Subcomm. on the Const. of the H. Comm. on the Judiciary, 

112th Cong. (2012) [hereinafter CIANA Hearing]; Markup of H.R. 3803, the District of Columbia 

Pain-Capable Unborn Child Protection Act, by the H. Comm. on the Judiciary, 112th Cong. (July 

18, 2012); Markup of H.R. 2299, the Child Interstate Abortion Notification Act, by the H. Comm. 

on the Judiciary, 112th Cong. (Mar. 27, 2012); The District of Columbia Pain-Capable Unborn 

Child Protection Act: Hearing on H.R. 3803 Before the H. Subcomm on the Const. of the H. 

Comm. on the Judiciary, 112th Cong. (2012); The Obama Administration’s Abuse of Power: 

Hearing Before the H. Comm. on the Judiciary, 112th Cong. (2012). 3 H.R. 2299 defines a ‘‘minor’’ as ‘‘an individual who is not older than the maximum age requiring parental notification or consent, or proceedings in a State court, under the law requiring 

parental involvement in a minor’s abortion decision.’’ H.R. 2299, 112th Cong. § 2 (2011). 

Dissenting Views 

H.R. 2299, the ‘‘Child Interstate Abortion Notification Act,’’ 

(CIANA) imposes draconian criminal penalties on a vast array of 

individuals—including the clergy, grandparents, and health care 

professionals—arising from their involvement in assisting a minor 

in obtaining an abortion. This measure is yet another attack by the 

Majority against women’s reproductive freedom.1 For example, the 

House Judiciary Committee has, to date, met on 12 occasions during this Congress to consider various measures intended to restrict 

women’s reproductive freedom.2

While, in most instances, young women 3 should and do turn to 

their parents when facing difficult decisions regarding their pregnancy, not all circumstances are ideal. In some cases, it is impossible or even dangerous for a young woman to involve her parents 

in that decision, or even to inform them of the pregnancy. Where, 

for example, the parent, close relative, or family friend may have 

caused the pregnancy, it may become necessary for the young 

woman to turn to a sibling, a grandparent, a clergyperson, or other 

trusted adult for assistance and guidance. CIANA, however, would 

turn that responsible adult into a criminal and thereby effectively 

force this young woman to face one of the most difficult situations 

in her life alone. 

CIANA also imposes criminal penalties on health care professionals who fail to comply with the bill’s unreasonable notification 

requirements. Under the bill, health care professionals would be 

forced to be knowledgeable of and to comply with the laws of all 

50 states, the District of Columbia, Puerto Rico, territories, possessions, and Indian tribes and reservations. Such professionals would 

also be forced under CIANA to comply with a new Federal parental 


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4 CIANA Hearing (letter from the American Academy of Pediatrics, the American Congress 

of Obstetricians and Gynecologists, & the Society for Adolescent Health and Medicine to Rep. 

Trent Franks (R-AZ), Chair, & Rep. Jerrold Nadler (D-NY), Ranking Member, Subcomm. on the 

Const. of the H. Comm. on the Judiciary (Mar. 7, 2012)) (on file with the H. Comm. on the Judiciary, Democratic staff). 5 Id. at 104 (testimony of the National Latina Institute for Reproductive Health). 6 Id. at 145 (testimony of Michelle Forcier, Board Member, Physicians for Reproductive Choice 

and Health). 7 Id. at 140 (testimony of Debra Ness, President, & Andrea Friedman, Director of Reproductive 

Health Programs, National Partnership for Women and Families). 8 Id. at 149 (testimony of Kirsten Moore, President & CEO, Reproductive Health Technologies 

Project). 9 Id. at 137 (testimony of the National Abortion Federation). 10 Id. at 109 (testimony of Laura W. Murphy, Director, Washington Legislative Office, et al. 

American Civil Liberties Union). 11 Id. at 117 (testimony of the Center for Reproductive Rights). 12 Id. at 134 (letter from Abortion Care Network, Advocates for Youth, American Association 

of University Women, American Civil Liberties Union, American Medical Student Association, 

Association of Reproductive Health Professionals, Black Women’s Health Imperative, Break the 

Cycle, Center for Reproductive Rights, DC For Democracy, JACPAC, National Abortion Federation, National Asian Pacific American Women’s Forum, National Council of Jewish Women, National Latina Institute for Reproductive Health, National Family Planning & Reproductive 

Health, National Network of Abortion Funds, National Partnership for Women & Families, National Women’s Health Network, National Women’s Law Center, National Organization for 

Women, NARAL Pro-Choice America, People For the American Way, Physicians for Reproductive Choice and Health, Planned Parenthood Federation of America, and Population Connection 

to Rep. Trent Franks (R-AZ), Chair, & Rep. Jerrold Nadler (D-NY), Ranking Member, Subcomm. 

on the Const. of the H. Comm. on the Judiciary (Mar. 8, 2012). 13Letter from Anti-Defamation League, Catholics for Choice, Concerned Clergy for Choice, Hadassah, Jewish Reconstructionist Federation, Jewish Women International, Methodist Federation for Social Action, National Council of Jewish Women, Presbyterian Voices for Justice, Religious Coalition for Reproductive Choice, Religious Institute, Spiritual Youth for Reproductive 

Freedom, Union for Reform Judaism, Unitarian Universalist Association of Congregations, Unitarian Universalist Women’s Federation, Women’s Alliance for Theology, Ethics and Ritual, 

Women of Reform Judaism to Rep. Trent Franks (R-AZ), Chair, & Rep. Jerrold Nadler (D-NY), 

Ranking Member, Subcomm. on the Const. of the H. Comm. on the Judiciary (Mar. 27, 2012) 

(on file with the H. Comm. on the Judiciary, Democratic staff). 

notification requirement, which is unconstitutionally restrictive. 

Health care professionals would be subject to criminal sanction 

under the bill if they fail to comply with these requirements. As a 

result, CIANA would criminalize the otherwise lawful practice of 

medicine and dangerously undermine the doctor-patient relationship. 

Finally, CIANA violates fundamental principles of federalism. 

The bill would effectively force a young woman to carry the laws 

of her state on her back whenever she traveled across state lines. 

And, it would impose laws enacted in one state on the citizens of 

another state, even in those states that have no comparable statutes and states that specifically rejected such measures. 

Not surprisingly, H.R. 2299 is opposed by the American Academy 

of Pediatrics, the American Congress of Obstetricians and Gynecologists, and the Society for Adolescent Health and Medicine;4 the 

National Latina Institute for Reproductive Health;5 Physicians for 

Reproductive Choice and Health;6 the National Partnership for 

Women and Families;7 the Reproductive Health Technologies 

Project;8 the National Abortion Federation;9 the American Civil 

Liberties Union;10 the Center for Reproductive Rights;11 a coalition 

of 26 women’s health and civil liberties organizations;12 and a coalition of 17 religious and faith based organizations and communities.13

For these reasons, and those described below, we respectfully dissent and we urge our colleagues to reject this seriously flawed bill. 


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14See, e.g., Child Interstate Abortion Notification Act, H.R. 748, 109th Cong. (2005); Child 

Custody Protection Act, S. 403, 109th Cong. (2005); Child Custody Protection Act, H.R. 1755, 

108th Cong. (2003); Child Custody Protection Act, S. 851, 108th Cong. (2003); Child Custody 

Protection Act, H.R. 476, 107th Cong. (2001); Child Custody Protection Act, H.R. 1218, 106th 

Cong. (1999); Child Custody Protection Act, S. 661, 106th Cong. (1999); Child Custody Protection 

Act, H.R. 3682, 105th Cong. (1998); Child Custody Protection Act, S. 1645, 105th Cong. (1998). 15For reasons that are not entirely clear, both sections 2331 and 2332 are entitled ‘‘Transportation of minors in circumvention of certain laws relating to abortion.’’ 

DESCRIPTION AND BACKGROUND

CIANA is old wine in a new bottle. Similar legislation has been 

introduced in at least five prior Congresses under Republican leadership.14 The bill provides both criminal penalties for, and a civil 

cause of action against, a person who takes an unemancipated 

minor across state or international boundaries for the purpose of 

obtaining an abortion in circumvention of the minor’s home state’s 

parental involvement laws. It also imposes criminal penalties on, 

and provides for a civil cause of action against, any physician who 

performs such an abortion. 

A summary of the principal substantive provisions of H.R. 2299 

follows. The bill amends title 18 of the United States Code to add 

two new chapters 117A and 117B. As added by the bill, chapter 

117A consists of sections 2431 and 2432.15 New section 2431(a)(1), 

in turn, makes it a crime, punishable by a fine or imprisonment of 

up to 1 year for anyone who ‘‘knowingly transports a minor across 

a State line, with the intent that such minor obtain an abortion, 

and thereby in fact abridges the right of a parent under a law requiring parental involvement in a minor’s abortion decision, in 

force in the State where the minor resides.’’ The prohibition is triggered if ‘‘an abortion is performed or induced on the minor, in a 

State or a foreign nation other than the State where the minor resides, without the parental consent or notification, or the judicial 

authorization, that would have been required by that law had the 

abortion been performed in the State where the minor resides.’’ 

Subsection 2431(a)(2) makes this prohibition applicable to an individual who takes the minor across an international boundary. 

Section 2431(b) specifies an unconstitutionally narrow exception 

to the bill’s prohibition. The exception applies only ‘‘if the abortion 

was necessary to save the life of the minor because her life was endangered by a physical disorder, physical injury, or physical illness, 

including a life endangering physical condition caused by or arising 

from the pregnancy itself.’’ 

Section 2431(c) sets forth two affirmative defenses. It provides 

that it is an affirmative defense to a prosecution for an offense, or 

to a civil action, based on a violation of new section 2431, if the 

defendant: 

(1) reasonably believed, based on information the defendant obtained directly from a parent of the minor, that before the minor obtained the abortion, the parental consent 

or notification took place that would have been required by 

the law requiring parental involvement in a minor’s abortion decision, had the abortion been performed in the State 

where the minor resides; or 

(2) was presented with documentation showing with a reasonable degree of certainty that a court in the minor’s 


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State of residence waived any parental notification required by the laws of that State, or otherwise authorized 

that the minor be allowed to procure an abortion. 

Section 2431(d) provides a cause of action to a parent ‘‘who suffers harm from a violation’’ of section 2431(a), unless the parent 

committed an act of incest with the minor. 

Section 2431(e) sets forth various definitions. 

New section 2432 specifies that an individual who has had incest 

with a minor and transports that minor across state lines with the 

intention that the minor obtain an abortion would be subject to a 

fine or imprisonment of not more than 1 year. 

New chapter 117B, as added to title 18 of the United States 

Code, consists solely of section 2435, which does not impose any 

legal duties or penalties on the minor. Rather, the focus of this provision is on the health care profession. 

Section 2435(a) mandates that a physician give 24 hours ‘‘actual 

notice’’ to a parent before performing an abortion on a minor who 

is from out-of-state. This provision applies even if the minor came 

from a state that does not have a parental consent or notification 

law. Note that section 2435(d)(2) defines ‘‘actual notice’’ as ‘‘the giving of a written notice directly, in person.’’ Section 2435(a)(2), in 

turn, authorizes the physician to give at least 24 hours ‘‘constructive notice’’ to the patient’s parents if it is not possible to provide 

them with ‘‘actual notice’’ after the abortion provider has made a 

reasonable effort to do so. Although section 2435(d)(3) defines ‘‘constructive notice’’ as ‘‘notice that is given by certified mail, return 

receipt requested, restricted delivery to the last known address of 

the person being notified,’’ the bill fails to define ‘‘reasonable effort.’’ 

Section 2435(b) specifies five exceptions to section 2435(a): 

(1) the abortion is performed or induced in a State that 

has, in force, a law requiring parental involvement in a 

minor’s abortion decision and the physician complies with 

the requirements of that law; 

(2) the physician is presented with documentation showing 

with a reasonable degree of certainty that a court in the 

minor’s State of residence has waived any parental notification required by the laws of that State, or has otherwise 

authorized that the minor be allowed to procure an abortion; 

(3) the minor declares in a signed written statement that 

she is the victim of sexual abuse, neglect, or physical 

abuse by a parent, and, before an abortion is performed on 

the minor, the physician notifies the authorities specified 

to receive reports of child abuse or neglect by the law of 

the State in which the minor resides of the known or suspected abuse or neglect; 

(4) the abortion is necessary to save the life of the minor 

because her life was endangered by a physical disorder, 

physical injury, or physical illness, including a life endangering physical condition caused by or arising from the 

pregnancy itself, but an exception under this paragraph 


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16 Bellotti v. Baird, 443 U.S. 622, 643–44 (1979). 

does not apply unless the attending physician or an agent 

of such physician, within 24 hours after completion of the 

abortion, notifies a parent in writing that an abortion was 

performed on the minor and of the circumstances that warranted invocation of this paragraph; or 

(5) the minor is physically accompanied by a person who 

presents the physician or his agent with documentation 

showing with a reasonable degree of certainty that he or 

she is in fact the parent of that minor. 

It should be noted that the bill fails to include any exception for 

an instance where the parent cannot be located or where it is otherwise impossible to provide timely written notice. The bill’s exception for a minor accompanied by an individual who ‘‘presents the 

physician or his agent with documentation showing with a reasonable degree of certainty that he or she is in fact the parent of that 

minor,’’ fails to specify what would qualify as sufficient documentation. Also, the narrowness of the exception for the minor’s medical 

condition would prohibit a physician from performing an abortion 

where the minor is from out of state and the minor has a non-life 

threatening medical emergency. 

Section 2435’s requirements, as set forth in subsection (a), and 

limited exceptions, as set forth in subsection (b), create some very 

convoluted requirements for physicians and their patients. If a 

minor from a state with no parental consent or notice laws traveled 

to a state also with no parental consent or notification laws, the 

bill requires the physician to provide ‘‘actual notice’’ directly in person to the patient’s parents without the minor having the option 

of a judicial bypass. The bill’s failure to provide for this option directly violates prior Supreme Court rulings.16 Also, in order for the 

exceptions to apply in cases where the minor is the victim of sexual 

abuse, the doctor must report any sexual abuse to the proper authorities where the minor resides. This exception only comes into 

play if one of the abusers was a parent pursuant to section 

2435(b)(3). H.R. 2299, however, fails to define the term ‘‘proper authorities.’’ 

Other problems presented by the provisions include the following. If a minor from a state with a strict parental consent or 

notification law went to another state with a strict parental consent or notice law, the minor is required to abide by her own state 

law in order for an adult to transport her across state lines. H.R. 

2299 requires the physician to comply with the laws of the state 

in which her practice is located as well. Minors who live in very 

rural states may find that cities in adjoining states are closer than 

cities in other states. Additionally, the minor’s own jurisdiction 

may not have a provider of abortion services. 

If a minor who comes from a state with a strict parental consent 

or notification law seeks an abortion in a state with no parental 

consent or notice law, then the minor must still abide by her state 

law in order for an adult to transport her across state lines. And, 

the physician must provide ‘‘actual notice’’ to the patient’s parents. 

As a result, a physician would be required to know: (1) the requireVerDate Mar 15 2010 22:28 Sep 14, 2012 Jkt 019006 PO 00000 Frm 00071 Fmt 6601 Sfmt 6601 E:\HR\OC\HR671.XXX HR671

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17 U.S. Department of Health and Human Services, Administration of Children, Youth and 

Families, Children’s Bureau, Child Maltreatment 2008 (2010). 

ments of this legislation; (2) the laws of all 50 states, the District 

of Columbia, Puerto Rico, territories, possessions, Indian tribes and 

reservations concerning parental consent or notice; and (3) the 

place of residence of the minor in order for her to comply with this 

bill. 

Section 2435(c) authorizes a parent who ‘‘suffers harm’’ from a 

violation of section 2435(a) to file a civil action unless the parent 

had committed an act of incest with the minor. And, section 

2435(d) sets forth various definitions. 

CONCERNS WITH H.R. 2299

I. H.R. 2299 ENDANGERS THE HEALTH AND SAFETY OF YOUNG WOMEN

Every young woman should be able to turn to her parents when 

faced with a pregnancy and receive the counsel and support she 

needs. Fortunately, that occurs in the overwhelming majority of 

cases, and this bill would be inapplicable under such circumstances. 

Unfortunately, there are many reasons why some pregnant 

young women cannot turn to their parents for support and guidance. CIANA simply ignores this very real fact and fails to take 

into account those instances where a minor may need immediate 

treatment or where the minor’s parents themselves pose a direct 

threat to the young woman. 

A major flaw of CIANA is that it would render responsible 

adults—including well-intentioned siblings, grandparents, and 

members of the clergy—subject to criminal prosecution and civil 

suit. The bill would make it impossible for a pregnant minor to 

seek the assistance of any other adult no matter what the situation 

is at home. 

We attempted to address this serious defect of the bill by offering 

amendments to exempt persons to whom a young woman might 

turn for assistance in a difficult situation. For example, Rep. 

Jerrold Nadler (D-NY) offered an amendment to exempt a grandparent or adult sibling of the minor unless the grandparent or 

adult sibling had sexual contact with the minor. Rep. Robert C. 

‘‘Bobby’’ Scott (D-VA) offered an amendment that would have exempted taxicab drivers, bus drivers, or other persons in the business of professional transport who might unwittingly be subject to 

this legislation, unless that person had sexual conduct with the 

minor or is a registered sex offender. Rep. Scott also offered an 

amendment that would have added siblings to the minor and the 

parents of the minor as persons who could not be sued or prosecuted under the bill. Rep. Sheila Jackson Lee (D-TX) offered an 

amendment creating an exception for clergy, godparents, aunts, uncles, or first cousins of the minor unless that person had sexual 

contact with the minor. Each of these amendments was rejected. 

Another equally serious flaw of CIANA is that it ignores the 

kinds of problems young people face. An estimated 772,000 children 

were found to be victims of abuse or neglect in 2008.17 Young 

women considering abortion are particularly vulnerable because 


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18See, e.g., H. Amaro et al., Violence During Pregnancy and Substance Abuse, 80 AM. J. OF

PUB. HEALTH 575–579 (1990); University of Pittsburgh Medical Center, Information for Patients, 

Abuse During Pregnancy, ED/JAW Rev. (Mar. 2003). 19 American Psychological Association, Parental Consent Laws for Adolescent Reproductive 

Health Care: What Does the Psychological Research Say? (Feb. 2000), citing A.B. Berenson, et 

al., Prevalence of Physical and Sexual Assault in Pregnant Adolescents, 13 J. of Adolescent 

Health 466–69 (1992). 20 CIANA Hearing at 43 (testimony of the Very Reverend Kathleen Ragsdale). 21Martin Donohoe, Parental Notification and Consent Laws for Teen Abortions: Overview and 

2006 Ballot Measures MEDSCAPE Ob/Gyn & Women’s Health, Feb. 9, 2007, available at http:// 

www.medscape.com/viewarticle/549316 (last visited Oct. 20, 2010); Stanley K. Henshaw & Kathryn Kost, Parental Involvement in Minors’ Abortion Decisions, 24 FAMILY PLANNING PERSPECTIVES 197, 199–200 (1992). 22 Helena Silverstein, Girls on the Stand: How Courts Fail Pregnant Minors (2007) (quoting 

Melissa Jacobs). Are Courts Prepared to Handle Judicial Bypass Proceedings? 32 Human Rights 

4 (Winter 2005). 23Margie Boule, An American Tragedy, Sunday Oregonian, Aug. 27, 1989. 24Planned Parenthood of Southeastern Pennsylvania v. Casey, 505 U.S. 833, 889 (1992) (citing expert witness testimony). 

family violence is often at its worst during a family member’s pregnancy.18

Nearly half of pregnant teens who have a history of abuse report 

being assaulted during their pregnancy, most often by a family 

member.19 For example, at the hearing on this legislation, The 

Very Reverend Dr. Katherine Hancock Ragsdale discussed some of 

these problems that young women face.20 She movingly described 

a 15-year-old who had been made pregnant during a date rape and 

sought to obtain an abortion on her own because she feared violence if her father found out about the pregnancy. 

Among minors who did not tell a parent of their abortion, 30 percent had experienced violence in their family or feared violence or 

being forced to leave home.21 As one young woman explained, ‘‘[m]y 

older sister got pregnant when she was seventeen. My mother 

pushed her against the wall, slapped her across the face and then 

grabbed her by the hair, pulled her through the living room out the 

front door and threw her off the porch. We don’t know where she 

is now.’’ 22 In Idaho, a 13-year-old student named Spring Adams 

was shot to death by her father after he learned she was to terminate a pregnancy caused by his acts of incest.23

As the Supreme Court has recognized, ‘‘[m]ere notification of 

pregnancy is frequently a flashpoint for battering and violence 

within the family. The number of battering incidents is high during 

the pregnancy and often the worst abuse can be associated with 

pregnancy.’’ 24

To address this very real danger, Rep. Hank Johnson (D-GA) offered an amendment that would have created an exception to the 

bill if the disclosure of the pregnancy or the decision to terminate 

the pregnancy to one or both of the minor’s parents would endanger the physical safety of the minor. Similarly, Rep. Jackson Lee 

offered an amendment that would have created an exception where 

the pregnancy was the result of sexual contact with a parent or 

any other person who has permanent or temporary care or custody 

or responsibility for the supervision of the minor, or by any household or family member. Both amendments were rejected. 


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25 Casey, 505 U.S. at 879. 26 Id. 27 126 S. Ct. 961, 967 (2006). In Doe v. Bolton, 410 U.S. 179 (1973), the Court held that, to 

determine whether an abortion is necessary to protect a woman’s ‘‘health,’’ a doctor may exercise 

his or her judgment based on various factors, such as a woman’s physical, emotional, psychological, and familial well-being, as well as her age. 28 Ayotte, 126 S. Ct. at 967 (‘‘New Hampshire has not taken real issue with the factual basis 

of this litigation: In some very small percentage of cases, pregnant minors, like adult women, 

need immediate abortions to avert serious and often irreversible damage to their health.’’). 29 Roe v. Wade, 410 U.S. 113, 164–65 (1973) (holding that a state may regulate or proscribe 

post-viability abortions with the exception where it is necessary for the preservation of the life 

or health of the woman). 

II. H.R. 2299 IS UNCONSTITUTIONAL

A. H.R. 2299 Lacks an Adequate Exception To Protect the Life of 

a Young Woman and Fails To Include Any Exception To Protect 

Her Health 

H.R. 2299 has an unconstitutionally narrow exception to protect 

the life of the woman, and no health exception. These exceptions 

are especially important in light of the tremendous uncertainty and 

onerous civil and criminal penalties responsible adults and health 

care providers would face under the bill. In particular, the delay 

that the bill’s notice requirements would impose under section 2432 

could be fatal or dangerous to a young woman’s health and future 

fertility. 

The narrowness of the ‘‘life’’ exception in both sections—applying 

only ‘‘if the abortion was necessary to save the life of the minor because her life was endangered by a physical disorder, physical injury, or physical illness, including a life endangering physical condition caused by or arising from the pregnancy itself’’—would also 

place health care providers in an impossible position. Just how severe must a physical threat to a woman’s health be before a physician could feel confident that a life exception may be invoked? How 

much could a court second-guess a medical decision of this type in 

a future court proceeding? What would be the cost of defending 

such a case even if a physician ultimately prevailed in a civil or 

criminal case, or both? 

As the Supreme Court has long-recognized, laws containing life 

exceptions cannot pick and choose among life-threatening circumstances.25 The Court requires any restriction on abortion to include an exception ‘‘where it is necessary, in appropriate medical 

judgment, for the preservation of the life or the health of the mother.’’ 26 In Ayotte v. Planned Parenthood of Northern New England, 

the Court expressly reiterated its prior holdings in Roe and Casey 

that a state may not restrict access to an abortion that is necessary 

to preserve the life or health of the pregnant woman.27 The Court 

also stated the factual proposition that in a small number of cases 

a pregnant minor requires an immediate abortion to prevent serious health consequences, something proponents of this legislation 

still incorrectly assert is not the case.28 Therefore, a state statute 

that restricts a pregnant minor’s access to an abortion must include an exception for medical emergencies involving the minor’s 

health or life. 

In recognition of the fact that CIANA fails to include any health 

exception whatsoever in clear violation of Supreme Court precedent,29 Rep. Judy Chu (D-CA) offered an amendment that would 


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30Planned Parenthood v. Danforth, 428 U.S. 52, 74 (1976). 31 Bellotti, 443 U.S. at 643–44. 32Danforth, 428 U.S. at 75. 33 497 U.S. 502 (1990). 34 520 U.S. 292 (1997). 35 Id. at 295. 

have expanded the exception to save the life of the young woman 

to include protecting her health as required by the Constitution. 

Rep. Melvin Watt (D-NC) offered an amendment that would have 

created an exception for a person who has a good faith belief that 

the minor’s life or health would be endangered by the delay necessary to comply with the law requiring parental involvement in a 

minor’s abortion decision in the state where the minor resides, including any proceedings in state court. Rep. Watt also offered an 

amendment to create an exception to protect the life and health of 

the minor. Rep. Mike Quigley (D-IL) offered an amendment to create an exception of the minor’s pregnancy was the result of rape 

or incest. All of these amendments were rejected. 

B. H.R. 2299 Fails To Include the Constitutionally-Mandated Judicial Bypass for Parental Notification and Consent Laws 

The Supreme Court has held that a state may not impose a blanket parental-consent requirement that would empower a parent to 

veto a young woman’s decision to have an abortion.30 If a state requires a minor to obtain consent from one or both of the minor’s 

parents, it must also give her the opportunity to bypass that mandate by seeking a judicial determination that she is either sufficiently mature to make her own decision or that, even if she is ‘‘immature,’’ the proposed abortion is in her ‘‘best interests.’’ 31 As the 

Supreme Court has recognized, ‘‘Any independent interest the parent may have in the termination of the minor daughter’s pregnancy 

is no more weighty than the right of privacy of the competent 

minor mature enough to become pregnant.’’ 32 Consistent with this 

holding, the courts have made it clear that reasonable alternatives 

to parental consent are necessary for these laws to pass constitutional scrutiny. 

The Court has also invalidated state parental consent laws that 

do not include judicial bypass procedures. In Ohio v. Akron Center 

for Reproductive Health, the Court, in holding that the Ohio parental notification statute at issue was constitutional, appeared to suggest that the statute’s judicial bypass procedure adequately protected a pregnant minor’s right to obtain an abortion.33 The Court 

expressly declined, however, to decide whether a state parental notification law that did not include a judicial bypass procedure 

would per se violate the Constitution. In Lambert v. Wicklund, the 

Court similarly declined to reach the question of whether a state 

parental notification law must contain a judicial bypass procedure.34 Rather, the Court held narrowly that the Montana parental 

notification law at issue, which contained a judicial bypass procedure, did not place an undue burden on a pregnant minor’s right 

to obtain an abortion.35

A parental notification law would be unconstitutional if it did not 

provide a pregnant minor with some alternative to parental notification. In H.L. v. Matheson, the Court upheld as constitutional a 

state statute that requires an unemancipated minor who lives with 


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36 450 U.S. 398 (1981). 37 Belotti v. Baird, 443 U.S. 622 (1979). 38 Id. at 647. 39 Akron, 497 U.S. at 513. 40 Id. at 515. 41Danforth, 428 U.S. at 74. 

her parents to notify them, ‘‘if possible,’’ before she obtains an abortion, but includes exceptions for a minor who demonstrates that notification is not in her best interests.36 Moreover, in Belotti v. 

Baird, the Court indicated that a parental notification law would 

be unconstitutional if it did not provide an alternative to notification for a ‘‘mature’’ minor or when notification would not be in a 

minor’s best interests.37 In that case, the Court observed: 

[U]nder state regulation such as that undertaken by Massachusetts, every minor must have the opportunity—if she 

so desires—to go directly to a court without first consulting 

or notifying her parents. If she satisfies the court that she 

is mature and well enough informed to make intelligently 

the abortion decision on her own, the court must authorize 

her to act without parental consultation or consent.38

The Court has yet to establish specific parameters for the adequacy of judicial bypass procedures in the context of state parental 

involvement laws. In writing for the majority in Akron, Justice 

Kennedy rejected the dissenting opinion’s call to articulate specific 

procedural thresholds for the constitutionality of a judicial bypass 

alternative, such as whether it must be anonymous or only confidential, or how quickly a state must provide a pregnant minor 

with the opportunity for a court proceeding. He stated only that the 

Ohio judicial bypass procedure contained ‘‘reasonable steps’’ to protect the identity of pregnant minors seeking a judicial bypass and 

that the procedure included adequate provisions to expedite a pregnant minor’s request for a proceeding.39 The Court’s majority also 

held that a state may validly require a pregnant minor to establish 

‘‘by clear and convincing evidence’’ during a judicial bypass hearing 

that she is mature enough to make an abortion decision without 

parental involvement.40

To address this defect, Rep. Nadler offered an amendment that 

would have allowed an adult who had a reasonable belief that compliance with the judicial bypass procedure of the minor’s state of 

residence would either compromise the minor’s intent to maintain 

confidentiality with respect to the choice to terminate the pregnancy, or would be futile or ineffective in the minor’s home state, 

could apply to a Federal district court in the district in which the 

minor resides for a waiver of the application of the Act. The 

amendment was rejected. 

C. H.R. 2299 Imposes an Unconstitutional Undue Burden on a 

Young Woman’s Right To Obtain an Abortion 

The Supreme Court has ruled that the constitutional right to privacy includes a minor’s decision to terminate her pregnancy.41 In 

addition, the Court has held that any restriction that has the purpose or effect of placing an ‘‘undue burden’’ on a woman’s right to 


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42 Casey, 505 U.S. at 874. 43The following states do not have enforceable parental involvement laws and would likely 

be subject to CIANA’s Federal notification provisions: Alaska, California, Connecticut, Florida, 

Hawaii, Idaho, Illinois, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, 

Oklahoma, Oregon, Vermont, Washington, and the District of Columbia. NARAL Pro-Choice 

America Foundation, Who Decides? The Status of Women’s Reproductive Rights in the United 

States (21th ed. 2012), available at www.WhoDecides.org. 44The bill provides two exceptions: the narrow exception to preserve the life, but not the 

health of the young woman; and the exception for a young woman who ‘‘declares in a signed 

written statement that she is the victim of sexual abuse, neglect, or physical abuse by a parent, 

and, before an abortion in performed on the minor, the physician notifies the authorities specified 

to receive reports of child abuse or neglect by the law of the State in which the minor resides 

of the known or suspected abuse or neglect.’’ H.R. 2299, 112th Cong. § 2435(a)(4)–(5) (2011) (emphasis added). 45 Hodgson v. Minnesota, 497 U.S. 417, 420 (1990); Akron 497 U.S. at 510. 46 Id. 47 Casey, 505 U.S. at 886. 48Memorandum from Professors Laurence H. Tribe, Harvard University School of Law, & 

Peter J. Rubin, Georgetown University Law Center, to the H. Comm. on the Judiciary, at 2 

(Sept. 2, 2001) (on file with the H. Comm. on the Judiciary, Democratic staff). 49 Id. 

choose to have an abortion prior to viability is unconstitutional.42

H.R. 2299 is in conflict with this longstanding precedent. 

The bill’s Federal parental notification provision—which is imposed where neither the state in which the procedure is performed 

nor the young woman’s home state have their own parental notification schemes—does not include any judicial bypass.43 Accordingly, the young woman will not be able to obtain an abortion until 

the physician provides notice of the abortion to one of her parents.44 CIANA’s Federal notification provision thus makes parental 

notification mandatory for these young women with absolutely no 

option for a court bypass. As a result, this provision directly violates the Supreme Court’s holdings that a statute requiring parental involvement, in order to be constitutional, must offer an alternative such as a judicial bypass.45

Moreover, the requirement that the doctor must provide 24 hours 

actual notice, or at least 48 hours of constructive notice to the parents of the minor before providing the abortion care, would also impose an undue burden on a woman’s right to choose.46 In contrast, 

the Supreme Court in Casey upheld a 24-hour delay precisely because there was an exception for the preservation of the life and 

health of the woman.47

Without these exceptions, CIANA’s Federal notification provision 

would likely be held unconstitutional because these delays will 

place a woman’s health at risk and impose an ‘‘undue burden’’ on 

a woman’s right to choose. 

III. H.R. 2299 VIOLATES FUNDAMENTAL PRINCIPLES OF FEDERALISM

H.R. 2299 would require young women to carry their own state 

laws with them when they travel to other states.48 As Professors 

Laurence Tribe of Harvard Law School and Peter Rubin of Georgetown University Law Center have explained, the predecessor 

version of this legislation ‘‘amounts to a statutory attempt to force 

this most vulnerable class of young women to carry the restrictive 

laws of their home states strapped to their backs, bearing the great 

weight of those laws like the bars of a prison that follows them 

wherever they go.’’ 49

It would, moreover, impose on the people of one state who have 

specifically considered and rejected parental notification laws, the 


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laws of another state requiring such notification. It would nullify 

the right of a state, within its own borders, to set its own policies 

in this very difficult area. 

To address this defect, Rep. Scott offered an amendment creating 

an exception if neither the minor’s state of residence, nor the state 

in which the abortion is performed, have a parental notification law 

in effect. The amendment was rejected. 

This bill would also treat a young woman who travels to a state, 

or who resides in a state temporarily (such as a college student), 

differently than a minor living in that state. For example, New 

York does not have a parental notification or consent law. Nevertheless, a young woman who travels into New York, or who temporarily resides in New York, would be subject under H.R. 2299 to 

an entirely different legal scheme. She would either have to obtain 

a court bypass from her home state or, if no bypass is available, 

be subject to the bill’s Federal mandatory notice requirements. 

CIANA would thus discriminate against young women within the 

same state on the basis of their state of origin and would deprive 

them of their right to travel to engage in conduct legal in another 

state in violation of constitutionally protected rights to equal protection and interstate travel. 

CONCLUSION

Without question, promoting the involvement of parents in decisions concerning the pregnancy of a minor is a laudable and desirable goal. H.R. 2299, however, ignores the real circumstances that 

often affect young pregnant women and, by doing so, places these 

women at mortal risk. These young people must not be forced to 

risk their lives and health if they seek the protection of responsible 

adults in those circumstances where their parents have or will precipitate a dangerous situation for their child. This bill violates 

these basic principles of humanity and regard for human dimension 

of these problems. It also violates the Constitution in significant respects and tramples upon fundamental principles of federalism. 

For these reasons, we respectfully dissent, and we urge our colleagues to oppose this seriously flawed and unconstitutional legislation. 

JOHN CONYERS, JR. 

HOWARD L. BERMAN. 

JERROLD NADLER. 

ROBERT C. ‘‘BOBBY’’ SCOTT. 

MELVIN L. WATT. 

ZOE LOFGREN. 

SHEILA JACKSON LEE. 

STEVE COHEN. 

HENRY C. ‘‘HANK’’ JOHNSON, JR. 

MIKE QUIGLEY. 

JUDY CHU. 

TED DEUTCH. 

LINDA T. SA ́ NCHEZ. 

JARED POLIS. 

Æ 


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