Idaho's parental consent law prevents young mothers from accessing healthcare services.

A 36-week pregnant patient was experiencing mild but frequent contractions. She had come to the emergency room of this small lakeside town because she was new to the area and did not have a doctor. Normally, Dr. Caitlin Gustafson would begin a pelvic exam to determine if labor had started. However, this time she called the hospital's lawyers.

The expectant mother, Aleah, was only 13 years old. And under a new Idaho law that requires parental consent for nearly all minors' health care, Gustafson could be sued for treating her because her great-aunt brought her in.

Afterward, there were more than two hours of frantic moments as they tried to reach Aleah's mother, who lived in a car, and the girl's legal guardian, her grandmother. The grandmother eventually gave verbal consent for the exam — from the jail in Boise where she was being held on drug charges.

"I was going crazy," said Anna Karren, the relative who had taken Aleah home days earlier. What if the hospital couldn't reach the right person? "They want guardianship papers, and I don't have them."

This frustrating scene reflected the consequences of another health care regulation effort that has left doctors uneasy in a state that already has some of the strictest abortion laws in the country, which therapists, adolescent advocates, school officials, and some law enforcement officials have described as misguided and dangerous.

Critics say the law, which also grants parents access to minors' health records and eliminates the privacy that providers and adolescent advocates say is crucial, ignores the fact that parents are not always available or reliable. They argue that three months after its implementation, the law has hindered adolescents' access to counseling services, limited evidence collection in sexual assault cases, and caused schools to require parental consent for treating scrapes with ice packs and band-aids.

"It has been a terrible law with horrific consequences for young people, especially those who are victims of parental abuse. I've seen young people who don't want to attend therapy for fear their abusers will have access to what they talk about," said state representative Marco Erickson (R), a youth organization leader who voted for the law despite his concerns, in an email. "I tried to warn my colleagues, but mine was the only Republican voice among a group that doesn't understand how things work on the ground."

Supporters of the law allowing emergency treatment say it is a reasonable step to prevent minors from discussing issues like birth control and gender identity with doctors, counselors, and other adults without first informing their parents.

This type of legislation is another front in the parental rights movement, which is pushing for book bans and restrictions on school curricula. The law was supported by the conservative Christian group Alliance Defending Freedom, which has won several victories in the U.S. Supreme Court and has pointed to gender-affirming school counseling as an example of youth health care gone wrong. The group says seven states, including Idaho, now "fully" protect parental rights in health care decisions.

Many states limit minors' autonomy and generally allow them to obtain birth control or receive treatment for sexually transmitted infections, mental health issues, and substance abuse only with parental involvement. This is still very permissive for parental rights advocates.

A federal appeals court recently ruled that a Texas law requiring parental consent applies to federally funded Title X clinics that have provided minors with confidential birth control for decades. This decision, which the Congressional Research Service said has "potentially broad implications," was made in a case brought by a father from Amarillo who argued that the law violated his rights under Texas Family Law while raising his daughters to avoid premarital sex.

"We don't let kids drive, get tattoos, or drink, but are we going to allow them to make medical decisions that will affect the rest of their lives without their parents?" said Representative Barbara Ehardt (R), the sponsor of the Idaho bill. "The most reliable bond we can have is the bond between a child and their parent, and anyone who intervenes is someone else. That has to stop."

According to Ehardt, fears that the law will hinder sexual assault examinations are a "ridiculous" misinterpretation of the law. Idaho Attorney General Raúl R. Labrador (R) accused critics of trying to "create unnecessary strife and conflict" with "overreaching" interpretations of the law, Idaho Education News reported.

Providers' attorneys disagree and say the law's broad language opens the door to legal actions, including basic health services provided by coaches or teachers. Boise attorney Kim Stanger said she advises doctors and hospitals: "Assume you want to get parental consent."

The contractions Aleah experienced that August afternoon turned out to be a false alarm. Days later, when she went for a check-up, hospital staff again had to seek permission from her grandmother in jail. By her next appointment, her grandmother had signed a power of attorney giving her the authority to make decisions about the girl's health care — "and for the baby too," she had written.

These extra words were unnecessary. One of the strange aspects of the new law was that while Aleah could not give consent for her own care, she could be a parent who could give consent for her baby.

Aleah had been living with her aunt three hours south until she faced a threat. That was when Karren, a construction worker at a ski resort, received a panicked phone call. She had not been in contact with Aleah's grandmother — her own sister — for some time. Still, she did not hesitate.

"I said I would get her," Karren recounted. "I will go get her, bring her here, and take care of this and be the guardian."

Like many baby showers, 13-year-old Aleah's included a cake with cream swirls.

Due to her age, Aleah was only referred to by her first name; she had been moved around throughout her life. This included periods in foster care and halfway houses, apart from her six siblings. She had only lived with her mother for a short time a few years ago. Her father had long been absent.

As for her teenage baby's father, he was now in a juvenile detention center. The two had not thought about birth control, Aleah admitted, and she had never considered abortion since it would require traveling to another state.