Six years ago, Maureen Sweeney worked at a Cleveland-area hospital in the labor and delivery unit. She helped hundreds of women deliver their children, many of whom were minors in their early teens.
That's because in Ohio, the rate of teenage pregnancy is slightly higher than the national average. This year, about 23 in 1,000 teenage girls will become pregnant
Many years later there's one patient that still sticks out in Sweeney's mind.
"It was a 15-year-old woman who was coming in, in labor to the emergency room," Sweeney remembers.
The girl was scared. She didn't talk much and didn't trust any of the doctors. She told Sweeney she had no family and that she was a runaway.
"She was by herself and she was living on the streets or between friends houses," Sweeney says.
In that moment, Sweeney became the young woman's only support system to help her through her delivery.
"So as it progressed and it got more and more painful, she did request an epidural," Sweeney says.
An epidural is a common painkiller that eases the pain of labor. As she had done many times before, Sweeney followed hospital protocol and called the anesthesia department. But to her shock, they told her they could not help her young patient.
"They said that without parental consent that she would not be able to sign for her own epidural," Sweeney says.
In Ohio, women under 18 who are in labor cannot consent to their own health care. They can receive emergency services, but nothing considered to be elective. For the many Ohio minors who become pregnant, it's a painful gap in coverage.
It's also complicated by the fact that in Ohio, there is no legal process for emancipation: a minor's parent's must be deceased, or the minor must be married or enlisted in the armed forces to be granted independent legal status.
When the hospital wouldn't authorize an epidural, Sweeney called Children Services, because often time a children services agent can sign for medical consent in these cases - but it was 3 a.m. The young woman was in active labor and an agent couldn't make it to the hospital until 9 a.m.
Sweeney remembers how hard it was to tell her patient the news.
"I had to go in, sit down with her and talk about the fact that she wasn't going to be able to get an epidural, and she was going to have to do this naturally," Sweeney says.
That's when the woman broke down. Sweeney says she folded in on herself in tears.
Minors need permission from their parents before they can receive most any medical treatment, but each state has imposed a number of exceptions, like emergency services. Ohio is one of just 13 states that makes no exception for pregnant women.
Doctor Michael Cackovic from the delivery department at The Ohio State University Wexner Medical Center says he sees these cases every couple of months. He says it's frustrating to see his patients in unnecessary pain.
"First of all, from a labor and delivery standpoint, you don't like to see anybody uncomfortable," Cackovic says.
Both Cackovic and Sweeney reported that just as frequently, there are cases where the mothers intentionally deny their teenage daughters an epidural–as a sort of punishment for getting pregnant.
All Cackovic can do is try and talk them out of it.
"To take the mom aside and say, you know, this isn't some life lesson here, this is basically pain and there's no reason for somebody to go through that," he says.
This gap in Ohio law bars a young mother from the choice to have a C-section. And she can't consent for a procedure to test for chromosomal abnormalities in the fetus.
Cackovic thinks that's pretty backwards.
After birth, the teenage mother can consent to the care for her baby, but she can't consent to the prenatal procedure that would help pinpoint a diagnosis.
There's no way to know for sure how many women this affects. Researching for this story, though, it became clear that few people, including advocates for reproductive rights and civil liberties, were even aware it was a problem.
Sweeney thinks that's probably because this population of teenage mothers is especially vulnerable.
"If they're told you don't have the right to ask for this, what's going to make them bring this up to an ACLU lawyer?" she says.
Two Ohio lawmakers, Reps. Nickie Antonio and Kristin Boggs, are currently working to fix this oversight with a bill, HB 302, that's progressing through the Ohio House.
Were you denied treatment during pregnancy due to a lack of parental consent? We want to talk to you. Email us: firstname.lastname@example.org.