Who consents for the underage where you work?? long

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Specializes in OB L&D Mother/Baby.

Seems like lately we've had an increase in our teenage population in our OB... I've had several young ladies in their mid teens in the past month. Not that they are all delivering but they have come in for various complaints related to pregnancy. Anyway, we've had a bit of a debate as far as who is supposed to be signing or consenting to treatment for these girls. They are under 18 so they should have a parents consent, but then they are pregnant so are they automatically emancipated?? When the babies are born the moms sign for the baby's treatment, but they can't sign for themselves??

Many are having their parents sign for treatment for themselves but then are uncooperative or non compliant. For example I had a 15 yr old a few weeks ago that was 34ish weeks and was refusing terb for ctxn's. She said she just wanted to have the baby etc... I looked at the parents and said that her doctor had ordered the medication and it was in the best interest of the baby blahblahblah went thru the whole explanation that we may have to ship the baby as we have no nicu... The girl is pi$$ed off at me and says the baby's been in there long enough, she's fat and wants the kid out. Anyway the cusodial parent agrees and the girl is no less annoyed and angry at me ends up accepting the terb... It really didn't help that two days later she came back and said that her doc told her that she could deliver whenever!!!

Sometime ago we also had a patient that had been pushing for hours, doc suggested that they either try forceps or go for a c/s... the parents refused either and left the unit. The patient says she'd rather have the c/s. Parents come back and are upset because the nurses did not try more positions during labor and pushing although she requested an epidural when she was 3cm. Finally they agreed to sign for a c/s.

Ok so basically just curious what your protocols are as far as consents for treatment or specific care (epidurals, surgery etc) thanks in advance

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In Texas, a pregnant patient is an emacipated (spelling?) adult. As much as I hate it....they get to make all the decisions....for example. Teen mom comes in in labor....the patient is requesting an epidural. The patient's mother said "NO" she needs to suffer the consequences of her decisions.....I politely explained to the mother that she could not legally refuse an epidural for her daughter. Needless to say she was pissed.....she had been waiting 9 months to "make her daughter have natural labor" only to find out that she was not legally able to do so.

However....the only time we have ever had a "super young mom" as in 12.....her foster mother signed all the legal documents....

I know this is wierd....but this is just my experience....

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Specializes in LDRP.

Had a 15 year old patient once, the registration folks came up and had her mother sign the generic consent for treatment.

Though, when the anes. came up to do her epidural, he got all upset when her mother signed the consent for her, said the patient has to sign it.

aren't pregnant minors considered emancipated?

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Specializes in Community, OB, Nursery.

Where I am pregnant minors are considered emancipated and can consent/refuse as an adult would.

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Specializes in Acute Hemodialysis, Cardiac, ICU, OR.

I got curious, so I started looking...

In PA: http://www.jlc.org/index.php/factsheets/teenpreg#1

"Can a teenager who is pregnant consent to her own medical treatment? Yes. A teenager who is pregnant or has been pregnant can consent to her own medical care, including prenatal care. A minor who seeks an abortion in Pennsylvania, however, will either need to obtain her parent's or guardian's consent or a court order. See the section on abortion below for more information."

And this from Planned Parenthood: http://www.plannedparenthood.org/news-articles-press/politics-policy-issues/teen-pregnancy-sex-education/teen-pregnancy-6239.htm

"While children need no permission from their parents to become parents, 33 states currently have laws in effect, or scheduled to take effect, that mandate parental consent or notification prior to a minor's abortion. Most of these states, however, allow a minor mother to place her child for adoption without her parents' involvement. Legislators in these states have decided, in effect, that while young women may not be mature enough to decide for themselves to terminate a pregnancy, they are all mature enough to become mothers and to make medical and other life decisions for their children....

In 45 states and the District of Columbia, a mother who is a minor may legally place her child for adoption without her parent's involvement (AGI, 1995)."

I suppose it depends on your state's laws... but kind of crazy that while underage can't sign for an abortion but CAN sign for medical care and adoption... Do a search to verify what's appropriate in your area, and would probably be a good idea to print it off and take it to work -- it's only a matter of time before someone on your staff has the 'wrong' person sign for something and a lawsuit ensues. Another idea would be to broach the question to your hospital's legal team (in administration) and get their 'official' answer.

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In my state, pregnant minors (and I see quite a few) are NOT emancipated, and their parents must sign for all of their care, including the consent for an epidural. Makes it fun when the parents drop them off at the ER door and leave.

You have to see what your state requires - there are differences from state to state.

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Specializes in OB, lactation.

In Florida, a minor can consent to medical care related to pregnancy but is not necessarily considered emancipated just because they are pregnant or have a child.

Here's a little pamphlet about emancipation in FL:

http://www.legalaidocba.org/documents/Emancipation.pdf

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Specializes in med-surg, ER, rehab, neuro, OB.
In Texas, a pregnant patient is an emacipated (spelling?) adult. As much as I hate it....they get to make all the decisions....for example. Teen mom comes in in labor....the patient is requesting an epidural. The patient's mother said "NO" she needs to suffer the consequences of her decisions.....I politely explained to the mother that she could not legally refuse an epidural for her daughter. Needless to say she was pissed.....she had been waiting 9 months to "make her daughter have natural labor" only to find out that she was not legally able to do so.

Good Lord, that is horrible. "Make" her daughter have a natural labor? What kind of a sick person wants to see her child suffer? I just can't even imagine....

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

As said above, everyplace I worked, the teen mother-to-be was considered emancipated and therefore, unless completely deemed incompetent, made ALL her own healthcare decisions. NO moms "making" them undergo natural labor "to teach them a lesson" on my watch. It does not work anyhow. These moms probably missed that boat when their girls were MUCH younger and pre-pubertal.

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In Illinois a minor can sign for their treatment during pregnancy and for the baby after birth but cannot sign for herself after birth unless she meets one of the other criteria (married, emancipated by court, etc).

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Specializes in nursery, L and D.

In NC, where I have worked in the past, we always allowed minors to sign consents for her treatment during pregnancy/childbirth. I just read a bunch of the NC laws, and it seems that we should have been having the parents sign for everything. It is very confusing, and hopefully I haven't done anything wrong that will come back and bite me!

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