by Julie Maslowsky, Renee Odom-Konja, Catherine Gimbrone, Rosie Hanneke, Katie Wyant-Stein, Lotte Brewer, Olivia Janette, Shannon Ryan, Cambray Smith, Shruthi Krishna, Laura D Lindberg
Contraception
Volume 164, December 2026, 111726, https://doi.org/10.1016/j.contraception.2026.111726
Abstract
Objectives
To systematically assess the inclusion of minor adolescents in U.S. abortion research from 2019 to 2023.
Study design: A systematic scoping review was conducted using PubMed, Embase, CINAHL, PsycINFO, Sociological Abstracts, PAIS, and Web of Science for studies published between January 1, 2019-December 31, 2023. Studies were screened by independent raters and included if peer-reviewed, written in English, U.S.-based, and containing individual-level data on people seeking or receiving abortion care.
Results: Screening resulted in 344 eligible studies. Minor adolescents were enrolled in n = 94 (27.3%) of studies and not enrolled in 150 (43.6%) of studies. In the remaining n = 100 (29.1%) studies, there was insufficient information to determine whether minors were enrolled. In n = 125 (83.3%) of the n = 150 studies not enrolling minors, minors were specifically excluded in the study’s inclusion criteria. Among n = 36,361,364 total participants across all 344 studies examined, n = 406,529 (1.1%) were reported to be minor adolescents.
Conclusions: There is a considerable body of research on abortion access and experiences among minors in the U.S. However, minors’ inclusion remains under-reported in this literature. Based on our results, we provide recommendations to support transparent and standardized reporting of minors in abortion research. Such standardization will help to grow the evidence base on minors and abortion and subsequently support the development of evidence-based policies and clinical guidance for minors. The recommendations provided herein can also form the basis for future development of consensus guidelines on reporting minors’ inclusion in studies.
From the Introduction
Abortion is a component of comprehensive sexual and re productive healthcare; 1 in 4 women in the United States (U.S.) will have an abortion in their lifetime. Adolescents are the most likely of all age groups to have their pregnancies end in abortion. Adolescents ages 15–19 have the highest abortion ratio of any age group (389 abortions per 1000 live births for 15- to 19-year-olds, compared with 301 per 1000 live births for 20- to 24-year-olds). Minor adolescents, i.e., those under age 18, comprised approximately 2.3% of annual abortion patients in 2021–2022, the most recent year in which data for this age group are available. Minors face more barriers to abortion access than adults. Following the Supreme Court’s Dobbs decision, two-thirds of U.S. minor adolescents, over 7 million young people, live in a state that bans or seriously restricts their abortion access. Further, minors are at the center of many attempts to further restrict reproductive rights.
Ongoing research on abortion is essential to test emerging clinical innovations and to monitor individuals’ access to and experience with abortion, especially as abortion access is increasingly restricted in the U.S. A recent professional consensus report raised concerns that minors are frequently excluded from abortion research despite professional recommendations that they should be included in research on all health conditions and procedures affecting them, including sexual and reproductive health procedures such as abortion. Our goal was to systematically examine the extent to which minor adolescents (under age 18) are included in U.S.-based research on abortion. Based on our review of existing studies, we offer guidance for transparent reporting of inclusion of minor adolescents in sexual and reproductive health research.
Our primary research question was: To what extent are minor adolescents (under age 18) represented in U.S. research on abortion published from 2019 to 2023? We chose this five-year period in order to capture multiple recent years that included both pre- and post- Dobbs v. Jackson.
© 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).