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As an obstetrician-gynecologist, my top priority is ensuring that my patients receive quality medical care throughout their lives—from birth control, to having a baby, to menopause. Ensuring my patients’ safety is of utmost importance to me. That’s why I will vote “No” on Proposition 4 on November 4, to prevent the so-called parental notification measure from threatening teenagers’ health.

Proposition 4 would require healthcare providers to inform a young woman’s parents of her decision to have an abortion. We can all agree that it’s best when a pregnant teen involves her parents, and that’s one of the first questions I ask any teenage patient. If she hasn’t, I encourage her to do so. Happily, the vast majority of teens do tell their parents when they are pregnant.

But sadly, some teens live in chaotic, troubled, or even abusive homes. Some live in families where a relative has caused the pregnancy. These young women will be harmed by Proposition 4, because they will be forced to choose between one of two unworkable options to avoid notifying a parent.

The first option, judicial bypass, would require a pregnant teen to appear before a judge and request a court order authorizing her to terminate her pregnancy. Navigating our crowded, complex court system would be a daunting challenge for anyone, but particularly so for a pregnant, frightened teen. Imagine if that teen needed an interpreter. This just isn’t a realistic option.

Under Proposition 4, a teen could also ask her doctor to notify another adult relative. However, this option would require the teenager to write a statement charging her parents with abuse, which the doctor would then be required to send to law enforcement. The parents could learn of the teen’s abortion when police came to investigate.

Faced with these options, some scared, pregnant teens will feel they have nowhere to turn. Some young women will try to harm themselves to induce a miscarriage. Some will seek an unsafe, illegal abortion. And some teens, feeling desperate, may even try to kill themselves.

I recently treated a patient, Priya, whose older sister fought horribly with their parents when they learned she planned to have an abortion. Fearing the same response to her own pregnancy, Priya sought advice from a friend, who suggested she use household cleaning products to cause a miscarriage. She came to me a few weeks later after noticing spotting. Priya was lucky she sought medical advice when she did, before her friend’s misguided advice harmed her health. If Proposition 4 passes, I fear many more teens will harm themselves out of fear and desperation.

Immigrant teens are particularly vulnerable to Proposition 4. In many of the communities I serve, including South Asian immigrants, some parents don’t want their children to date, let alone have sex. If Proposition 4 passes, many of my patients will face a frightening dilemma. And when I go home at night, I will worry. What path will my patient choose? What terrible decision might she make?

Please, for the safety of your daughters, your friends’ daughters, all of our daughters, vote NO on Proposition 4.

Pratima Gupta is a physician practicing in San Francisco and Oakland and a board member of Physicians for Reproductive Choice and Health.

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