Like many teens, my high school years had their fair share of bumps. It was the 1990s, and I was part of a fast crowd; I started dating early and didn’t always make great decisions. But growing up would have been a lot bumpier had I not had supportive parents, decent sex ed at school, and access to reproductive health care via a free clinic just a few bus stops away.

Though I knew I was lucky to have the family I did, I largely took my sex ed and health-care access for granted. But I also knew that things had been pretty different in the not-too-distant past. That was primarily thanks to my mother’s reminiscences about coming of age in New York at a time when the birth control pill was brand new and available solely to married women, and long before Roe v. Wade functionally legalized abortion.

In my mother’s day, the options for pregnant girls were generally bleak: a shameful pregnancy and closed adoption, a teen marriage, or an abortion. These were illegal, of course, but criminalizing abortion has never eradicated it. What criminalization did ensure was that most abortions happened underground and at great risk to everyone involved.

Some could be obtained by other means: Money and connections could make a trip abroad to a place like Sweden an option; or, if you happened to be able to convince three psychiatrists that you would kill yourself before having a baby—as my mother-in-law did when she was 19—you might be one of the few girls or women from the United States allowed to terminate in a hospital.

“My boyfriend had already given me half the money for an illegal abortion in Pennsylvania,” she told me recently. “It was 1969, and we were shocked when my case got approved.”

For a long time, such experiences seemed to me like relics from the distant past. However, the creeping erosion of reproductive rights means that needed health care is increasingly out of reach, and around the country, history looks to be repeating itself in unsettling ways.

For example, after Planned Parenthood and other clinics were forced to withdraw from Title X funding in 2019 because of a “gag rule” on abortion referrals, the family planning program’s capacity to provide contraceptive services fell by at least 46 percent. In many states, “conscience clauses” mean that pharmacists are allowed to refuse to dispense emergency contraception pills, which are a form of birth control that can be taken up to five days after sex and are effective at preventing pregnancy.

And in 2021 alone, well over 100 abortion restrictions were passed in what the Guttmacher Institute called “a year that has been marked by unprecedented threats to U.S. abortion rights and access.”

For teens, the situation is particularly fraught: They not only face the same barriers as adults, but as minors, they also are uniquely limited in what services they can access and how.

This is starkly apparent when it comes to abortion, as the majority of states require parental involvement in a minor’s abortion. For many people, such rules seem like common sense. In reality, parental involvement laws don’t improve adult-teen communication and instead have been found to prevent minors from accessing abortion.

“Every parent wants their children to be safe and healthy,” said Dr. Sara C. Flowers, vice president of education and training at Planned Parenthood Federation of America. “Ideally, every teen who needs an abortion would feel safe talking with their caring adult about their decision, and that caring adult would support them and help them access the care they need.”

“Unfortunately, instead of protecting young people, parental consent laws often prevent young people from being able to make the best and most timely decisions for their health, well-being, and future.” Flowers added that parental involvement laws also perpetuate abortion stigma and risk jeopardizing the health and well-being teens whose support systems might be absent, vulnerable, inconsistent, or unsupportive.

But it isn’t only with abortion that teens face barriers. Suburban and rural teens are often unable to travel to the doctor without their parents. That might not seem like such a hurdle for a routine physical, but it can be insurmountable when the matter at hand is sensitive. Even if a teenager can get to a doctor alone, they may avoid doing so out of fear that their confidentiality will be breached. This is a valid concern, since in many cases, doctors are required to share information with a parent. Not to mention, if the teen uses their health insurance, the visit will typically show up on the parent or guardian’s statement.

Additionally, libraries around the country are being called on to ban books on sexuality, LGBTQ issues, and more. Comprehensive sex education is under attack. One of the many troubling outcomes of such attacks is that even before teens discover that their access to reproductive health services may be limited, they lack the basic knowledge about what care they might actually need.

Fortunately, there are things we can do to support youth. As a health educator who works with young people, and as a parent to three kids, I know that some of those things include helping teens overcome the many barriers they face in accessing reproductive health care. Here are four ways to do that.

Open the door to conversations about sex

Those conversations are often easier than parents think and they can be started by simply referencing everyday moments, like TV shows, news stories and family events. It is also fine to acknowledge one’s own discomfort with the topic and to admit when you don’t have all the answers. But when we make the topic of sex taboo, we make it far more likely that teens will learn about it in far riskier places.

It’s also OK to acknowledge one’s own discomfort in the topic and to admit when you don’t have all the answers.

“The more children know about sexuality, the longer they wait to engage in sexual [behaviors],” certified sex educator and therapist, Dr. Lexx said, adding that this is something she explains can also help young people make safer decisions.

Allow teens privacy during doctor’s visits

Some providers are great about that; my kids’ pediatrician, for example, asks parents to step out halfway through a visit once the child turns 13. Others will need to have a parent make this request. Doing so helps youth get the care they need and also makes it more likely that you will actually be woven into conversations and decision-making in a way a young person is comfortable with.

Help youth access reproductive health care

Consider helping teens obtain birth control, including emergency contraception or, if needed, an abortion. That is especially important if you live in a state with parental involvement laws for abortion. And, if Roe v. Wade is overturned, you might also want to determine if medication abortion will be an option where you live, or whether it will be possible to take a child out of state for the procedure.

If you live in a state with parental involvement laws, this can be particularly complicated.

“In some states, parents should be prepared to take their child to multiple appointments to access care and help them process the experience of receiving biased counseling focused on fake harms associated with abortion care,” Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights, said.

Smith also advises parents in Texas to understand the implications of Texas SB 8, which prevents everyone, including young people, from accessing abortion care after embryonic cardiac activity can be detected, typically around six weeks’ gestation.

“Parents should be prepared to help their young person travel to another state to seek care if the pregnancy has progressed to that point,” she said.

Make yourself heard

Your vote matters in local politics, and your voice matters in conversations about sex education. For example, parental support for comprehensive sexuality education programs can mean the difference between a school adopting a curriculum that covers pregnancy prevention and reproductive health, or a curriculum that follows the disproven and ineffective abstinence-only model (often referred to as “sexual risk avoidance”) and teaches that the only acceptable place to have sex is in a cross-gender marriage, typically for the purposes of reproduction, while omitting any practical information about sexuality or health care in the process.

In an ideal world, teens would have the ability to manage their reproductive health care with a certain amount of independence and privacy while still involving their parents in important decisions.

But in today’s climate, that is becoming increasingly difficult. The fact that a generation of young people may have to relive the experiences of their grandmothers is chilling. So one of the best things we can do to help keep our kids safe is to step in and step up in the places where they cannot do so themselves.