Indianapolis — In Indiana, a 17-year-old can deliver a baby and then give a doctor permission to circumcise him. But during her delivery, she can’t give the doctors permission to give her an epidural. She needs her parents to consent to that, and they can refuse.

The 17-year-old can consent to her infant’s hearing testing, vaccines and anything else the baby might need. But she cannot consent to a long-acting, reversible contraceptive — such as an IUD or an arm implant — to prevent her from getting pregnant again. Once again, she needs her parents’ permission, and if her parents aren’t around, she’s out of luck.

According to a report released this month by the Guttmacher Institute, 24 states do not explicitly give all minors the right to receive contraceptives without their parents’ permission. Minors in 11 states still do not have the right to consent to contraception even after giving birth. There are situations where a minor can consent — if married, legally emancipated or on active military duty, or after a sexual assault by a family member — but these apply to only a small minority of teenage mothers.

For many years now Americans have been celebrating the decline in teenage pregnancy rates. But the general trend obscures some more alarming statistics. Data from a 2005 study show that of the adolescents who do get pregnant, up to 44 percent will conceive again within a year. A local study of teenage pregnancies in Indianapolis found that 1 in 3 adolescents who delivered between 2010 and 2012 were pregnant again in less than 18 months.