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  5. The Economic Impact of Access to Reproductive Health Services
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The Economic Impact of Access to Reproductive Health Services

Paper Session

Saturday, Jan. 7, 2023 2:30 PM - 4:30 PM (CST)

Hilton Riverside, Commerce
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Hosted By: American Economic Association & Committee on the Status of Women in the Economics Profession
  • Chair: Martha Bailey, University of California-Los Angeles

Can Personalized Digital Counseling Improve Consumer Search For Modern Contraceptive Methods?

Susan Athey
,
Stanford University
Katy Bergstrom
,
Tulane University
Vitor Hadad
,
Stanford University
Julian C. Jamison
,
University of Exeter
Berk Özler
,
World Bank
Luca Parisotto
,
World Bank
Julius Dohbit Sama
,
University of Yaoundé I

Abstract

Long-acting reversible contraceptives (LARCs) are highly effective in preventing unintended pregnancies, but like many promising modern technologies take-up remains low. This paper analyzes a randomized controlled trial of a personalized digital counseling intervention addressing informational constraints and choice architecture, cross-randomized with discounts for LARCs. The counseling intervention encourages shared decision-making (SDM) using a tablet-based app, which provides a tailored ranking of modern methods to each client according to their elicited needs and preferences. Take-up of LARCs in the status quo regime at full price was 11%, which increased to 28% with discounts. SDM roughly tripled the share of clients adopting a LARC at full price to 35% and discounts had no incremental impact in this group. Consistent with theoretical models of consumer search, SDM clients evaluated more methods, which led to higher adoption rates for second- or lower-ranked LARCs. Our findings suggest that lowcost individualized recommendations can potentially be as effective in increasing unfamiliar technology adoption as providing large subsidies.

Effects of Restrictive Abortion Legislation on Cohort Mortality: Evidence from 19th Century Law Variation

Joanna Lahey
,
Texas A&M University
Marianne Wanamaker
,
University of Tennessee

Abstract

TBD

Trap'd Teens: Impacts of Abortion Provider Regulations on Fertility & Education

Kelly Jones
,
American University
Mayra Pineda-Torres
,
Georgia Institute of Technology

Abstract

Targeted regulations of abortion providers (TRAP laws) are the fastest growing abortion restriction in the U.S. These often result in clinic closures, limiting abortion access. We study how women's exposure to these laws in adolescence affects their fertility and educational attainment. For this study, we codify the legal history of all TRAP laws ever implemented. We explore the impacts of TRAP laws on teen births using an event-study analysis and stacked differences-in-differences methodology to avoid issues of negative weighting inherent in two-way fixed effects approaches. Consistent with other evidence on abortion access, we find that impacts on births are large and robust for Black women. Black teen births in states that implemented TRAP laws increased by 3 percent relative to changes in states without these restrictions. We offer evidence that these impacts are driven by reductions in abortion access, abortion use, and contraception use among Black teens. We further document that adolescent exposure to TRAP laws has downstream impacts on education. We find that Black women first exposed to TRAP laws before age 18 are 1 to 3 percentage points less likely to initiate and complete college. This study documents the important role that abortion access plays in reducing the harmful economic impacts of unintended teen motherhood. The findings suggest that modern abortion restrictions are harming women's efforts at economic advancement and are perpetuating racial inequality.

How Subsidies Affect Contraceptive Use, Pregnancies, and Abortion among Low-Income Women in the U.S.: A Randomized Control Trial

Martha Bailey
,
University of California-Los Angeles
Vanessa Lang
,
University of Michigan
Iris Vrioni
,
University of Michigan
Lea Bart
,
University of Michigan
Alexa Prettyman
,
University of California-Los Angeles
Daniel Eisenberg
,
University of California-Los Angeles
Paula Fomby
,
University of Michigan
Jennifer Barber
,
Indiana University
Vanessa Dalton
,
University of Michigan

Abstract

This paper uses a randomized control trial to examine how subsidies affect the use of contraceptives among low-income women seeking reproductive health care in the U.S. Study participants are randomized to receive vouchers which cover the costs of any contraceptive up to a maximum value of 50% or 100% of a name-brand intrauterine device. We find that women’s choice of contraception is highly sensitive to price, with the elasticity of LARC take-up ranging from -2.3 to -3.4. The findings imply that a U.S. policy eliminating out-of-pocket costs for Title X women would reduce pregnancies by 5.4%, birth rates by 3.5%, and abortions by 8.1%.
JEL Classifications
  • I1 - Health