The Power of Abortion Policy: Re-Examining the Effects of Young Women's Access to Reproductive Control
Journal of Political Economy, forthcoming
I provide new evidence on the relative “powers” of contraception and abortion policy in effecting the dramatic social transformations of the 1960s and 1970s. Trends in sexual behavior suggest that young women’s increased access to the birth control pill fueled the sexual revolution, but neither these trends nor difference-in-difference estimates support the view that this also led to substantial changes in family formation. Rather, the estimates robustly suggest that it was liberalized access to abortion that allowed large numbers of women to delay marriage and motherhood.
Family Planning Funding Cuts and Teen Childbearing
Journal of Health Economics, September 2017, Pages 168-185
Abortion is one of the most divisive policy issues to date. In the last four years, over 250 provisions aimed at restricting access to abortion have been adopted. Publicly funded family planning clinics provide low-cost and free contraception to nearly 1.5 million teens each year. In recent years, several states have considered legislation to defund family planning services, although little is known about how these cuts affect teen pregnancy. This paper fills this knowledge gap by exploiting a policy change in Texas that reduced funding for family planning services by 67 percent and resulted in over 80 clinic closures. I estimate the effects of the funding cuts on teen health outcomes using a difference-in-differences approach that compares the changes in teen birth rates in Texas counties that lost family planning funding to changes in counties outside of Texas with publicly funded clinics. I find that reducing funding for family planning services in Texas increased teen birth rates by approximately 3.4 percent over four years with effects concentrated 2-3 years after the initial cuts.
The Astonishing Population Averted by China’s Birth Restrictions: Estimates, Nightmares, and Reprogrammed Ambitions
Demography, August 2017, Pages 1375–1400
China launched an unprecedented program to control its population in 1971. Experts have dismissed the official estimate of 400 million births averted by this program as greatly exaggerated yet neglect to provide their own estimates. Counterfactual projections based on fertility declines in other countries suggest that China’s program-averted population numbered 360–520 million as of 2015. The low end of this range is based on Vietnam — China’s best national comparator, with a two-child program of its own — and the high end is based on a 16-country comparator selected, ironically, by critics of the official estimate. The latter comparator further implies that China’s one-child program itself averted a population of 400 million by 2015, three-quarters of the total averted population. All such estimates are projected to double by 2060, due mostly to counterfactual population momentum. These and other findings presented herein affirm the astonishing impact of China’s draconian policy choices and challenge the current consensus that rapid socioeconomic progress drove China’s fertility well below two children per family. International comparisons of fertility and income suggest instead that China’s very low fertility arrived two or three decades too soon. If China had not harshly enforced a norm of 1.5-children during the last quarter century, most mothers would have had two children, one-half birth higher than observed.
Effects of State-Level Earned Income Tax Credit Laws in the U.S. on Maternal Health Behaviors and Infant Health Outcomes
Sara Markowitz et al.
NBER Working Paper, August 2017
The purpose of this paper is to investigate the effects of state-level Earned Income Tax Credit (EITC) laws in the U.S. on maternal health behaviors and infant health outcomes. Using multi-state, multi-year difference-in-differences analyses, we estimated effects of state EITC generosity on maternal health behaviors, birth weight and gestation weeks. We find little difference in maternal health behaviors associated with state-level EITC. In contrast, results for key infant health outcomes of birth weight and gestation weeks show small improvements in states with EITCs, with larger effects seen among states with more generous EITCs. Our results provide evidence for important health benefits of state-level EITC policies.
Excess Male Infant Mortality: The Gene-Institution Interactions
Roland Pongou, Barthelemy Kuate Defo & Zacharie Tsala Dimbuene
American Economic Review, May 2017, Pages 541-545
Excess male mortality at early ages is an important source of child inequality in most societies. We examine how improvement in the quality of political institutions affects the male survival disadvantage. Using data on twins in combination with a natural experiment on the development of African institutions, we quantify the distinct effects of biology and preconception environment on the infant mortality sex gap and find that these effects are important only in poor institutions. The analysis implies that improved institutions constrain genetic expression and mitigate preconception influences on excess male infant mortality, which is an optimistic finding with pragmatic implications.
The Effect of Ambient Temperature Shocks during Conception and Early Pregnancy on Later Life Outcomes
Joshua Wilde, Bénédicte Apouey & Toni Jung
European Economic Review, August 2017, Pages 87-107
A large body of research has recently shown that early life or in utero shocks, especially climatic shocks, may affect long-run human capital outcomes. Most of these effects are assumed to be biological – including poor nutrition during critical windows of fetal development, or through increased maternal stress. However, in addition to these biological effects, climatic conditions at the time of conception may also cause changes in parental behavior, not only affecting the mix of parents who conceive, but also the characteristics of the children once born. This paper explores whether increases in ambient temperature at the time of conception, while in utero, or after birth cause better educational and health outcomes as adults. Using Census and Demographic and Health Survey data from sub-Saharan Africa, we show that individuals conceived during high temperatures have higher educational attainment and literacy. In addition, we find evidence of temperature effects at other times in utero, especially during the first trimester. We then explore the biological and behavioral mechanisms through which this effect may occur, including heat-induced changes in sexual behavior, differences in parental characteristics, and intensified fetal selection. We conclude that fetal selection is the most likely mechanism driving our result. We also show that temperature deviations change the mix of conceiving women to be wealthier, partly since heat-induced reductions in sexual activity are larger for poorer women.
Partible Paternity, the Secondary Sex Ratio, and a Possible Trivers-Willard Effect
Stephen Beckerman et al.
Current Anthropology, August 2017, Pages 540-543
Partible paternity, the belief that a child can have more than one biological father, is widespread in lowland South America. An analysis of demographic data sets from four lowland tribes (Aché, Barí, Ese Eja, and Surui) reveals a systematic variation in the sex ratios of live births with respect to the number of fathers to whom the births are attributed. Births attributed to only one father show a sex ratio that is unexceptional for South America; births with two fathers are highly male biased, while children with three or more fathers are female biased. This pattern may be a manifestation of a phenomenon predicted by the Trivers-Willard hypothesis, which proposes that, in many circumstances, females in good condition might bias their offspring toward males, whereas those in poor condition would produce a preponderance of females. If, as suggested below, a woman with a husband and a single extramarital lover tends to be better cared for before and during a pregnancy than other women, this difference might result in the improved maternal condition required by the Trivers-Willard hypothesis for excess males, whereas women who accept two or more lovers might be preponderantly those who are already in distress, thus tending to produce female-biased offspring.
A Randomized Trial of Motivational Interviewing and Facilitated Contraceptive Access to Prevent Rapid Repeat Pregnancy among Adolescent Mothers
Jack Stevens et al.
American Journal of Obstetrics and Gynecology, forthcoming
Background: Most interventions designed to reduce teen pregnancy rates have not focused on pregnant and/or parenting adolescents. Therefore, a large randomized controlled trial was conducted regarding a motivational interviewing program entitled Teen Options to Prevent Pregnancy in a low income sample of adolescent mothers. This program recommended monthly sessions between a participant and a registered nurse over 18 months. This program also featured facilitated birth control access through transportation assistance and a part-time contraceptive clinic.
Study Design: Five hundred ninety-eight adolescent females were enrolled from seven obstetrics/gynecology clinics and five postpartum units of a large hospital system in a Midwestern city. Each participant was enrolled at least 28 weeks pregnant or less than 9 weeks postpartum. Each participant was randomized to either the Teen Options to Prevent Pregnancy intervention or a Usual Care control condition. Intervention participants averaged 4.5 hours of assistance. Participants were contacted by blinded research staff at 6 months and 18 months to complete self-report surveys. Differences in outcomes between the intervention and control groups were assessed using ordinary least-squares regression.
Results: There was an 18.1 percent absolute reduction in self-reported repeat pregnancy in the intervention group relative to the control group (20.5% versus 38.6%%; p < .001). There was a 13.7 percent absolute increase in self-reported long-acting reversible contraception use in the intervention group relative to the control group (40.2% versus 26.5%, p = .002). There was no evidence of harmful effects of the intervention on sexual risk behaviors, such as having sexual intercourse without a condom or greater number of partners.
Conclusions: The Teen Options to Prevent Pregnancy program represents one of the few evidence-based interventions to reduce rapid repeat teen pregnancy. This relatively brief intervention may be a viable alternative to more time-intensive programs that adolescent mothers may be unable or unwilling to receive.