Imagine that women regularly using contraceptives suddenly had to pay a lot more to prevent pregnancy. What would happen? The Trump administration, which rolled back mandates for companies to cover birth control last week, insists that we don’t know the answer. “The rates of, and reasons for, unintended pregnancy are notoriously difficult to measure,” the administration said in justifying the change. “In particular, association and causality can be hard to disentangle.”
Sure, separating cause from effect can be hard. But as it turns out, the country of Chile offered a perfect natural experiment on the impact of higher contraceptive prices. From December 2007 to April 2008, three pharmaceutical retailers in Chile colluded to increase the price of nearly all contraceptive drugs in the country. Prices for some birth control methods doubled.
The result was a public health disaster, as detailed in a new paper distributed by the National Bureau of Economic Research. The price hike resulted in a sharp decrease in contraceptive use in Chile, leading to a 4 percent increase in the country’s birth rate. The study also suggests that this spike in births was largely due to unplanned pregnancies, as the data shows an increase in fetal deaths, low birth weight and infant deaths. All of these are linked to neglect or lack of prenatal care — and all were on the decline before the price shock.
And the ripples go beyond health: The study’s authors report that children conceived during the period of the price shock were less likely to enroll in kindergarten, first grade and second grade.
Chile’s experience adds weight to the mountain of evidence that access to contraception does significantly reduce unplanned pregnancies. It also shows just how painful removing that access can be for mothers and…