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The Children of the Missed Pill

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  • Tomás Rau
  • Miguel Sarzosa
  • Sergio S. Urzúa

Abstract

We use sharp, massive and unexpected price increases of oral contraceptives—product of a documented case of collusion among pharmaceutical retailers in Chile—as a natural experiment to estimate the impact of access to the Pill on fertility and newborn health. Our empirical strategy combines multiple sources of information and takes into account the seasonality of conceptions and the general trends of fertility, as well as the dynamics that arise after interrupting Pill's intake. Our estimates suggest that due to the price hike, the weekly birth rate increased by 4%. We show large effects on the number of children born to unmarried mothers, from mothers in their early 20's, and to primiparae women. Moreover, we find evidence of significant deterioration of newborn health as measured by the incidence of low birthweight and infant mortality. We suggest that the “extra” conceptions faced dire conditions during gestation as a result of mothers' unhealthy behaviors. In addition, we document a disproportional increase of 27% in the weekly miscarriage and stillbirth rates, which we interpret as manifestations of active efforts of termination in a country where abortion was illegal. As the “extra” children reached school age, we find lower school enrollment rates and higher participation in programs for students with special needs. Our results suggest that access to contraceptives may prevent conceptions that will turn out to be in relatively poor health, and thereby may improve the average health of children conceived.

Suggested Citation

  • Tomás Rau & Miguel Sarzosa & Sergio S. Urzúa, 2017. "The Children of the Missed Pill," NBER Working Papers 23911, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:23911
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    3. Mookerjee, Mehreen & Ojha, Manini & Roy, Sanket, 2023. "Family planning practices: Examining the link between contraception and child health," Economic Modelling, Elsevier, vol. 129(C).
    4. Marie, Olivier & Zwiers, Esmée, 2022. "Religious Barriers to Birth Control Access," CEPR Discussion Papers 17427, C.E.P.R. Discussion Papers.
    5. Andia, Tatiana & Mantilla, César & Morales, Álvaro & Ortiz, Santiago & Rodríguez-Lesmes, Paul, 2022. "Does price-cap regulation work for increasing access to contraceptives? Aggregate- and pharmacy-level evidence from Colombia," Social Science & Medicine, Elsevier, vol. 311(C).
    6. Fiorentini, Gianluca & Bruni, Matteo Lippi & Mammi, Irene, 2022. "The same old medicine but cheaper: The impact of patent expiry on physicians’ prescribing behaviour," Journal of Economic Behavior & Organization, Elsevier, vol. 204(C), pages 37-68.
    7. Damian Clarke & Gustavo Cortés Méndez & Diego Vergara Sepúlveda, 2020. "Growing together: assessing equity and efficiency in a prenatal health program," Journal of Population Economics, Springer;European Society for Population Economics, vol. 33(3), pages 883-956, July.
    8. Pablo A. Celhay & Emilio Depetris-Chauvin & Cristina Riquelme, 2023. "When a Strike Strikes Twice: Massive Student Mobilizations and Teenage Pregnancy in Chile," Working Papers 267, Red Nacional de Investigadores en Economía (RedNIE).

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    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • K42 - Law and Economics - - Legal Procedure, the Legal System, and Illegal Behavior - - - Illegal Behavior and the Enforcement of Law
    • L13 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Oligopoly and Other Imperfect Markets
    • L4 - Industrial Organization - - Antitrust Issues and Policies
    • L41 - Industrial Organization - - Antitrust Issues and Policies - - - Monopolization; Horizontal Anticompetitive Practices

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