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The children of the missed pill

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  • Rau, Tomás
  • Sarzosa, Miguel
  • Urzúa, Sergio

Abstract

We assess the impact of exogenous variation in oral contraceptives prices—a year-long decline followed by a sharp increase due to a documented collusion case—on fertility decisions and newborns’ outcomes. Our empirical strategy follows an interrupted time-series design, which is implemented using multiple sources of administrative information. As prices skyrocketed (45% within a few weeks), the Pill’s consumption plunged, and weekly conceptions increased (3.2% after a few months). We show large effects on the number of children born to unmarried mothers, to mothers in their early twenties, and to primiparae women. The incidence of low birth weight and fetal/infant deaths increased (declined) as the cost of birth control pills rose (fell). In addition, we document a disproportional increase in the weekly miscarriage and stillbirth rates. As children reached school age, we find lower school enrollment rates and higher participation in special education programs. Our evidence suggests these “extra” conceptions were more likely to face adverse conditions during critical periods of development.

Suggested Citation

  • Rau, Tomás & Sarzosa, Miguel & Urzúa, Sergio, 2021. "The children of the missed pill," Journal of Health Economics, Elsevier, vol. 79(C).
  • Handle: RePEc:eee:jhecon:v:79:y:2021:i:c:s0167629621000813
    DOI: 10.1016/j.jhealeco.2021.102496
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    2. Athey, Susan & Bergstrom, Katy & Hadad, Vitor & Jamison, Julian C. & Ozler, Berk & Parisotto, Luca & Sama, Julius Dohbit, 2021. "Shared Decision-Making: Can Improved Counseling Increase Willingness to Pay for Modern Contraceptives?," Research Papers 3987, Stanford University, Graduate School of Business.
    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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    More about this item

    Keywords

    Fertility; Health; Impact of collusion;
    All these keywords.

    JEL classification:

    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D18 - Microeconomics - - Household Behavior - - - Consumer Protection

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