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Access to Emergency Contraception and its Impact on Fertility and Sexual Behavior


  • Karen Mulligan


Half of all pregnancies in the USA are unintended, suggesting a high incidence of either improper or nonuse of contraceptives. Emergency birth control (EBC) provides individuals with additional insurance against unplanned pregnancy in the presence of contraception failure. This study is the first to estimate the impact of switching EBC from prescription to nonprescription status in the USA on abortions and risky sexual behavior as measured by STD rates. Utilizing state‐level variation in access to EBC, we find that providing individuals with over‐the‐counter access to EBC leads to increase STD rates and has no effect on abortion rates. Moreover, individual‐level analysis using the National Longitudinal Survey of Youth indicates that risky sexual behavior such as engaging in unprotected sex and number of sexual encounters increases as a result of over‐the‐counter access to EBC, which is consistent with the state‐level STD findings. Copyright © 2015 John Wiley & Sons, Ltd.

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  • Karen Mulligan, 2016. "Access to Emergency Contraception and its Impact on Fertility and Sexual Behavior," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 455-469, April.
  • Handle: RePEc:wly:hlthec:v:25:y:2016:i:4:p:455-469
    DOI: 10.1002/hec.3163

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    References listed on IDEAS

    1. Christine Piette Durrance, 2013. "The Effects Of Increased Access To Emergency Contraception On Sexually Transmitted Disease And Abortion Rates," Economic Inquiry, Western Economic Association International, vol. 51(3), pages 1682-1695, July.
    2. Elizabeth Oltmans Ananat & Jonathan Gruber & Phillip B. Levine & Douglas Staiger, 2009. "Abortion and Selection," The Review of Economics and Statistics, MIT Press, vol. 91(1), pages 124-136, February.
    3. Colman, Silvie & Dee, Thomas S. & Joyce, Ted, 2013. "Do parental involvement laws deter risky teen sex?," Journal of Health Economics, Elsevier, vol. 32(5), pages 873-880.
    4. Sen, Bisakha, 2003. "An indirect test for whether restricting Medicaid funding for abortion increases pregnancy-avoidance behavior," Economics Letters, Elsevier, vol. 81(2), pages 155-163, November.
    5. Girma, Sourafel & Paton, David, 2011. "The impact of emergency birth control on teen pregnancy and STIs," Journal of Health Economics, Elsevier, vol. 30(2), pages 373-380, March.
    6. Bisakha Sen, 2003. "A preliminary investigation of the effects of restrictions on Medicaid funding for abortions on female STD rates," Health Economics, John Wiley & Sons, Ltd., vol. 12(6), pages 453-464, June.
    7. Joseph J. Sabia & Daniel I. Rees, 2013. "The Effect Of Parental Involvement Laws On Youth Suicide," Economic Inquiry, Western Economic Association International, vol. 51(1), pages 620-636, January.
    8. repec:taf:jnlbes:v:30:y:2012:i:2:p:312-325 is not listed on IDEAS
    9. Levine, Phillip B., 2003. "Parental involvement laws and fertility behavior," Journal of Health Economics, Elsevier, vol. 22(5), pages 861-878, September.
    10. Justin Wolfers, 2006. "Did Unilateral Divorce Laws Raise Divorce Rates? A Reconciliation and New Results," American Economic Review, American Economic Association, vol. 96(5), pages 1802-1820, December.
    11. Levine, Phillip B. & Trainor, Amy B. & Zimmerman, David J., 1996. "The effect of Medicaid abortion funding restrictions on abortions, pregnancies and births," Journal of Health Economics, Elsevier, vol. 15(5), pages 555-578, October.
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    Cited by:

    1. Hill, Elaine L. & Slusky, David J.G. & Ginther, Donna K., 2019. "Reproductive health care in Catholic-owned hospitals," Journal of Health Economics, Elsevier, vol. 65(C), pages 48-62.
    2. Paton, David & Wright, Liam, 2017. "The effect of spending cuts on teen pregnancy," Journal of Health Economics, Elsevier, vol. 54(C), pages 135-146.
    3. Nuevo-Chiquero, Ana & Pino, Francisco J., 2019. "To Pill or Not to Pill? Access to Emergency Contraception and Contraceptive Behaviour," IZA Discussion Papers 12076, Institute of Labor Economics (IZA).
    4. Martha J. Bailey & Jason M. Lindo, 2017. "Access and Use of Contraception and Its Effects on Women’s Outcomes in the U.S," NBER Working Papers 23465, National Bureau of Economic Research, Inc.

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