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Behind-the-counter, but Over-the-border? The Assessment of the Geographical Spillover Effect of Increased Access to Emergency Contraception

Author

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  • Inna Cintina

    (UHERO, University of Hawaii at Manoa)

Abstract

Washington was the first state to ease the prescription requirements making emergency contraception (EC) available behind-the-counter at pharmacies to women of any age in 1998. I hypothesize that the increased availability of EC affects fertility rates beyond the borders of the state that allows it. In contrast to the literature, I show that increased access to EC is associated with a statistically significant albeit economically small decrease in abortion rates in Washington counties where women had access to no-prescription EC pharmacies. Yet, there is no effect on pregnancy rates. These results are robust in a number of specifications. Finally, I find some evidence in support of the spillover effects in Idaho, but not Oregon. However, after accounting for changes in the availability of abortion services, the decrease in fertility rates in "treated" Idaho counties is rather small and models lack sufficient power to detect it.

Suggested Citation

  • Inna Cintina, 2013. "Behind-the-counter, but Over-the-border? The Assessment of the Geographical Spillover Effect of Increased Access to Emergency Contraception," Working Papers 2013-6R, University of Hawaii Economic Research Organization, University of Hawaii at Manoa, revised May 2014.
    • Handle: RePEc:hae:wpaper:2013-6r
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    References listed on IDEAS

    as
    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 & Daniel M. Hungerman, 2012. "The Power of the Pill for the Next Generation: Oral Contraception's Effects on Fertility, Abortion, and Maternal and Child Characteristics," The Review of Economics and Statistics, MIT Press, vol. 94(1), pages 37-51, February.
    3. Cook, Philip J. & Parnell, Allan M. & Moore, Michael J. & Pagnini, Deanna, 1999. "The effects of short-term variation in abortion funding on pregnancy outcomes," Journal of Health Economics, Elsevier, vol. 18(2), pages 241-257, April.
    4. Blank, Rebecca M. & George, Christine C. & London, Rebecca A., 1996. "State abortion rates the impact of policies, providers, politics, demographics, and economic environment," Journal of Health Economics, Elsevier, vol. 15(5), pages 513-553, October.
    5. Bitler, Marianne & Zavodny, Madeline, 2001. "The effect of abortion restrictions on the timing of abortions," Journal of Health Economics, Elsevier, vol. 20(6), pages 1011-1032, November.
    6. Martha J. Bailey, 2006. "More Power to the Pill: The Impact of Contraceptive Freedom on Women's Life Cycle Labor Supply," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 121(1), pages 289-320.
    7. Joshua D. Angrist & William N. Evans, 1996. "Schooling and Labor Market Consequences of the 1970 State Abortion Reforms," NBER Working Papers 5406, National Bureau of Economic Research, Inc.
    8. Cartoof, V.G. & Klerman, L.V., 1986. "Parental consent for abortion: Impact of the Massachusetts law," American Journal of Public Health, American Public Health Association, vol. 76(4), pages 397-400.
    Full references (including those not matched with items on IDEAS)

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    Cited by:

    1. Inna Cintina & Morgen S. Johansen, 2014. "The Effect of Plan B on Teen Abortions: Evidence From the 2006 FDA Ruling," Working Papers 2014-1, University of Hawaii Economic Research Organization, University of Hawaii at Manoa, revised Jun 2014.
    2. Inna Cintina & Morgen S. Johansen, 2015. "The Effect Of Plan B On Teen Abortions: Evidence From The 2006 Fda Ruling," Contemporary Economic Policy, Western Economic Association International, vol. 33(3), pages 418-433, July.
    3. 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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    More about this item

    Keywords

    Emergency contraception; Plan B; Abortion; Pregnancy; Border-hopping; Travel distance;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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