The children of the missed pill

• DOI: 10.1016/j.jhealeco.2021.102496
• Publication Date: 2021-07-23T13:16:10Z
• Authors: Tomás Rau; Miguel Sarzosa; Sergio Urzúa
• Keywords: 330; IMPACT; FAMILY-PLANNING PROGRAMS; ABORTION; Pregnancy; 03 Salud y bienestar; 0502 economics and business; INTERGENERATIONAL TRANSMISSION; Humans; Child; 05 Gender Equality; Impact of collusion; 4. Education; ORAL-CONTRACEPTIVES; 05 social sciences; Infant, Newborn; Prenatal Care; BIRTH-WEIGHT; 3. Good health; Abortion, Spontaneous; PREGNANCY; Contraception; Fertility; Health; PRICE CHANGES; 03 Good Health and Well-being; Female; 05 Igualdad de género; ACCESS

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.