In recent weeks, a number of media outlets have been touting studies which purportedly show that greater access to contraception lowers both abortion rates and the rate of unintended pregnancies. In fairness, some of these studies are a step up from the research that the Guttmacher Institute typically publishes. Some have appeared in peer-reviewed journals and analyze actual data. Unfortunately, the evidence they provide is far from conclusive.
For instance, Mother Jones and the blog Faith in Public Life both recently cited two separate studies which showed that women who obtained greater quantities of birth-control pills were more likely to continue using birth control. Both studies appeared in the journal Obstetrics and Gynecology. One analyzed women from El Paso, Texas, and the other looked at women from California.
The obvious problem with both studies is that the women who obtain a larger quantify of birth-control pills might be different from the other women in the study. That is, women who obtain a large quantity of birth control might be more committed to their decision not to have children. Conversely, women who obtain smaller quantities of contraception might be less certain of their short-term childbearing plans. There exist other problems with these studies as well. For instance, the study of El Paso women only analyzes discontinuation rates. It does not specifically analyze how the quantity of contraception provided affects either abortion rates or the rates of unintended pregnancies.
Now, the California study is more interesting. It did analyze both abortion rates and pregnancy rates. However, the results were inconsistent. Women who obtained three months’ supply of birth-control pills were actually more likely to get pregnant and obtain an abortion than women who obtained only one month of birth-control pills. Only among the cohort that received a year’s worth of birth-control pills were there reductions in both the pregnancy rate and abortion rate. However, again it is possible that the differences were due to the attitudes of those women who obtained a year’s supply of birth control rather than the actual availability of the contraception itself.
Last week , the New York Times got in on the act. On their Economix blog they touted an analysis by Adam Thomas of the Brookings Institution. He argues that a media campaign, improved sex-education classes, and expanded access to contraception would all significantly reduce the number of unplanned pregnancies. The research he cited on contraception was interesting. A Brookings study analyzed states that received waivers to expand their Medicaid family-planning services. They found these expansions led to small but statistically significant increases in contraceptive use and decreases in the birth rate for teens and non-teens.
However, these results should be interpreted with caution. First, states that received waivers to expand their Medicaid family-planning programs might be different from other states. For instance, states with resources for a Medicaid expansion might be performing better economically. Greater contraceptive use could come from women having more disposable income or women making a greater effort to prevent pregnancy to take advantage of better employment opportunities. Second, the results might reflect the fact that states which are expanding Medicaid family-planning programs might be more politically liberal and have contraceptive usage rates that are rising faster than other states.
Taking the results of the Brookings study at face value, they still show that expansions in Medicaid family-planning programs caused only relatively small changes in both contraceptive usage rates and birth rates. These results are consistent with previous research by both Guttmacher and the CDC which shows that a small percentage of sexually active women forgo contraception due to either the cost or lack of availability. All in all, the ability of government programs to increase contraceptive use seems very limited.
Ever since the announcement of the HHS contraceptive mandate, the mainstream-media spin machine has gone into overdrive touting the purported public-health benefits that will flow from increased contraceptive use. However, they have provided little research indicating that the mandate would either increase the use of contraception or reduce the unplanned pregnancy rate. Additionally, the media invariably ignores research which shows that hormonal contraceptives increase the risk of breast cancer, cervical cancer, and liver cancer. All in all, it is safe to stay the main effect of the HHS mandate will be the erosion of the conscience rights of Catholics and others who oppose artificial contraception on moral and religious grounds.
— Michael J. New is an assistant professor of political science at the University of Michigan –Dearborn, a fellow at the Witherspoon Institute, and an adjunct scholar at the Charlotte Lozier Institute in Washington, D.C. Follow him on Twitter at @Michael_J_New
Editor’s Note: This piece has been changed since its orginal posting. The analysis that Adam Thomas wrote for the Brookings Institution will be published in the Journal of Policy Analysis and Management. The Brookings study that specifically analyzed Medicaid funding expansions has appeared in The Review of Economics and Statistics.