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

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  • Karen Mulligan

Abstract

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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    Cited by:

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    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. Lena Janys & Bettina Siflinger, 2021. "Mental Health and Abortions among Young Women: Time-Varying Unobserved Heterogeneity, Health Behaviors, and Risky Decisions," ECONtribute Discussion Papers Series 083, University of Bonn and University of Cologne, Germany.
    5. Lena Janys & Bettina Siflinger, 2021. "Mental Health and Abortions among Young Women: Time-varying Unobserved Heterogeneity, Health Behaviors, and Risky Decisions," Papers 2103.12159, arXiv.org, revised May 2022.
    6. Janys, Lena & Siflinger, Bettina, 2024. "Mental health and abortions among young women: time-varying unobserved heterogeneity, health behaviors, and risky decisions," Journal of Econometrics, Elsevier, vol. 238(1).
    7. Pfeifer, Gregor & Stockburger, Mirjam, 2023. "The morning after: Prescription-free access to emergency contraceptive pills," Journal of Health Economics, Elsevier, vol. 91(C).
    8. 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.
    9. Spencer, Melissa K., 2024. "Safer sex? The effect of AIDS risk on birth rates," Journal of Health Economics, Elsevier, vol. 95(C).

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