Effect of Immediate Postpartum Contraception on Teen Birth Spacing and Infant Health: Evidence from Medicaid

• In Event: The Economics of Fertility: Fertility Responses to Taxation, Contraception, Safety Net, and Child Care

Abstract

I examine the effect of subsidizing contraception on birth spacing and infant health among teenage mothers. My analysis exploits state-level changes in the Medicaid payment structure that reduced hospitals' financial disincentives to provide long-acting-reversible-contraceptives (LARCs) to women on Medicaid while still in the hospital for a delivery. I use restricted individual-level birth data from the National Center for Health Statistics combined state policy data to identify treated births at the individual-month-level. Following a two-way fixed effects event study specification, I find that the policy may improve some birth outcomes, but the average effects on teenage fertility and birth spacing are small and imprecise. The estimated average intent-to-treat effect is a decline of 0.027 short-interval births per 1,000 female teens--5% of the pre-policy mean--but the estimate is not statistically significant. My results highlight that changing hospitals’ financial incentives does not ensure that eligible patients can access and receive contraception. Effective implementation may require complementary efforts to address persistent barriers to immediate postpartum contraceptive provision. More research is needed to understand the limitations of the policy to improve IPP-LARC access and help women and adolescents optimize their birth spacing.

Author

• Elizabeth Krause, University of Notre Dame
  Presenting Author