The Educational and Labor-Market Effects of Increasing Reproductive Autonomy: Evidence from a Randomized Controlled Trial

• In Event: Policy Influences on Labor Force Participation and Employment over the Life Course

Abstract

This paper provides the first experimental evidence on the educational and labor-market effects of expanding financial access to contraception among low-income, uninsured women in the United States. We leverage the Michigan Contraceptive Access, Research, and Evaluation Study (M-CARES), a large randomized controlled trial that assigned contraceptive vouchers to 4,192 women aged 18–35 at Title X clinics between 2018 and 2023. The vouchers eliminated out-of-pocket costs for any contraceptive method, generating substantial increases in contraceptive uptake and shifts toward more effective methods. Prior work shows that these changes reduced unintended pregnancies and abortions.
We examine whether these improvements in reproductive autonomy translate into downstream gains in human capital and labor-market outcomes using follow-up survey data collected 25 to 51 months after enrollment.Our results are based on the Year 2 Follow-Up survey and should be interpreted as preliminary. Ongoing work links participants to IRS administrative tax records and, pending access, National Student Clearinghouse data to provide more precise measures of earnings and educational attainment. Within this framework, we document three main findings.
First, we find suggestive but imprecise evidence of gains in educational attainment. Intent-to-treat estimates imply roughly a 20% increase in years of education accumulated during the study window. While estimates are consistently positive across specifications and align with prior quasi-experimental evidence, they fall short of conventional significance thresholds, likely reflecting both measurement noise in self-reported education and the relatively short horizon for observing degree completion.
Second, we find little evidence of effects on labor-force participation or hours worked. This is consistent with the high baseline participation rate in our sample (94%), which leaves limited scope for extensive-margin responses. However, among women not currently employed, voucher use substantially increases job search: the probability of actively searching for work rises by approximately 15–20 percentage points. This pattern suggests that improved control over fertility may reduce barriers to labor-market re-entry, potentially by lowering uncertainty and facilitating forward-looking planning.Third, and most robustly, we find consistent evidence of occupational upgrading.
Voucher recipients shift into occupations with higher cognitive skill requirements, higher socioeconomic status, and lower prevalence of low-wage employment. Instrumental variables estimates indicate that voucher use reduces the probability of working in a bottom-quintile wage occupation by 6–7 percentage points—about a 15% decline relative to the control mean—with similar patterns across alternative measures of occupational quality. These results suggest that the primary margin of adjustment operates through job quality rather than employment per se.Taken together, our findings indicate that expanding access to contraception affects not only fertility outcomes but also the trajectory and quality of women’s economic opportunities. These results are directly relevant for current policy debates surrounding Title X funding and access to reproductive health services. Ongoing analyses using linked administrative data will allow us to assess the persistence and mechanisms of these effects over the longer run.

Author

• Giulia Olivero, University of California - Los Angeles
  Presenting Author