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From: Brookings Papers on Economic Activity
Spring 2013
pp. 396-409 | 10.1353/eca.2013.0006

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Comment by Raquel Fernández

This interesting and well-written paper provides a brief but useful history of family planning in the United States and of the economics literature in this area, before going on to examine the second-generation consequences of policies that affected access to contraception. The analysis uses variation arising from two changes that are argued to have occurred in a random fashion: the first is the cross-state variation in married women's access to the newly introduced oral contraceptive ("the Pill") between 1957 and 1965, resulting from differences across states in the applicability of Comstock-era laws to the sale of contraceptives (referred to in the paper as "sales bans"); the second is variation in the cost and ease of access to contraception across counties from 1964 to 1973, resulting from differences in timing of the introduction of various federal family planning grants.

An extensive literature has established that access to oral contraception affected first-generation outcomes such as the timing of births and marriages, college enrollment and completion, female labor force participation, and on-the-job investment, among others. Access to family planning has also been found to affect many of the same variables, both in the United States and in developing countries. There has been far less investigation, however, into how these policies affected outcomes in the next generation. Why is this? In large part, this scarcity may simply reflect the absence of data that could be combined with an empirical strategy allowing one to study these outcomes. In addition, these questions inevitably confront the researcher with the fact that policies that influence fertility will have effects stemming from several channels: changes in the composition of individuals who become parents; any quality-quantity effects due to changes in household size; and potential cohort effects in the second generation that may arise from changes in its relative size or composition (for example, peer effects).

Disentangling these channels is a daunting task: witness the fact that the literature is still debating whether there exists a quantity-quality trade-off in the number of children in a household—a much simpler issue. From the perspective of the policymaker, however, and indeed even of the academic economist, investigating whether there are any second-generation effects at all may be the question of first-order interest, even if it does not allow the mechanisms to be identified. This paper provides some initial steps in this direction, but I will argue that overall the evidence provided here of any net effect is weak.

Fertility Effects on the First Generation

Bailey first shows that the two policies she analyzes did affect fertility. Although this is not a necessary ingredient in order for ease of access to contraception to matter, it is perhaps the author's preferred channel implicitly, and the easiest finding to establish.

A first piece of evidence concerns the effect of differential access to the Pill on fertility. Bailey summarizes her original findings (from Bailey 2010) showing that similar proportions of women claim to have ever used some form of contraception in states where contraceptives were freely available and in those states where it was not, but that use of the Pill spread earlier in the former. (Unfortunately, the frequency with which contraception was used—the more relevant variable—was not asked.) The intent of this exercise is to persuade the reader that demand for contraception was not very different across both types of states, and hence that it was the type of contraception available that resulted in fertility differences across states. As Bailey's figure 5 shows, the difference in total fertility rates across these groups of states was stable before the Pill was introduced (1951-57) but became negative and significant during part of the time that the sales ban was in place.

Although figure 5 makes an excellent case for fertility differentials between states with and without sales bans, some questions could linger regarding these results. This was a period of large changes in fertility in the United States. The baby boom was peaking and then falling before eventually stabilizing (see figure 4 in the paper). To the extent that underlying heterogeneity across states is...

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