The Incidental Fertility Effects of School Condom Distribution Programs

Abstract

While the fertility effects of improving teenagers’ access to contraception are theoretically ambiguous, most empirical work has shown that access decreases teen fertility. In this paper, we consider the fertility effects of access to condoms—a method of contraception not considered in prior work. We exploit variation across counties and across time in teenagers’ exposure to condom distribution programs in schools. We find that access to condoms in schools increases teen fertility by about 12 percent. The results suggest that the effects of condom access varied significantly across different programs; the positive fertility estimates are driven by communities where condoms are provided without mandated counseling. Programs that mandated counseling have zero or negative fertility effects, but estimates on these counties are less robust across specifications.

Unintended consequences of health insurance: Affordable Care Act's free contraception mandate and risky sex

“…In certain contexts, even easier access to condoms did not reduce the number of pregnancies or STIs. Buckles and Hungerman (2016) find that school-based programs that distributed condoms increased teen pregnancy, particularly if additional information was not provided with condoms. Conversely, Lovenheim, Reback, and Wedenoja (2016) find that school-based health centers, which provide access to prescription birth control and often condoms, reduced teen fertility.…”

The Paradox of the Pill: Heterogeneous Effects of Oral Contraceptive Access

“…Buckles and Hungerman (2018) provide a salient illustration of this principle. First, depending on baseline levels of sexual activity and fertility, gains in contraceptive efficacy tend to have two effects and not one: reducing fertility for the already sexually active, and increasing sexual activity among the less active.…”

Teen Fertility and Siblings’ Outcomes

“…This fundamental uncertainty underlies the ongoing debate on the effects of teen pregnancy (see Diaz and Fiel 2016). Moreover, many identification strategies that work for studying teen fertility (e.g., Buckles & Hungerman's (2018) study of condom distribution programs) cannot disentangle the spillover consequences of teen pregnancy, especially given that siblings tend to be relatively closely spaced. In this paper, I make use of longitudinal school district data, in which children are observed annually throughout their schooling years, to conduct an event study analysis.…”