The Supply of Birth Control Methods, Education and Fertility: Evidence from Romania

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The Supply of Birth Control Methods, Education
and Fertility Evidence from Romania

• Kiki Pop-Eleches
• Columbia University

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Question 1

• How important is the supply of methods of birth
  control in decreasing fertility rates?
  
• This question is important to find out if family
  planning programs work
  
• Still a lot of disagreement in the literature
• Difficulties with estimation
• - hard to find an exogenous change in price of
  birth control methods that has an instantaneous
  effect
  

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Question 2

• Why do educated women have lower fertility?
• The negative association is very robust.
• Example
• Romania (early 1990s) TFR 2.26 - primary,
  1.66 - secondary, 1.07 - tertiary education
  
• Tanzania (1990s) TFR 6.4 no education, 3.2 -
  secondary
  
• Consistent with a number of theories
• Difficult to distinguish among theories
  empirically

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Why do we care?

• Demographic transition
• Family planning programs
• Unwanted fertility can affect children
  (Pop-Eleches, 2005) and parents

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Mechanisms (1) Demand for children vs. Supply
of birth control methods

• Definition desired fertility is the number of
  children demanded if birth control is costless
  
• determined by demand factors such as the
  opportunity cost of the mothers time, family
  income, taste etc.
  
• Definition optimal fertility refers to the
  fertility level after the cost of birth control
  is included into the decision-making process
  
• determined by demand factors and the cost of
  birth control methods

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Mechanisms (2) Education and Fertility

• Demand for children educated women have higher
  opportunity cost, taste for less children etc.
  
• ? education reduces fertility
• Supply of birth control methods
• 1. financial cost of contraception
• 2. psychic cost of contraception
• 3. cost of acquiring information about
  contraceptive method and cost of using it
  efficiently
  
• ? education reduces fertility

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Abortion and birth control policy regimes in
Romania

• 1957- 1966 liberal abortion policy
• ?1.2 million abortions in 1965, 5 for every live
  birth
  
• 1966 abortion and family planning outlawed
• ?exceptions for women over 45, women with more
  than 4 children, serious health problems
  
• Initial fertility impact was very large
• ?in 1967 the birth rate doubles
• The government introduced limited pronatalist
  incentives
  
• - paid medical leaves for pregnancy
• - increases in financial allowance from 100 to
  130 lei (about 3)
  
• - maternity grants of 1000 lei (85) for third
  or higher order births
  
• - Heroine mother
• - Divorces were made much more difficult to
  obtain
  
• Policy sustained until December 1989 with minor
  modifications
  

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Summary of Results

• Large increases in fertility overall 25 higher
  lifetime fertility (about .5 children) as a
  result of restricting access to methods of
  fertility control.
• Fertility differential narrows substantially (by
  about 50) when birth control methods become
  widely available.
  

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Data

• The analysis is based on the CDCs 1993
  Reproductive Health Survey in Romania
  
• The dataset covers the reproductive histories of
  4792 women aged 15-44.
  
• Good information on pregnancy outcomes and
  monthly calendar of birth control methods used
  from 1988-mid 1993.
  
• Also 1997 Reproductive Health Survey from
  Moldova, 5412 observations, more limited
  information for the period 1988-1993
  
• 1992 census for robustness results

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TOTAL PREGNANCY RATES BEFORE (1988-1989) AND
AFTER (1991-1992), BY EDUCATION
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TOTAL ABORTION RATES BEFORE (1988-1989) AND
AFTER (1991-1992), BY EDUCATION
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TOTAL BIRTH RATES BEFORE (1988-1989) AND AFTER
(1991-1992), BY EDUCATION
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Estimation

• outcome depending on specification pregnancy,
  abortion, birth, etc.
  
• - education a dummy for having secondary
  education or higher
  
• - after a dummy taking value 1 if event occurs
  in 1991 or 1992, 0 otherwise
  
• - transition a dummy taking value 1 if event
  occurs in 1990, 0 otherwise

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Estimation (II) Romania and Moldova

• outcome depending on specification pregnancy,
  abortion, birth, etc
  
• education a dummy for having secondary education
  or higher
  
• after a dummy taking value 1 if event occurs in
  1991 or 1992, 0 otherwise
  
• - romania indicator

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Robustness checks

• Results are robust to
• unwanted outcomes
• fixed effects analysis
• restrict to women over 20
• inclusion of controls SES-index, urban, region,
  religion

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The immediate fertility response in 1990

• Use census data from 1992
• Use Own Children Method of Fertility Estimation
  (Cho et al. 1986)

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Long term impact of the 1966 policy change

• Data from 1992 Census
• For women born before1950, the number of children
  ever born is a good indicator of lifetime
  fertility

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Aged 37 in 1967
Aged 17 in 1967
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Aged 37 in 1967
Aged 17 in 1967
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Contraceptive Specific Pregnancy Rates

• explore the effect of ex-ante contraceptive
  methods on pregnancy rates

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Exposure to the policy

• Educated more affected by introduction of ban in
  1966
  
• Educated reach N when they are younger
• Educated have more sex in 1993

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Conclusion

• The supply of birth control methods had a large
  fertility impact on all socioeconomic groups
  (about .5 children or a 25 increase)
  
• Fertility differentials narrow between
  educational groups after the ban on
  contraceptives, even after controlling for other
  measures of SES.

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Fertility by quarter of birth
2.9
2.7
2.5
2.3
Number of children
fm1ceb
b
2.1
1.9
1.7
1.5
915
920
925
930
935
940
945
950
955
Year of birth
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Prevalence of ex-ante contraceptive methods

• explore the use of ex-ante contraceptive methods
  prior to 1989 and the adoption after
  liberalization

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