The morning after: Prescription-free access to emergency contraceptive pills

J Health Econ. 2023 Sep:91:102775. doi: 10.1016/j.jhealeco.2023.102775. Epub 2023 Jun 12.

Abstract

We analyze the introduction of prescription-free access to morning-after pills-emergency contraceptives that aim to prevent unintended pregnancy and subsequent abortion after unprotected sexual intercourse. Exploiting a staggered difference-in-differences setting for Europe combined with randomization inference, we find sharp increases in sales and manufacturers' revenues of more than 90%. However, whilst not reducing abortions significantly, the policy triggers an unexpected increase in fertility of 4%, particularly among women aged 25-34. We elaborate on mechanisms by looking at within-country evidence from several EU countries, which suggests that fertility is driven by decreasing use of birth control pills in response to easier access to morning-after pills.

Keywords: Difference-in-differences; Emergency contraception; Fertility; Morning-after pill; Unintended side effects.

MeSH terms

  • Adult
  • Commerce
  • Contraception
  • Contraceptives, Postcoital*
  • Europe
  • Female
  • Humans
  • Pregnancy

Substances

  • Contraceptives, Postcoital