Unaffordable birth control led to less healthy ‘extra’ babies in Chile

In 2008, the cost of birth control in Chile doubled almost overnight without warning. Today, the effects of the price hike are still unfolding in the lives of children conceived in the following days, a new study distributed by the National Bureau of Economic Research found.

The paper, “The Children of the Missed Pill,” estimates between 183 and 265 “extra” individuals were born in Chile per week due to hikes in prices of birth control coordinated by the three largest pharmacies in the country at the time. Without access to contraception, women were forced to have children before they were ready, the researchers from Purdue University, University of Maryland, and Pontificia Universidad Católica de Chile found.

Chile has maintained some of the world’s most stringent anti-abortion regulations since 1989, according to Human Rights Watch, and only recently decriminalized abortion in the case of rape or danger to a mother’s life.

Children conceived of these unplanned pregnancies are more likely to have health problems before and after birth, the study found, with year-to-year increases in the number of fetal deaths, the number of underweight births, and the number of infant deaths that exceed the increase in the overall birth rate. As these “extra” children reach grade school age, they are less likely to enroll in school, and those who did enroll in school were more likely to attend special education programs.

“Access to contraception actually increases the average health of the babies conceived by preventing the conception of babies from mothers that are not ready to have babies,” said Miguel Sarzosa, assistant professor of economics at Purdue University and co-author of the report.

However, studies like these are difficult to draw conclusions from or apply to other locations, said Brian Levine, practice director of the Colorado Center for Reproductive Medicine and member of the American Congress of Obstetricians and Gynecologists (ACOG). “This is correlation without causation,” he said. “It is more of a sociological problem where unmarried women and low-income people have less support, and how you handle yourself during a pregnancy can greatly impact a child’s later outcomes.”

Access to contraception is also not guaranteed to prevent planned pregnancies: More than half of women who got abortions last year were using some form of contraception.

This makes it difficult to translate the latest study to the US, where affordable birth control is at risk after President Donald Trump announced he will roll back the Obamacare requirement that employers offer coverage of a variety of birth control methods, Levine said, though he opposes Trump’s policy change. Women saved an estimated $1.4 billion on birth control pills alone in 2013 after the Affordable Care Act’s birth control benefit was passed.

Still, Sarzosa, said researchers are “very confident” the results are representative of the direct effects of birth control prices, as rates increased consistently across the country except in one city that had access to cheap contraceptives over the border in Peru. The study should serve as a warning to places like the U.S. on the long-term effects of price hikes in family planning, he added.

“As a society, our results suggest it’s of interest for all to provide access to contraception so women can decide when they’re economical, psychologically, and biologically ready to have a baby so they can provide all the resources a baby requires,” Sarzosa said.

Filed under