Effects of Expanding Contraceptive Choice: New Evidence from Virginia's Contraceptive Access Initiative

Jessica H. Kiser, Analisa Packham, Janelle Anthony, Evelyn Escobar and Emily Yeatts

No 35108, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: In 2018, the Virginia Department of Health implemented the Contraceptive Access Initiative (CAI) to increase access to long-acting reversible contraceptives (LARCs). We use encounter-level data on contraceptive choice in participating CAI clinics and county-level natality data from 2014--2021 to estimate relative changes in LARC take-up and childbearing rates before and after the CAI. Difference-in-differences estimates indicate that the CAI reduced birth rates in participating counties by approximately 3 percent, or less than half of the effect size of other similar, state-level programs. We show that this smaller effect is likely due to existing high LARC take-up and contraceptive substitution.

JEL-codes: I18 I38 J18 (search for similar items in EconPapers)
Date: 2026-04
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