The Power of the Pill: Evidence from Oral Contraceptive Sales

Kelly Suzanne Ragan

The Economic Journal, 2025, vol. 135, issue 670, 2054-2066

Abstract: The introduction of oral contraception (‘the pill’) was a watershed in fertility control. Yet, the pill’s impact on childbearing has been hard to establish due to limited data. I exploit rich data on pill sales across markets and time to characterise how Swedish teens’ access to pharmacies shaped pill sales and fertility after the pill’s introduction. Pill sales are highly sensitive to pharmacy access, and teen fertility responds strongly to pill sales. The unique data establish an important link in the causal chain from pill access to women’s fertility. Estimated fertility responses to the pill could explain the halving of teen births after the pill’s introduction, a finding that is robust to accounting for trends in female education, abortion provision and other factors.

Date: 2025
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