Access to the emergency contraceptive pill and women’s reproductive health: Evidence from public reform in Chile

Abstract

We examine the sharp expansion in availability of the emergency contraceptive pill in Chile following legalized access through municipal public health care centers. We study the period 2002–2016 and a broad rollout of the emergency contraceptive pill occurring between 2008 and 2011. By combining a number of administrative data sets on health outcomes and pharmaceutical use, and using event-study and difference- in-differences methods, we document that this expansion improved certain classes of women’s reproductive health outcomes, notably reducing rates of abortionrelated morbidity. These improvements were greater in areas of the country where the rollout of the emergency contraceptive pill was more extensive. We also document some evidence that refusal to provide the emergency contraceptive pill upon a women’s request was linked with a worsening in reproductive health outcomes. These results point to the importance of contraceptive access as a determinant of women’s reproductive health and well-being and relates to a growing body of work documenting the importance of women’s autonomy as a determinant of health.