Three Essays on U.S. Reproductive Health Policy and Women's Fertility and Economic Outcomes

<p dir="ltr">Policies governing the set of reproductive choices available to individuals and the information about these choices are integral to fertility and economic wellbeing. This dissertation studies how policies that alter an individuals' reproductive choice set impact fertility decisions and economic outcomes like educational attainment. </p><p dir="ltr">Chapter 1 examines the effect of U.S. Food and Drug Administration approval of over-the-counter access to emergency contraceptive pills (ECPs) for teenagers. Using a synthetic difference-in-differences approach, I estimate the causal effect of the 2006 policy granting access to over-the-counter ECPs to people aged 18 and over on teen births and educational attainment. I find that the policy decreases birth rates by 10 percent to 20 percent for the treated age groups. I provide suggestive evidence of a lag in the effect that is driven by births in nonmetropolitan counties, indicating that availability and information may be important aspects to access. The policy increases women's likelihood of completing college by about 5 percent relative to men. These findings highlight the vital role of emergency contraception in shaping teen fertility patterns and long-term educational attainment.</p><p dir="ltr">Chapter 2 investigates the effects of increases in distance to the nearest abortion provider on abortion rates and birth rates. I study the impact of a targeted regulations of abortion provider (TRAP) law in Ohio, 2013 HB59. This law banned public hospitals from making transfer agreements with abortion providers, while continuing to require abortion providers to have a transfer agreement. The analysis provides Ohio-specific causal evidence that the 2013 TRAP law reduced abortion rates by as much as 18 percent, consistent with previous literature. The policy decreased the birth rates of women in their younger twenties, indicating that the policy reduced abortion rates directly and through a behavioral response to the reduced abortion access.</p><p dir="ltr">Chapter 3 analyzes the effect of mandates requiring schools to teach comprehensive sexual health education (CSHE) in three states, California, Oregon, and Washington, on teaching outcomes, teen behavior, and teen births. I estimate the causal impact using synthetic difference-in-differences and Poisson event study regression methods. I find that the California mandate increased the probability that schools teach sex education topics by an average of 17 percent. This effect is driven by the take up of sex education curriculum in middle schools rather than in high schools. In Washington, the increases in the likelihood of teaching CSHE topics were more moderate but provide early evidence of the positive impact of the 2020 policy. CSHE may play a pivotal role in the success of students in school and in their future. This study underlines the importance of studying these state mandates that model high-quality sex education. </p><p dir="ltr"><br></p>