Women with easier access to the full range of contraceptive methods, including intrauterine devices (IUDs) and implants, are as much as 12% more likely to obtain a four-year college degree than those with limited access, according to new University of Colorado research.
The study, published this month in the journal Health Affairs, comes amid concerns that access to contraception is under threat in the wake of the Dobbs decision, the U.S. Supreme Court ruling that revoked women’s constitutional right to abortion care.
That decision, the authors said, has already led to the closure of many family planning clinics that provide contraception. In some states, the same legal and social strategies used to ban abortion are now being applied to restrict contraceptive access.
“This isn’t paranoia. Restrictions on contraception are coming next,” said study co-author Amanda Stevenson, assistant professor of sociology at CU Boulder. “Against that backdrop, this study shows that people who live in places where it’s easier to get contraception are better able to achieve their educational goals.”
The study, led by CU Denver Health and Behavioral Science Professor Sara Yeatman, centers around the Colorado Family Planning Initiative (CFPI), a 2009 effort that expanded access to a wide array of contraception across the state.
Funded by a $27 million private grant, the program augmented funding for clinics supported by the federal family planning grant program Title X, which tends to serve low-income, uninsured and young women. It enabled participating clinics to not only provide inexpensive forms of birth control like condoms and birth control pills but also offer more costly forms of long-acting, reversible contraception (LARC) for no or low cost.
Previous research has shown that the introduction of the pill in the 1960s improved college completion rates, but few studies have examined the impact of broadening access to birth control on women.
“Public funding of contraception in the United States often hinges on the idea that expanding access improves lives, but we don’t actually have a lot of hard evidence,” said Yeatman, also a research affiliate with CU Boulder’s Institute for Behavioral Science.
2,300 additional graduates
The team analyzed de-identified U.S. Census data to follow roughly 11,000 Colorado women from ages 22 to 24 and born between 1987 and 1994.
They compared four-year college degree attainment of those who were adolescents in Colorado when CFPI was in full swing to those born too early or too late to benefit from the program.
To parse out how much of an impact CFPI versus other factors had on graduation trends, they also compared the Colorado cohorts to same-aged matches in nine peer states and to the U.S. as a whole.
Among Colorado women born in 1990 (who were out of high school by the time CFPI was implemented), 30% completed college by age 24. Among those born in 1992 to 1994 who were in high school at the start of CFPI, the rate was 34%.
After adjusting for other national trends, the researchers determined that between 1.8 and 3.5 of those percentage points of improvement were a direct result of CFPI.
That translates to a 6% to 12% improvement in Colorado graduation rates.
Put another way, an additional 2,300 Colorado women born between 1992 and 1994 completed a four-year degree by the time they were 22 to 24 as a result of the program, the authors said.
State data has shown that over the span of the program, birth and abortion rates declined significantly in Colorado.
A path to a brighter future
The authors of the new study stress that the program didn’t only influence graduation rates by preventing unwanted pregnancies.
“Our data suggest that this policy also worked through non-fertility pathways,” said Yeatman. “That simply giving women expanded access to contraception may have increased their confidence that they can control their fertility in the future and led them to consider college when maybe they wouldn’t have otherwise.”
Funding for CFPI ended in 2015. Nationwide, Title X continues to be underfunded with research showing only about 45% of people who need subsidized care are able to get it.
Meantime, several state lawmakers have introduced bills to reduce access to and information about contraception.
Lawmakers in Missouri recently tried and failed to block federal funding for clinics providing emergency contraceptives, or Plan B, and IUDs. And a Louisiana House committee recently passed a bill saying that personhood begins at fertilization, an interpretation that abortion-rights advocates fear could be used to outlaw IUDs. The bill failed.
Yeatman and Stevenson note that anti-abortion activists have also begun to support social media campaigns that emphasize the danger of hormonal contraception.
“While it may be too late to protect abortion rights in much of the country, it’s not too late to start talking about the benefits that access to contraception confers,” Stevenson said.
She and Yeatman hope that this study, and previous research showing contraceptive access improves high school graduation rates, will provide a science-based counter-narrative and encourage policymakers to boost, not cut, funding for contraception.
“This study contributes to a small but growing body of causal evidence showing that access to the means of controlling fertility makes it possible for people to live the lives they want to live,” said Stevenson.
Study co-authors include CU Boulder Economics Ph.D. candidate James Flynn, Katie Genadek, of the U.S. Census Bureau, Stockholm University Professor Stefanie Mollborn, CU Boulder Sociology Professor Jane Menken.