Contraception and the American Dream

Children raised in stable, two-parent families do much better in life. But gaps in family stability and family structure are widening, threatening social mobility. Marriage matters here. Money matters, too. But the most effective way to prevent nonmarital births and restore marriage, or at least to promote more stable relationships and better outcomes for children is helping couples to avoid early, unplanned childbearing. This is the argument we make in a new policy brief for The Future of Children, a joint publication between Brookings and Princeton University.

The high costs of unplanned births

Births outside marriage were once the exception: just 5 percent of the total in 1960. Now they are very common, rising to a peak of 41 percent in 2009. There are many reasons for the rise in non-marital births. But unplanned pregnancies are a significant factor: 60 percent of nonmarital births to women under 30 are unplanned.

The long-run educational and social consequences for children raised in unstable homes are poor. There are more immediate costs, too. Children in female-headed families are five times as likely to live in poverty. Fathers of children being raised by single women can face crippling child support payments. Taxpayers pay a price too, with increased public spending on health care costs associated with the birth, and an increased likelihood that the child will be eligible for cash and in-kind welfare benefits.

The huge value of contraception

Given the costs of unplanned births, contraception is highly cost-effective. This is particularly true for the most reliable forms. Every $1 spent on implants and IUDs saves more than $7, according to a study by Diana Greene Foster. The savings grow if longer-term benefits are included, such as higher levels of maternal education. An important study by Martha Bailey of the University of Michigan suggests that the expansion of federal funding for family planning clinics between 1964 and 1973, along with a reduction in unplanned births caused by expanded legal access to abortion had positive effects on children born afterward, including effects on their education, employment, wages, and family incomes as adults.

The promise of LARCs

Only about 7 percent of all women 15–44 use Long-Acting Reversible Contraception (LARCs). But LARCs seem highly effective, in large part because they change the ‘default’ for women, from having to take action to avoid pregnancy (that is, consistently take a pill or use a condom) to having to take action to become pregnant (that is, remove an IUD or an implant). A raft of recent studies of programs offering LARCs in St. Louis and Colorado, as well as a study using random assignment, conducted by the Bixby Center at the University of California, San Francisco, find significant effects on rates of abortion and unplanned births.

The politics of birth control

There are many concerns about expanding access to birth control, especially among Republicans. Many conservatives believe LARCs are an abortifacient but the truth is that they reduce the abortion rate by preventing accidental pregnancies.

Politics necessary involves a contest of values. We believe that in the case of birth control, the benefits of expanded access are sufficiently strong that most elected officials will want to support it once they understand the benefits.