Contraceptive supply and fertility outcomes: Evidence from Ghana

Total fertility rates in Sub-Saharan Africa are nearly double that of any other region in the world. Evidence is mixed on whether providing contraceptives has an impact on fertility. I exploit exogenous, intermittent reductions in contraceptive supply in Ghana, which resulted from targeted cuts in U.S. funding, to examine impacts on pregnancy, abortion, and births. Women are unable to compensate for the supply reduction using traditional methods for preventing pregnancy, which increases by 10%. Only non-poor women offset these unwanted pregnancies with induced abortion. Using separate data, I find that poor women experience increases in realized fertility of 7-10%. JEL Codes: I15, J13, O19, F35 ∗International Food Policy Research Institute; 2033 K St NW, Washington, DC 20017; (202) 8624641; [email protected]. The author gratefully acknowledges funding from the National Science Foundation’s Doctoral Dissertation Research Improvement Grant, the William and Flora Hewlett Foundation’s Fellowship in Population, Reproductive Health and Economic Development, the UC Berkeley Population Center (NICHD R21 HD056581), and the Center of Evaluation for Global Action. Thanks are owed to Elisabeth Sadoulet, Alain de Janvry, Jeremy Magruder, Ted Miguel, Pascaline Dupas, Craig McIntosh, Erick Gong, Gil Shapira, Melissa Hidrobo and participants of the PopPov research conference. Research assistance was provided by Aviva Lipkowitz. All remaining errors are my own.