Contraceptive access and infant health outcomes

This paper documents an important unintended consequence of expanding contraceptive access; it reduces the rates of adverse infant health outcomes. I study a large family planning initiative in the St. Louis metropolitan area that provided thousands of long-acting reversible contraceptives (LARCs) to reproductive-age women at no cost. Using a synthetic difference-in-differences design, I find that the program led to substantial improvements in infant health, reducing extremely preterm births by 2.18 and infant deaths by 1.74 per 1,000 live births, reductions of approximately 20% for each outcome. I find meaningful reductions for both Black and White mothers, though the effects on Black mothers are less precisely estimated and are smaller as a percentage of the baseline rates, particularly for extremely preterm births.