More Pills, Safer Sex? Emergency Contraception and Sexual and Reproductive Behavior Among Youths in Chile

Implementation of sexual and reproductive health policies in Chile has faced strong opposition in the past 30 years. However, during the 2000s, the country introduced the possibility of access to emergency contraceptive pills; access varied at the local level, depending on each municipality's decision to adopt the policy. Taking advantage of this unstructured implementation of the emergency contraception policy in the country, the study aimed at identifying the impact of the availability of emergency contraception pills on sexual and reproductive behavior, using multilinear regressions as well as time, municipality, and individual controls. In terms of sexual behavior, the estimations showed that, in municipalities where emergency contraception was available, youths were less likely to initiate sexual activity-compared to those living in municipalities where the pill was not available-no effect in terms of the number of sexual partners during a year, and more likely to use hormonal contraception. Estimations showed that emergency contraception availability influenced sexual and reproductive health outcomes directly (e.g., by reducing the number of unplanned pregnancies) but also had an indirect effect by changing people's behavior. Results highlight the link between contraceptive methods and their usefulness as a strategy to engage youths with the health system.