Teen girls and young women in Colorado graduated high school at higher rates after the state expanded access to affordable contraception — some of the strongest quantitative evidence of better reproductive choices shaping the life trajectories of women.
In a new study, published Wednesday in Science Advances, researchers evaluated the Colorado Family Planning Initiative, a program that made it much easier for people to get the method of contraception they wanted at Title X clinics in the state. Girls who simply were in Colorado and under 16 after the initiative began in 2009 had graduation rates 1.66 percentage points higher overall — young white women's graduation rates went up 2.16 points, while young Hispanic women's rates went up 4.86 points. In all, an additional 3,800 young women born between 1994 and 1996 got their high school diplomas because the state made it easier to access an array of contraception.
The family planning initiative, which Republicans in the state have since chosen to abandon, "was fundamentally about enhancing choice," lead author Amanda Jean Stevenson said. "The vast majority of young women in Colorado didn't go to a clinic during this time, right? So this effect is a conservative estimate — it's an estimate of the actual effect that the policy itself had."
Stevenson and her co-authors pointed out that they did not measure exactly how the program affected girls and young women; they looked at data from the U.S. Census Bureau, and they did not consider factors such as how close teens were to a Title X clinic, whether they went to a clinic or whether they used contraception. "The Colorado Family Planning Initiative was designed to improve access for all Colorado residents, and so we consider everybody who lived in Colorado to be 'treated,'" Stevenson, an assistant professor at the University of Colorado Boulder, told The Academic Times.
It was possible, she and her co-authors wrote, that the mere option of free or low-cost contraceptives could have a positive impact on girls' commitment to their education.
The study compared Colorado to all other states and, in particular, to 17 similar states so that researchers could determine how graduation rates might have changed without the family planning program. The researchers found that 88% of young Colorado women who were over 16 when the initiative began had a high school diploma by the age of 22; post-initiative, 92% of young women had a diploma by age 22. According to the difference-in-difference analysis, some of the change was due to other factors, but 1.66 percentage points were because of the new program.
Prior research on how contraception affects women's lives post-1970s was murky, Stevenson said. She noticed the deficit when she was a doctoral student in Texas and state legislators wanted to dismantle family planning.
"As I prepared to try to provide expert testimony in those debates, I realized that the arguments that most advocates use, like 'family planning makes women's lives better,' while they're perfectly reasonable arguments, they weren't actually substantiated with empirical quantitative evidence," she said.
In Colorado, she set out to find that evidence — in part because high school graduation rates are cited to support family planning programs, using statistics that bother Stevenson.
"When advocates of the public subsidy of contraception argue that contraception improves women's lives on the basis that teen moms don't graduate from high school as much as people who don't have babies in their teen years," she said, "what they're basically arguing is not that people should have better access to contraception. They're arguing instead that people should just use more contraception, and, specifically, disadvantaged people should use more contraception."
Stevenson cited bodily autonomy as one of the many justifications for contraceptive access that require no data at all. "There are a variety of arguments that are all really, really good for why we should support people's access to the means of controlling their fertility in the ways that they want to that have nothing to do with anything we can measure, that have to do with what's right and wrong," she said. "This study was worth doing — to me, anyway — mostly because the arguments that actually get used by people who support family planning public subsidies aren't rooted in those ideals. They're rooted in empirical evidence."
Stevenson was also clear that, while the statistical analyses were lacking, a preponderance of personal accounts precede — and may explain — the new findings. "When I say we didn't have empirical evidence, the piece that's really critical there is that we didn't have empirical quantitative evidence," she said. "Women tell us that family planning makes their lives better."
The paper, "The impact of contraceptive access on high school graduation," published May 5 in Science Advances, was authored by Amanda J. Stevenson, Stefanie Mollborn and Jane A. Menken, University of Colorado Boulder; Katie R. Genadek, University of Colorado Boulder and U.S. Census Bureau; and Sara Yeatman, University of Colorado Boulder and University of Colorado Denver.