Summary of The Power of the Pill: Oral Contraceptives and Women’s Career and Marriage Decisions, by Claudia Goldin and Lawrence F. Katz (Part 2)
Further, “mature minors” were allowed access to contraceptive methods by judicial decision and statute.
Fig. 1.—Fraction of college graduate women first taking the pill at various ages (among
those with no births before age 23). Source: Inter-university Consortium for Political and
Social Research (1990). Three-year centered moving averages are shown.
Fig. 2.—Fraction of college graduate women receiving first family planning services at
various ages (among those not married by age 22). Source: Inter-university Consortium
for Political and Social Research (1985). Three-year centered moving averages are shown.
4) After these legal changes, the pill diffused rapidly among single women. Despite health scares, use of the pill has persisted.
5) While state laws did not stop a determined single woman from getting the pill, in the 1960s states attempted to directly regulate the sale of contraceptives.
a. 30 states prohibited advertisements regarding birth control and 22 had a general prohibition on contraceptive sales, often reflective of state social norms.
b. Social norms provide a data problem: there are few surveys that inquired about contraceptive use, as young unmarried women were not expected to be having sexual intercourse.
6) First Data Set National Health Interview Study (NHIS): ~13,000 women interviewed in 1987, and asked about their history of birth control usage. No age at first marriage, but age of first birth.
7) Second Data Set: National Survey of Family Growth, Cycle III (1982). Because of the drawback of the NHIS not having age at first marriage. NSFG asks about age of first marriage and first use of family planning services, but not about first pill use.
8) Consistent Results: Both data sets show that among women who would eventually graduate from college, the increase in contraceptive services for those of college age began with cohorts born around 1948.
9) Third Data Set: National Survey of Young Women 1971 (NSYW71). 4,611 young women 15-19 in 1971.
10) Fourth Data Set: National Survey of Adolescent Female Sexual Behavior 1976 (NSAF76). Also of young women 15-19, but half as large.
11) Comparisons between reported pill usage in NSYW71 and NHIS, and between NSAF76 and NHIS, show close results (33 and 34%, and 48.2% and 51.2, respectively). This provides good evidence that women accurately recall when they first took the pill.
12) Peak usage among married women occurred a half decade before rapid diffusion began for single women; one explanation for this difference concerns the state laws that affected the age of majority and mature minor rights. When these state laws changed, the period of most rapid increase in pill use occurred for unmarried women.
B) State Variation in Laws Affecting Contraceptive Services
1) In most states, physicians were required to obtain parental consent to issue nonemergency procedures (including contraceptive services) to minors.
2) After 1969, and the passage of the 26th amendment in light of the Vietnam war, the age of majority was lowered in almost all states, and “mature minor” classifications allowed family planning services to be used by minors without parental approval.
3) The legal ambiguity in the 1960s was actually an incentive for universities not to provide family planning services. Family planning in college is critical, as it comes at a time when career, marriage, and family decisions are being made.
4) According to the American College Health Association, 3.6% of reporting institutions prescribed the pill to unmarried students in 1966. In 1973, 19% would provide FPS to students regardless of age and marital status. Larger schools had a higher fraction providing services, with an estimated 42% of undergraduates having access to such services.
C) The Impact of State Laws on Pill Use
1) Did states with more lenient laws regarding access to contraceptive services by minors have higher pill use by young unmarried women?