Pill vs Gatekeeper Power: Birth Control Access, Religious Beliefs, and Women’s Outcomes

Esmée Zwiers¹ (with Olivier Marie²)

1 Princeton University

2 Erasmus University Rotterdam

We study how access to birth control affects short- and long-term outcomes of women in a new context: the 1970 liberalization of the contraceptive pill in the Netherlands. We first document a massive immediate drop in the birth rate post-liberalization that was particularly strong for young women, the group for which access restrictions were most drastically lifted. We then exploit area level social norms – proxied by votes for religious parties who were against relaxing access rules – to obtain causal estimates of the impact of the availability of the pill on female fertility control and especially changes in the prevalence of ill-timed births. We find that women who lived in areas that were less religiously resistant to the introduction of the pill were much less likely to experience an underage birth or marriage. These women went on to invest more in education and ended up in wealthier households. We then measure the importance of birth control providers’ beliefs in providing access to the available technology by estimating the additional effect of the religiosity of local health professionals on women’s outcomes. We that find a larger proportion of religious ‘gatekeepers’ around a woman at the time of liberalization all but wiped out any positive pill impact.