Reducing financial barriers to contraception lowers rate of unintended pregnancies and abortions

A UCLA clinical trial finds that reducing the costs of contraception results in 16% fewer unintended pregnancies and 12% fewer abortions among low-income women after two years.

In a working paper published by the National Bureau of Economic Research (NBER), the study offers rigorous experimental evidence that directly connects financial access to contraception for a broad population of women in the United States, helping to answer questions of long-standing academic and policy interest.

"According to our findings, eliminating financial barriers allowed women to choose more effective contraception methods and reduce undesired pregnancies and abortions," said Martha Bailey, professor of economics and director of the California Center for Population Research, and the study's lead author.

Removing all contraceptive costs through the M-CARES study

The findings were based on the Michigan Contraceptive Access, Research, and Evaluation Study (M-CARES) which recruited low-income women who sought care through Title X, a federal program that subsidizes reproductive health and family planning services for low-income Americans, between 2018 and 2023. During this period, randomly assigned participants were given vouchers that made any method of contraception free or sharply discounted. The goal of the M-CARES study was to remove cost barriers for all methods available at Title X providers and to follow changes in the choice of contraception and pregnancy outcomes over time.

Based on data analysis over a two-year period, the study found:

A significant reduction in pregnancies and abortions. Subsidizing contraception resulted in:

• A 16% reduction in pregnancies
• A 12% reduction in abortions

A shift toward more effective contraceptive methods. Removing all financial barriers:

• Increased the likelihood of buying contraception by 69%
• Raised the efficacy of chosen methods by 44%
• Raised the use of long-acting reversible contraceptives (LARCs), such as intrauterine devices (IUDs) and implants, by 217%

In the U.S., the rate of unintended pregnancy is more than five times higher among women in poverty than women with incomes at least two times the poverty level. The study suggests that the high cost of reliable contraception is an important contributor.

The findings are particularly relevant for policy discussions surrounding ongoing cuts to the Title X program, which serves millions of low-income Americans.

Earlier this year, the Trump administration froze millions of dollars in Title X grants, affecting providers in numerous states, including California. There is a strong possibility that Title X will continue to face cuts or complete elimination in the upcoming 2026 federal fiscal year.

Read the full story on the impact of financial access to contraception on the UCLA Social Science website.