College women willing to pay more for contraception when abortion is illegal

A new study suggests that the legal status of abortion impacts how college women value contraceptives. Researchers found that when women imagine a scenario where abortion is illegal, they demonstrate a higher willingness to pay for emergency contraception and condoms. These findings appeared in the Archives of Sexual Behavior.

College is often a period characterized by increased independence and sexual exploration. This life stage carries heightened risks for sexually transmitted infections and unintended pregnancies. The decision-making process regarding safe sex has become more complicated following recent changes in reproductive laws across the United States.

Researchers sought to understand the cognitive processes behind contraceptive use in this shifting legal landscape. They aimed to measure how the availability of abortion services influences the perceived value of preventative measures. The investigation was led by Jin H. Yoon from UTHealth McGovern Medical School.

Yoon collaborated with a team from Clemson University and the University of Houston-Clear Lake. The team employed a framework known as behavioral economics to analyze these decisions. This field combines principles from psychology and economics to explain why people make specific choices.

Behavioral economics often utilizes concepts like “demand” and “delay discounting” to quantify decision-making. Demand measures how much a person wants a product as its cost increases. This cost does not always refer to monetary price.

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It can also refer to barriers such as time, effort, or inconvenience. Delay discounting looks at how a reward loses value if a person must wait to receive it. This concept helps explain impulsive behavior.

An individual might choose a smaller, immediate reward over a larger, delayed one. In the context of sexual health, the immediate reward might be engaging in sex right now. The delayed reward is the future benefit of remaining free from infection or pregnancy.

The researchers recruited 109 cisgender female college students for the study. Participants were between the ages of 18 and 30. All participants reported having heterosexual intercourse within the past year.

The study utilized hypothetical vignettes to assess decision-making. Participants completed tasks on a computer in a laboratory setting. They faced two distinct conditions during the assessment.

In one condition, they were instructed to assume that abortion was legal in their area. In the other condition, they assumed abortion was illegal. This within-subject design allowed researchers to compare how the same individual’s choices changed based on the legal context.

One assessment was the condom purchase task. Participants imagined they met an attractive person at a party or bar. The scenario specified they were not in a committed relationship and the potential partner was leaving town the next day.

They were told there was no other source of birth control available. Participants then indicated whether they would purchase a three-pack of condoms at various prices. The prices ranged from zero dollars up to 500 dollars.

The researchers looked for the “breakpoint” in this task. This is the price at which the participant would refuse to buy the condoms. If they reached this point, they were asked if they would have unprotected sex or abstain entirely.

Another assessment measured condom delay discounting. Participants imagined the same social scenario. They were asked if they would wait to obtain a condom if it delayed sex by specific amounts of time.

The delays ranged from one minute to two hours. Participants used a sliding scale to indicate their willingness to wait. One end of the scale represented “Definitely sex now without a condom.”

The other end represented “Definitely wait for condom.” This measured how much the immediate desire for sex outweighed the safety of condom use as the wait time increased. A third task focused on emergency contraception.

This task was novel to this specific study. Participants imagined they had engaged in unprotected sex the night before. The scenario stated they were near ovulation, meaning the risk of pregnancy was high.

They were asked if they would purchase the “morning-after pill” at various price points. Prices ranged from free to 10,000 dollars. This allowed the researchers to construct a demand curve for emergency contraception.

The results showed a clear shift in behavior based on the hypothetical legal status of abortion. When abortion was framed as illegal, the perceived value of contraceptives increased across all three tasks. This was evident in the condom purchase task.

Participants were willing to pay higher prices for condoms when abortion access was restricted. They were also less likely to be “zero responders.” Zero responders are individuals who refuse to buy condoms even at the lowest prices.

Similar patterns emerged in the delay discounting task. When abortion was imagined as illegal, participants were more willing to wait longer periods to secure a condom. The immediate gratification of sex became less dominant compared to the desire for protection.

The demand for the morning-after pill also saw a significant increase in the illegal abortion condition. Participants indicated a willingness to pay substantially higher amounts to prevent pregnancy. This suggests that restricted abortion access increases the motivational value of backup contraceptive methods.

The study also collected data on the participants’ sexual history. This included questions about past risky behaviors, such as having sex without a condom or having multiple partners. These self-reported histories correlated with the behavioral economic results.

Women who reported a history of higher sexual risk-taking placed a lower value on contraceptives in the tasks. They were less willing to pay for condoms or the morning-after pill. They were also more likely to choose immediate sex over waiting for a condom.

This correlation supports the validity of the hypothetical tasks. It suggests that the computer-based decisions reflect, to some degree, real-world behavioral tendencies. The study also assessed attitudes toward the morning-after pill.

Participants who held positive views about the safety and efficacy of emergency contraception showed higher demand for it. This was true regardless of the abortion legality condition. Knowledge about reproductive health played a role as well.

There are limitations to this research that must be considered. The tasks relied on hypothetical scenarios rather than real-world behavior. Participants stated what they would do, which may differ from their actions in an emotionally charged moment.

The sample consisted primarily of White college students. This demographic profile limits how well the findings apply to other groups. Factors such as income, race, and geographic location likely influence contraceptive decision-making.

The study also used a fixed order for the tasks. Participants always completed the “abortion legal” condition before the “abortion illegal” condition. This could potentially introduce order effects into the data.

The researchers note that the study took place before South Carolina enacted a six-week abortion ban. The legal landscape is shifting rapidly. Future research would benefit from examining these behaviors in states with actual, rather than hypothetical, restrictions.

The results align with real-world trends observed after the Supreme Court’s Dobbs decision. Other data sources have shown fluctuations in pharmacy fills for emergency contraception in states with strict abortion bans. This study provides a mechanism to explain those trends.

It suggests that people rationally adjust their valuation of preventative measures when the “cost” of an unintended pregnancy increases. The cost in this case is the inability to access abortion services. Behavioral economics offers a useful tool for predicting public health outcomes.

The development of the emergency contraceptive purchase task is a specific contribution of this work. It provides a new metric for researchers to gauge how policy changes affect health behaviors. Future studies could use this tool to assess the impact of sex education programs.

Understanding these decision-making processes is vital for public health officials. It highlights the link between reproductive rights and preventative health behaviors. As laws continue to evolve, monitoring these behavioral shifts will remain a priority for social scientists.

The study, “Behavioral Economic Assessment of Contraceptive Use and Abortion Access Among College Cis Women in the U.S.,” was authored by Jin H. Yoon, Irene Pericot‑Valverde, Constanza de Dios, Sarah Voss, Caroline Allen, Catherine Chopade, Haley Neal, Erik G. Ortiz, Kelcy R. Coleman, Vincent Dang, and Lanelle Ochiam.