Quantifying Title X’s Assault on Fertility

Evidence continues to mount that misguided public policy has played a key role in reducing American birthrates from their robust levels of the Baby Boom era. John D. Mueller makes the case in Redeeming Economics (2010) that Roe v. Wade triggered a dramatic drop in the Total Fertility Rate. Likewise, a study by University of Michigan economist Martha J. Bailey documents a robust link between the federal foray into “family planning” and what she terms the “significant and persistent reductions in fertility.”

Using birth-record data from Vital Statistics from 1959 to 1988, and country-level aggregates of birthrates from the National Center for Health Statistics from 1968 to 1988, Bailey compared changes in the General Fertility Rate (GFR) in counties that were targets of the rollout of the federal birth-control campaign, including the notorious Title X, between 1964 and 1973, to the GFR in counties without federal intervention.

Bailey’s data show that, before Uncle Sam started pushing and dispensing contraception, the GFR had evolved similarly in both categories of counties. However, once federal family-planning systems were up and running, the economist claims that “a sharp trend break is visually evident and statistically significant,” as the GFR fell more quickly in funded than in unfunded counties. She writes: “Five years after these programs were established, the general fertility rate was 2 percent lower net of fertility reductions in similar communities that did not receive federally-funded family planning dollars.”

These fertility declines, she claims, resulted not simply from a delay in the timing of first births among younger women but also a reduction in completed childbearing among older women as the Michigan researcher discovered a 2-percent reduction in second births: “Together, delayed childbearing and reductions in higher-order births generated a decrease in the general fertility rate of 1.4 percent up to fifteen years after communities received their first federal family planning grant.”

As federal family planners were sowing their mischief in just one-fifth of U.S. counties, Bailey notes that these interventions account “for only a modest portion” of the large drop in the national GFR from 1959 to 1974. Yet, she makes it clear that the federal birth-control campaign was particularly effective with its intended subjects: “low-income” women. Childbearing among these women, she estimates, declined by 21 to 29 percent within ten years. Had Uncle Sam minded his own business, America would have benefited, according to her estimates, from roughly 1.8 million more births than actually occurred during the campaign’s first ten years.

A number of factors, including the robustness of her results across a wide range of specifications, lead Bailey to claim a causal effect—not just a link—between federal family-planning and reduced American fertility. That’s all well and good, yet the Michigan professor seems to imply that her documented effects actually served the interests of the “low-income” population. Perhaps if her future research measures the impact of federal family planning of the stunning rise of out-of-wedlock births, she might think otherwise.

(Martha J. Bailey, “Reexamining the Impact of Family Planning Programs on U.S. Fertility: Evidence from the War on Poverty and the Early Years of Title X,” National Bureau of Economic Research, Working Paper 17343, August 2011.)