Skip to Main Content

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

The UCLA study quantifies the benefits of federal programs that fund contraception for low-income Americans

Unsplash/Marina Raspopova

Citlalli Chávez-Nava

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.

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.

Removing all contraceptive costs through M-CARES study

The findings were based on the Michigan Contraceptive Access, Research, and Evaluation Study (M-CARES) which recruited low-income women at Title X medical providers between 2018-2023. 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.

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%

“It’s important to note that the effects of the study last well beyond the availability of the subsidies. The effects of increasing affordability extend over a two-year period and likely beyond,” said Bailey.

Furthermore, unlike previous academic studies, the M-CARES survey findings include high-quality administrative micro-data offering a more comprehensive view of contraceptive use.

“Most studies have only been able to document changes in childbirth. Because we had administrative records, we were able to see changes in pregnancies and abortions, which are severely underreported in surveys,” added Bailey.

Timely findings for the 2026 Congressional budget adoption

In March of this year, the Trump Administration announced a freeze of close to $35 million in funding to Title X grantees. This freeze left California, among seven other states, without Title X funding. And there is a strong possibility this program will continue to face cuts or complete elimination for the upcoming 2026 federal fiscal year.

Bailey thinks that further disruptions to Title X grantees will be devastating for low-income women, worsening not just their health, but their social and economic outcomes as well as resources for their children.

“Generalizing our survey findings, we see that keeping Title X sliding scale costs as they stand now, results in significantly higher rates of unintended pregnancy among low-income women and causes more abortions nationally than if contraception were completely free,” said Bailey.

Instead, Bailey says the M-CARES evaluation provides evidence that federal Title X dollars help U.S. families and expanding the program would also have benefits.

“The Title X program is a cost-effective way to empower parents to choose their families according to their own desires,” she said. “Preserving Title X and expanding its generosity would strengthen the reproductive health safety net.”

How lethal aggression increased reproductive success in wild chimpanzees

UCLA’s Compassionate Conversations focuses on ‘kindness to the stranger’

UCLA’s Jessica W. Lynch named 2025 Fulbright Scholar

Lynch plans to return to Brazil to further collaborate with a network of researchers at Brazil’s National Primate Center during spring 2026.

Video: UCLA Future of History Conference  

UCLA Social Sciences

UCLA’s Meyer and Renee Luskin Department of History and UCLA’s Luskin Center for History and Policy hosted the “Future of History of Conference” on Nov. 3 at UCLA’s Luskin Conference Center.  

The event featured Secretary of the Smithsonian Institution Lonnie G. Bunch III and opening remarks by UCLA’s Executive Vice Chancellor and Provost Darnell Hunt.  

Below are recordings from the event.  

PART I: A Conversation with UCLA History Faculty  

Featuring:  

• Kelly Lytle Hernández, Thomas E. Lifka Endowed Chair of History Professor of UCLA Meyer and Renee Luskin Department of History  

• Sanjay Subrahmanyam, Irving and Jean Stone Endowed Chair in Social Sciences Distinguished Professor, UCLA Meyer and Renee Luskin Department of History  

• Vivien Tejada Assistant Professor, UCLA Meyer and Renee Luskin Department of History  

Moderated by Brenda E. Stevenson Nickoll Family Endowed Chair in History and African American Studies Distinguished Professor, UCLA Meyer and Renee Luskin Department of History 

PART II: A Conversation with Secretary Lonnie G. Bunch III  

Featuring:  

• Robin D. G. Kelley Gary B. Nash Endowed Chair in United States History Distinguished Professor, UCLA Meyer and Renee Luskin Department of History  

• Athena N. Jackson, Norman and Armena Powell University Librarian, UCLA  

Moderated by David N. Myers Sady and Ludwig Kahn Endowed Chair in Jewish History Director, UCLA Luskin Center for History and Policy Distinguished Professor, UCLA Meyer and Renee Luskin Department of History  

‘Smarter machines, wiser humans’: The future of AI and communication

L.A. labor leaders link the past and future during visit to UCLA campus

New data upends myths about Mexican migrant labor

Farm workers pick strawberries at Lewis Taylor Farms, which is co-owned by William L. Brim and Edward Walker who have large scale cotton, peanut, vegetable and greenhouse operations in Fort Valley, GA, on May 7, 2019. Mr. Brim talks about the immigration and disaster relief challenges following Hurricane Michael. USDA helped this farm with the Farm Service Agency (FSA) Emergency Conservation Program (ECP) for structural damage cleanup. He also mentions the importance of having Secretary Sonny Perdue, a person with an agricultural background, come visit and listen to 75 producers six months ago, in southern Georgia. The farm’s operation includes bell peppers, cucumbers, eggplant, squash, strawberries, tomatoes, cantaloupe, watermelon and a variety of specialty peppers on 6,500 acres; and cotton and peanuts on 1,000 acres. Near the greenhouses is a circular crop of long-leaf pines seedlings under a pivot irrigation system equipped with micro sprinklers. Long-leaf pines are an indigenous tree in the Southeast. Growers are working to increase the number of this slower growing hearty hardwood tree in this region. USDA Photo by Lance Cheung. FSA https://www.fsa.usda.gov/index ECP https://www.fsa.usda.gov/programs-and-services/conservation-programs/emergency-conservation/index

Temporary Mexican labor migration to the U.S. is largely legal today due to the rapid expansion of H2-A and H2-B visas, reversing a longstanding trend of unauthorized migrant flows

Farm workers pick strawberries at Lewis Taylor Farms in Fort Valley, Georgia, May 7, 2019. / (Photo: USDA courtesy of Flickr; public domain.)

UCLA International Institute

One of the main impacts of social science research is overturning enduring assumptions based on outdated information. Research based on the latest empirical data can have particularly salient impacts when the subject is Mexican labor migration to United States.

The research of Ruben Hernández-León, professor of sociology and director of the UCLA Latin American Institute, has focused on the migration of Mexican workers to the U.S. and their return to Mexico throughout his career. He recently published an article with colleague Efrén Sandoval (CIESAS-Noreste, Mexico) on the explosion of U.S. H2-A and H2-B visas over the last 20-25 years.

H2 visas are granted to foreign workers to do temporary agricultural work (H2-A) or heterogeneous “low-skilled” work (H2-B, which covers temporary work in such varied fields as landscaping, tree trimming, hotels and resorts, fisheries and seafood processing) in the U.S. In the late 1990s, the combined annual total of the two visas was slightly more than 30,000. By fiscal year 2025, the total had jumped to roughly 455,000: an increase of over 1,500%.

“The growth of these visas has been connected to a very important transformation in Mexican migration over the past roughly 20 years: the channeling of formerly unauthorized flows to legal channels,” remarked Hernández-León.

Although technically open to workers from around the world, the vast majority of these time-limited visas are currently granted to Mexican workers (90% of H2-As, 65–70% of H2-Bs). Many of these workers return year after year to work for the same employers for a specified time period and then return home. “They become sort of career H2-visa workers,” said the professor. “Workers establish relations with employers. And employers want people who they trust, who they know will get the job done.”

The total number of Mexicans who annually receive H2 visas and travel legally to work in the U.S. is now conservatively estimated at 500,000. “This is roughly the same number of undocumented migrants who were crossing the border — south to north, from Mexico to the United States — during the heyday of undocumented migration in the late 1990s and early 2000s,” said Hernández-León.

Several major forces have pushed Mexican worker migration from an undocumented to a documented pipeline. First, pointed out the UCLA professor, “A very profound demographic change has been taking place in Mexico over the past 20 to 30 years. Mexican families are now having very few children, so there are fewer entrants into the general labor market.” Second, the migrant Mexican population in the U.S. is aging, especially farm workers, and these older workers are being replaced by H2 visa holders. Finally, border enforcement has made it increasingly difficult for employers to hire undocumented workers.

“A great many undocumented workers continue to work in U.S. agriculture, and the majority are still from Mexico,” continued Hernández-León, “but agribusinesses are using more and more H2 visas to get their workers, despite their complaints about the process.”

Mexican labor migration has traditionally been circular

The advent and growth of H2 visas, noted the professor, “has permitted a restoration of circulation, which was an old feature of U.S.-Mexico migration, but less so during the so-called undocumented years.”

One of the largest programs to bring Mexican workers to the U.S. on a legal basis was the Bracero Program, which ran from 1942 to 1964. “It was a bilateral agreement between the Mexico and the U.S. to bring millions of temporary workers to the U.S. from Mexico through the use of visas and contracts,” said Hernández-León.

When the program ended in 1964, observed the researcher, “The most important legal channel for Mexicans to work in the U.S. was closed. Labor migration did not end, however; it continued and even grew, only to become a largely unauthorized, irregular flow between the two countries for some 40 to 50 years.”

Travel to and from the U.S. on the part of migrant workers continued until border controls tightened in the 1990s, eventually making it difficult for them to return home. As a result, a large population of undocumented migrants stayed and settled in the U.S, said Hernández-León. They continue, he said, to work in agriculture and other industries where jobs either have very low social status in U.S. society or where surges of workers are needed seasonally.

Dilemmas and contradictions of the H2 visa regime

As opposed to the original Bracero Program, which was a bilateral treaty, the H2 visa regime — which amounts to a Bracero II program, albeit on a smaller scale — is operated entirely by the U.S.

Workers are thus unable to turn to the Mexican government to address such abuses as exploitative wages, factory town prices for local goods, “bribes” levied by brokers for U.S. employers, lack of water and shade in the fields and grossly substandard living quarters. Instead, they are largely left to turn to state authorities for enforcement of their contracts, a process that is spotty at best and varies by state.

H2-A visa workers are also being used by agribusinesses to pressure undocumented farm workers living in the U.S., who are beginning to organize unions to demand better working conditions and wages, observed Hernández-León.

“Whether or not the wages of H2-visa have a negative effect on the wages of U.S. workers,” commented the professor, “what U.S. employers are doing is not really satisfying temporary shortages. They creating a regular binational workforce.” And while the legal Mexican agricultural workforce remains small compared to the total agricultural U.S. workforce, it plays a significant role in harvesting, a critical step in the food production process overall.

“Temporary Mexican migration to the U.S. is largely legal now,” concluded Hernández-León. “That actually goes against a very established idea, which at this point is largely a myth, that the flow of migrant workers from Mexico is largely unauthorized. Employers have to petition H2 visa workers through the Department of Labor and Mexican workers have to clear Homeland Security inspections and interviews to receive these visas.”

This story was originally published via UCLA’s International Institute, here.

Harm to Table: Vulnerability and Exploitation in Los Angeles County Meatpacking and Food Processing

The Artful Dodger