1. Reproductive Health, Fertility, and Economic Development David E. Bloom David Canning Günther Fink Jocelyn E. Finlay Harvard School of Public Health Presentation for the William and Flora Hewlett Foundation January 16-18, 2009 Dublin

2. Overview Population dynamics and economic outcomes Income per capita Income per worker Workers per capita Labor force participation

3. The role of fertility W/P : working age per capita A decline in the fertility rate will change the population age structure. L/W: labor force participation of working age Fertility and maternal health affects female labor supply. Y/L : Income per worker Labor force growth affects capital labor ratio Family size affects human capital investments

4. Fertility and steady state working age share – Theory

5. Total fertility rates and working age shares in 2000

6. Effects of Fertility “Accounting” effect on working age share Effects on female labor supply and human and physical capital are behavioral Fertility is endogenous – we need methods to determine the direction of causality

7. Determining Causality Natural Experiments Matlab Micro-Instruments Twins Sex selection Macro-Instruments Abortion Laws Laws on contraception

8. Abortion Law Index We classify availability of legal abortion as depending on: 1.Life of the mother5. fetal impairment 2.physical health of the mother6. economic hardship 3.mental health of the mother7. on request 4. rape/incest Score one for each reason available About 26 percent of pregnancies worldwide end in abortion We estimate that going from a score of 0-7 reduces fertility by about 0.35 children in macro-panel data.

9. Exogeneity of the Abortion Index Exact timing of the change in the abortion law relative to country fixed effects and country specific time trends Changes in the law are discontinuous while we assume underlying social forces are continuous Changes in the law often decided by individual personalities in the deliberative process E.g. David Steel, US Supreme Court

10. Effect of Fertility on Economic Growth – instrumented with abortion laws

11. Effect of Fertility on Female Labor Force Participation – instrumented with abortion laws

12. First Stage

13. Using Micro-data Demographic and Health Survey (DHS) 76 Developing countries Starting in 1980s (subsumed the World Fertility Surveys) Up to 8 surveys in a country Macro study with micro data Heterogeneous response By socio-economic status (urban/rural, education) By country/year

14. Abortion Index: Application for micro data UN classifies abortion laws into seven categories 1.life-threatening pregnancies 5. fetal impairment 2.physical health of the mother6. economic hardship 3.mental health of the mother7. on request 4. rape E: Number of fertile years prior to the survey year the respondent is exposed to legal abortion for a given criteria F: Number of fertile years prior to the survey year i: index of the seven reasons for abortion Abortion Index =

15. Female Labor Supply: Micro

16. First stage

17. Future work Instruments Contraceptive laws Twins Sex selection Childhood outcomes Health Education Heterogeneous responses By country By socio-economic status

18. Thank you