Study explores impact of cash transfers on contraception use and satisfaction for mothers with low incomes

A new study published in the journal Contraception found relatively high levels of contraceptive satisfaction in a large sample of women living on low incomes. However, modest monthly cash transfers had few impacts on contraceptive use, satisfaction, or barriers to use.

Low income can lead to limited choice of and access to contraception. For example, previous research suggests that individuals with low- or unstable financial resources face a host of barriers to accessing contraception and are less likely to use their desired method of contraception than those with higher incomes.

UW-Madison Professor of Social Work Katherine Magnuson and scientist Molly Costanzo, both with the Institute for Research on Poverty, led research to examine whether unconditional cash transfers impact contraceptive use, increase contraceptive satisfaction, and reduce barriers to preferred methods for mothers with low incomes. The UW Collaborative for Reproductive Equity supported this work.

The research used data from Baby’s First Years, a national study of the impact of monthly cash transfers to families with low incomes. The study is one of the first within the United States to examine how cash transfers could support the use of preferred contraceptive methods and overall reproductive autonomy – an individual’s ability to make choices about reproduction, including contraceptive use, pregnancy, and childbearing, and realize these choices.

The CORE-supported research shows modest financial resources alone may not sufficiently address contraceptive access, availability, and satisfaction for individuals with low incomes.

One thousand mothers enrolled in the Baby’s First Years study at the time of childbirth across four U.S. sites, with 400 randomized to receive $333 per month and 600 to receive $20 each month for the first years of their child’s life. Mothers completed a survey around the time of their child’s second birthday that included information about contraception use.

Leveraging Baby’s First Years data, the CORE-supported researchers analyzed the impact of receiving the high-cash ($333/month) transfer on contraceptive use. Overall, most mothers (65%) reported using some type of contraception, and 75% reported using the method of their choice.

While researchers did not find an impact of the cash transfers on mothers’ use, choice of, satisfaction with, or barriers to contraception, the cash transfers were associated with trends towards using multiple contraceptive methods and greater use of short-term hormonal methods.

The study suggests a relatively high level of satisfaction with contraception use for mothers with low incomes in the Baby’s First Years study. Still, 25% were not using the method of their choice despite receiving the cash transfer.

One major takeaway is that modest financial resources alone may not sufficiently address contraceptive access, availability, and satisfaction for individuals with low incomes. Continued exploration of how nonfinancial factors influence contraception use is crucial to understanding how best to support reproductive autonomy.

View the full study.