COVID-19 emergency cash transfer and pregnancy in Brazil

BACKGROUND: Governmental financial assistance programs were widely adopted during COVID-19, but their impacts on women's reproductive behavior remain unknown. OBJECTIVE: This paper evaluates how a key social policy instrument implemented during the COVID-19 pandemic - emergency aid - impacted the probability of pregnancy among young women. We also examine whether the use of effective contraceptive methods helps explain the heterogeneous effects observed across socioeconomic groups. METHODS: We draw on unique population-based longitudinal data from 2020 and 2021 tracking the reproductive lives of women aged 18-34 in Pernambuco, Brazil, to analyze how emergency aid targeted at vulnerable households impacted pregnancy. We generate estimates emphasizing causal relationships by controlling for the non-random allocation of aid using a quasi-experimental strategy, the inverse probability weighting regression adjustment. RESULTS: Results highlight a reduction in the probability of pregnancy among women receiving emergency aid during the pandemic. The negative impact was more pronounced among the least educated and youngest women and those who initially intended larger families. We also found positive effects of emergency aid on contraception use among these socioeconomic groups. CONCLUSIONS: One possible explanation is that the emergency financial assistance helped women weather disruptions in public health services and ensured more consistent use of effective contraception, thereby, at least temporarily, helping women avoid pregnancy during a period of heightened socioeconomic uncertainties. Because those initially intending larger families and those least educated are among the poorer groups of women, the effects of the aid are stronger for these groups and for younger women, who have a larger reproductive window to meet their fertility preferences, which affords them the possibility of pregnancy in less uncertain times. CONTRIBUTION: Combined, findings build on a broader literature on the impact of cash transfers on fertility outcomes by highlighting how these processes have played out at the height of a massive public health crisis.