I appreciate McNulty and colleagues taking the time to respond to my research and continue the debate on this important issue. They begin by noting that the policy requiring parental consent for medical contraceptives applied only to women aged 17 years and younger, but the study I reported on examined births to women aged 18 years and younger. The study examined the fraction of births to women aged 18 years and younger instead of women aged 17 years and younger because gestation takes 9 months, and contraceptive policy at the time of conception is more relevant than policy at the time of birth. Most women aged 18 years at birth were 17 years old when they became pregnant; thus the county’s policy applied to them.
If the study had instead focused on the change in the fraction of births to women aged 17 years and younger in McHenry County relative to 3 nearby counties, the conclusion would have been the same: the share of births to young women in McHenry County relative to other counties increased after the parental requirement went into effect (the share in McHenry County declined by 0.05 percentage points, compared with a decline of 0.14 percentage points in the other areas, creating a relative increase in McHenry County).
Second, McNulty et al. note that the fraction of teenage births that occurred among women aged 18 and 19 years actually increased during the period after the policy went into effect. This is true, but regardless of whether one considers women aged 17 years and younger or those aged 18 years and younger, the relative fraction of births to young women in McHenry County compared with nearby counties increased. In addition, the fraction of teenage births that occurred among women aged 18 and 19 years also rose—albeit by a smaller amount—in the comparison counties after McHenry’s policy went into effect.
Finally, McNulty et al. question whether it is appropriate to draw any conclusions about the effects of McHenry County’s policy so soon after its enactment. The impact of this policy can be assessed better 5 or 10 years after its inception, and its impact should be reexamined in the future. However, given the substantial individual and societal costs that teenage births can impose, it is important not to wait to begin to assess the effects of such policies.