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Cutting Fertility? The Effect of Cesarean Deliveries on Subsequent Fertility and Maternal Labor Supply

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  • Martin Halla
  • Harald Mayr
  • Gerald J. Pruckner
  • Pilar Garcia-Gomez

Abstract

The incidence of Cesarean deliveries (CDs) has been on the rise. The procedure's cost and benefits are discussed controversially; in particular, since non-medically indicated cases seem widespread. We study the effect of CDs on subsequent fertility and maternal labor supply. Identification is achieved by exploiting variation in the supply-side's incentives to induce non-medically indicated CDs across weekdays. On weekends and public holidays obstetricians' are less likely to induce CDs (due tighter capacity constraints in hospital). On Fridays and other days preceding a holiday, they face an increased incentive to induce CDs (due to their demand for leisure on non-working days). We use high-quality administrative data from Austria. Women giving birth on different weekdays are pre-treatment observationally identical. Our instrumental variable estimates show that a non-planned CD at parity one decreases life cycle fertility by almost 17 percent. This reduction in fertility translates into a temporary increase in maternal employment.

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  • Martin Halla & Harald Mayr & Gerald J. Pruckner & Pilar Garcia-Gomez, 2016. "Cutting Fertility? The Effect of Cesarean Deliveries on Subsequent Fertility and Maternal Labor Supply," Working Papers 2016-14, Faculty of Economics and Statistics, Universität Innsbruck.
    • Handle: RePEc:inn:wpaper:2016-14
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    Cited by:

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    3. Ana Costa-Ramón & Mika Kortelainen & Ana Rodríguez-González & Lauri Sääksvuori, 2022. "The Long-Run Effects of Cesarean Sections," Journal of Human Resources, University of Wisconsin Press, vol. 57(6), pages 2048-2085.
    4. Costa-Ramón, Ana María & Rodríguez-González, Ana & Serra-Burriel, Miquel & Campillo-Artero, Carlos, 2018. "It's about time: Cesarean sections and neonatal health," Journal of Health Economics, Elsevier, vol. 59(C), pages 46-59.
    5. Tonei, Valentina, 2019. "Mother’s mental health after childbirth: Does the delivery method matter?," Journal of Health Economics, Elsevier, vol. 63(C), pages 182-196.
    6. David Card & Alessandra Fenizia & David Silver, 2019. "The Health Impacts of Hospital Delivery Practices," NBER Working Papers 25986, National Bureau of Economic Research, Inc.
    7. Hanna Mühlrad, 2022. "Cesarean sections for high‐risk births: health, fertility, and labor market outcomes," Scandinavian Journal of Economics, Wiley Blackwell, vol. 124(4), pages 1056-1086, October.
    8. David Card & Alessandra Fenizia & David Silver, 2018. "The Health Effects of Cesarean Delivery for Low-Risk First Births," NBER Working Papers 24493, National Bureau of Economic Research, Inc.
    9. Valentina Tonei, 2017. "Mother’s health after childbirth: does delivery method matter?," Discussion Papers 17/11, Department of Economics, University of York.
    10. Pilvar, Hanifa & Yousefi, Kowsar, 2021. "Changing physicians’ incentives to control the C-section rate: Evidence from a major health care reform in Iran," Journal of Health Economics, Elsevier, vol. 79(C).

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    More about this item

    Keywords

    Caesarean delivery; Caesarean section; fertility; female labor supply;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure

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