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Can Caesarean section improve child and maternal health? The case of breech babies

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  • Jensen, Vibeke Myrup
  • Wüst, Miriam

Abstract

This paper examines the health effects of Caesarean section (CS) for children and their mothers. We use exogenous variation in the probability of CS in a fuzzy regression discontinuity design. Using administrative Danish data, we exploit an information shock for obstetricians that sharply altered CS rates for breech babies. We find that CS decreases the child's probability of having a low APGAR score and the number of family doctor visits in the first year of life. We find no significant effects for severe neonatal morbidity or hospitalizations. While mothers are hospitalized longer after birth, we find no effects of CS for maternal post-birth complications or infections. Although the change in mode of delivery for the marginal breech babies increases direct costs, the health benefits show that CS is the safest option for these children.

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  • Jensen, Vibeke Myrup & Wüst, Miriam, 2015. "Can Caesarean section improve child and maternal health? The case of breech babies," Journal of Health Economics, Elsevier, vol. 39(C), pages 289-302.
    • Handle: RePEc:eee:jhecon:v:39:y:2015:i:c:p:289-302
    DOI: 10.1016/j.jhealeco.2014.07.004
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    1. Douglas Almond & Kenneth Y. Chay & David S. Lee, 2005. "The Costs of Low Birth Weight," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(3), pages 1031-1083.
    2. David S. Lee & Thomas Lemieux, 2009. "Regression Discontinuity Designs In Economics," Working Papers 1118, Princeton University, Department of Economics, Industrial Relations Section..
    3. Shearer, Elizabeth L., 1993. "Cesarean section: Medical benefits and costs," Social Science & Medicine, Elsevier, vol. 37(10), pages 1223-1231, November.
    4. David S. Lee & Thomas Lemieux, 2010. "Regression Discontinuity Designs in Economics," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 281-355, June.
    5. Shurtz, Ity, 2013. "The impact of medical errors on physician behavior: Evidence from malpractice litigation," Journal of Health Economics, Elsevier, vol. 32(2), pages 331-340.
    6. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    7. Douglas Almond & Joseph J. Doyle & Amanda E. Kowalski & Heidi Williams, 2010. "Estimating Marginal Returns to Medical Care: Evidence from At-risk Newborns," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(2), pages 591-634.
    8. Epstein, Andrew J. & Nicholson, Sean, 2009. "The formation and evolution of physician treatment styles: An application to cesarean sections," Journal of Health Economics, Elsevier, vol. 28(6), pages 1126-1140, December.
    9. Patricia Triunfo & Máximo Rossi, 2009. "The effect of physicians’ remuneration system on the Caesarean section rate: the Uruguayan case," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 333-345, December.
    10. Rossin, Maya, 2011. "The effects of maternity leave on children's birth and infant health outcomes in the United States," Journal of Health Economics, Elsevier, vol. 30(2), pages 221-239, March.
    11. Del Bono, Emilia & Francesconi, Marco & G. Best, Nicky, 2011. "Health information and health outcomes: an application of the regression discontinuity design to the 1995 UK contraceptive pill scare case," ISER Working Paper Series 2011-16, Institute for Social and Economic Research.
    12. Jonathan Gruber & Maria Owings, 1996. "Physician Financial Incentives and Cesarean Section Delivery," RAND Journal of Economics, The RAND Corporation, vol. 27(1), pages 99-123, Spring.
    13. Anderberg, Dan & Chevalier, Arnaud & Wadsworth, Jonathan, 2011. "Anatomy of a health scare: Education, income and the MMR controversy in the UK," Journal of Health Economics, Elsevier, vol. 30(3), pages 515-530, May.
    14. Grant, Darren, 2009. "Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project," Journal of Health Economics, Elsevier, vol. 28(1), pages 244-250, January.
    15. Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(2), pages 795-830.
    16. Almond, Douglas & Currie, Janet & Simeonova, Emilia, 2011. "Public vs. private provision of charity care? Evidence from the expiration of Hill-Burton requirements in Florida," Journal of Health Economics, Elsevier, vol. 30(1), pages 189-199, January.
    17. Del Bono, Emilia & Francesconi, Marco & Best, Nicky G., 2011. "Health information and health outcomes: an application of the regression discontinuity design to the 1995 UK contraceptive pill scare case," ISER Working Paper Series 2011-16, Institute for Social and Economic Research.
    18. Declercq, E. & Menacker, F. & MacDorman, M., 2006. "Maternal risk profiles and the primary cesarean rate in the United States, 1991-2002," American Journal of Public Health, American Public Health Association, vol. 96(5), pages 867-872.
    19. Joseph J. Doyle, 2011. "Returns to Local-Area Health Care Spending: Evidence from Health Shocks to Patients Far from Home," American Economic Journal: Applied Economics, American Economic Association, vol. 3(3), pages 221-243, July.
    20. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    21. Price, Joseph & Simon, Kosali, 2009. "Patient education and the impact of new medical research," Journal of Health Economics, Elsevier, vol. 28(6), pages 1166-1174, December.
    22. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, vol. 18(4), pages 491-522, August.
    23. Joseph J. Doyle Jr., 2008. "Child Protection and Adult Crime: Using Investigator Assignment to Estimate Causal Effects of Foster Care," Journal of Political Economy, University of Chicago Press, vol. 116(4), pages 746-770, August.
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    Cited by:

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    2. Halla, Martin & Mayr, Harald & Pruckner, Gerald J. & García-Gómez, Pilar, 2020. "Cutting fertility? Effects of cesarean deliveries on subsequent fertility and maternal labor supply," Journal of Health Economics, Elsevier, vol. 72(C).
    3. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    4. Maruyama, Shiko & Heinesen, Eskil, 2020. "Another look at returns to birthweight," Journal of Health Economics, Elsevier, vol. 70(C).
    5. Maibom, Jonas & Sievertsen, Hans H. & Simonsen, Marianne & Wüst, Miriam, 2021. "Maternity ward crowding, procedure use, and child health," Journal of Health Economics, Elsevier, vol. 75(C).
    6. Hope Corman & Dhaval Dave & Nancy E. Reichman, 2018. "Evolution of the Infant Health Production Function," Southern Economic Journal, John Wiley & Sons, vol. 85(1), pages 6-47, July.
    7. David Card & Alessandra Fenizia & David Silver, 2023. "The Health Impacts of Hospital Delivery Practices," American Economic Journal: Economic Policy, American Economic Association, vol. 15(2), pages 42-81, May.
    8. 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.
    9. 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.
    10. Guccio, Calogero & Lisi, Domenico, 2016. "Thus do all. Social interactions in inappropriate behavior for childbirth services in a highly decentralized healthcare system," Regional Science and Urban Economics, Elsevier, vol. 61(C), pages 1-17.
    11. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    12. 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.
    13. 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.
    14. Sofia Amaral‐Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1050-1064, September.
    15. Bachner, Florian & Halla, Martin & Pruckner, Gerald J., 2024. "Do Empty Beds Cause Cesarean Deliveries?," IZA Discussion Papers 16981, Institute of Labor Economics (IZA).
    16. Valentina Tonei, 2017. "Mother’s health after childbirth: does delivery method matter?," Discussion Papers 17/11, Department of Economics, University of York.
    17. Sofia Amaral-Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities in Italy," CERGE-EI Working Papers wp540, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    18. Maria Koch Gregersen, 2024. "Earlier routine induction of labor—Consequences on mother and child morbidity," Health Economics, John Wiley & Sons, Ltd., vol. 33(10), pages 2399-2418, October.

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    More about this item

    Keywords

    Caesarean section; Child health; Regression discontinuity design; Procedure use; Maternal health;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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