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Low-risk isn’t no-risk: Perinatal treatments and the health of low-income newborns

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  • Daysal, N. Meltem
  • Trandafir, Mircea
  • van Ewijk, Reyn

Abstract

We investigate the effects of perinatal medical treatments on low-income newborns who are classified as low-risk. A policy rule in The Netherlands states that low-risk deliveries before week 37 should be supervised by physicians and later deliveries only by midwives with no physician present. This creates large discontinuities in the probability of receiving medical interventions only physicians are allowed to perform. Using a regression discontinuity design, we find that babies born slightly before the week-37 cutoff are significantly less likely to die than babies born slightly later. Our data suggest that physician supervision of birth reduces the likelihood of adverse events such as fetal distress or emergency C-section. Our results indicate that low-income women benefit from receiving a higher level of medical care even if no explicit risk factors have been recognized, pointing to challenges in identifying all high-risk pregnancies. “Back-of-the-envelope” calculations suggest this additional care is highly cost-effective.

Suggested Citation

  • Daysal, N. Meltem & Trandafir, Mircea & van Ewijk, Reyn, 2019. "Low-risk isn’t no-risk: Perinatal treatments and the health of low-income newborns," Journal of Health Economics, Elsevier, vol. 64(C), pages 55-67.
  • Handle: RePEc:eee:jhecon:v:64:y:2019:i:c:p:55-67
    DOI: 10.1016/j.jhealeco.2019.01.006
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    References listed on IDEAS

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    Cited by:

    1. Nadine Geiger & Sebastian Wichert, 2019. "Birth in times of war - An investigation of health, mortality and social class using historical clinical records," CESifo Working Paper Series 7593, CESifo.
    2. Alfano, Marco, 2022. "Islamic law and investments in children: Evidence from the Sharia introduction in Nigeria," Journal of Health Economics, Elsevier, vol. 85(C).
    3. Brilli, Ylenia & Restrepo, Brandon J., 2020. "Birth weight, neonatal care, and infant mortality: Evidence from macrosomic babies," Economics & Human Biology, Elsevier, vol. 37(C).
    4. Hoehn-Velasco, Lauren & Jolles, Diana R. & Plemmons, Alicia & Silverio-Murillo, Adan, 2023. "Health outcomes and provider choice under full practice authority for certified nurse-midwives," Journal of Health Economics, Elsevier, vol. 92(C).

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    More about this item

    Keywords

    Perinatal care; Prematurity; Mortality; Midwives; Birth; Medical treatments; Medical interventions;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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