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Cesarean sections and subsequent fertility

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  • Karen Norberg
  • Juan Pantano

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Abstract

Cesarean sections are rising all over the world and may, in some countries, soon become the most common delivery mode. A growing body of medical literature documents a robust fact: women undergoing cesarean sections end up having less children. Unlike most of the medical literature, which assumes that this association is mostly working through a physiological channel, we investigate a possible channel linking c-section and subsequent fertility through differences in maternal behavior after a c-section. Using several national and cross-national demographic data sources, we find evidence that maternal choice is playing an important role in shaping the negative association between cesarean section and subsequent fertility. In particular, we show that women are more likely to engage in active contraception after a cesarean delivery and conclude that intentional avoidance of subsequent pregnancies after a c-section seems to be responsible for part of the negative association between c-sections and subsequent fertility. Copyright Springer-Verlag Berlin Heidelberg 2016

Suggested Citation

  • Karen Norberg & Juan Pantano, 2016. "Cesarean sections and subsequent fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 29(1), pages 5-37, January.
  • Handle: RePEc:spr:jopoec:v:29:y:2016:i:1:p:5-37
    DOI: 10.1007/s00148-015-0567-7
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    File URL: http://hdl.handle.net/10.1007/s00148-015-0567-7
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    References listed on IDEAS

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    1. Mutryn, Cynthia S., 1993. "Psychosocial impact of cesarean section on the family: A literature review," Social Science & Medicine, Elsevier, vol. 37(10), pages 1271-1281, November.
    2. Angrist, Joshua D & Evans, William N, 1998. "Children and Their Parents' Labor Supply: Evidence from Exogenous Variation in Family Size," American Economic Review, American Economic Association, vol. 88(3), pages 450-477, June.
    3. Brown, H. III, 1996. "Physician demand for leisure: implications for cesarean section rates," Journal of Health Economics, Elsevier, vol. 15(2), pages 233-242, April.
    4. 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.
    5. Janet Currie & W. Bentley MacLeod, 2017. "Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians," Journal of Labor Economics, University of Chicago Press, vol. 35(1), pages 1-43.
    6. 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.
    7. 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.
    8. Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, Oxford University Press, vol. 123(2), pages 795-830.
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    Cited by:

    1. 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, University of Innsbruck.

    More about this item

    Keywords

    Fertility; Infertility; C-Sections; Reproductive Health; J11; J13; I10;

    JEL classification:

    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • I10 - Health, Education, and Welfare - - Health - - - General

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