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Occupational Licensing and Maternal Health: Evidence from Early Midwifery Laws


  • D. Mark Anderson
  • Ryan Brown
  • Kerwin Kofi Charles
  • Daniel I. Rees


Exploiting variation across states and municipalities in the timing and details of midwifery laws introduced during the period 1900–1940 and using data assembled from various primary sources, we find that requiring midwives to be licensed reduced maternal mortality by 7%–8% and may have led to modest reductions in infant mortality. These estimates represent the strongest evidence to date that licensing restrictions can improve the health of consumers and are directly relevant to ongoing policy debates on the merits of licensing midwives.

Suggested Citation

  • D. Mark Anderson & Ryan Brown & Kerwin Kofi Charles & Daniel I. Rees, 2020. "Occupational Licensing and Maternal Health: Evidence from Early Midwifery Laws," Journal of Political Economy, University of Chicago Press, vol. 128(11), pages 4337-4383.
  • Handle: RePEc:ucp:jpolec:doi:10.1086/710555
    DOI: 10.1086/710555

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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 7th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-07 12:00:03


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2022. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," NBER Working Papers 30663, National Bureau of Economic Research, Inc.
    2. Kyle Rozema, 2021. "Does the Bar Exam Protect the Public?," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 18(4), pages 801-848, December.
    3. Vincent Geloso & Raymond J. March, 2021. "Rent seeking for madness: the political economy of mental asylums in the United States, 1870 to 1910," Public Choice, Springer, vol. 189(3), pages 375-404, December.
    4. Patrick Bennett, 2021. "The Work-To-School Transition: Job Displacement and Skill Upgrading among Young High School Dropouts," CESifo Working Paper Series 9417, CESifo.
    5. Koumenta, Maria & Pagliero, Mario & Rostam-Afschar, Davud, 2022. "Occupational Regulation, Institutions, and Migrants’ Labor Market Outcomes," Labour Economics, Elsevier, vol. 79(C).
    6. Marein, Brian, 2023. "Public health departments and the mortality transition in Latin America: Evidence from Puerto Rico," Journal of Development Economics, Elsevier, vol. 160(C).
    7. Bobby Chung & Jian Zou, 2021. "Teacher Licensing, Teacher Supply, and Student Achievement: Nationwide Implementation of edTPA," Working Papers 2021-039, Human Capital and Economic Opportunity Working Group.
    8. Patrick Bennett, 2022. "The Work-To-School Transitions:Job Displacement and Skill Upgrading among Young High School Dropouts," Working Papers 202205, University of Liverpool, Department of Economics.
    9. Sonia Bhalotra & Damian Clarke & Joseph Flavian Gomes & Atheendar Venkataramani, 2023. "Maternal Mortality and Women’s Political Power," Journal of the European Economic Association, European Economic Association, vol. 21(5), pages 2172-2208.
    10. Ilya Kukaev & Edward J. Timmons, 2023. "Certifiably employable?: The effects of occupational regulation on unemployment duration," Working Papers 23-02, Department of Economics, West Virginia University.
    11. Ji, Xi & Wu, Guowei & Su, Pinyi & Luo, Xuanyuan & Long, Xianling, 2022. "Does legislation improvement alleviate the decoupling between welfare and wealth in China?," Ecological Economics, Elsevier, vol. 201(C).
    12. D. Mark Anderson & Kerwin Kofi Charles & Michael McKelligott & Daniel I. Rees, 2022. "Safeguarding Consumers Through Minimum Quality Standards: Milk Inspections and Urban Mortality, 1880-1910," NBER Working Papers 30063, National Bureau of Economic Research, Inc.
    13. Andreas Kotsadam & Jo Thori Lind & Jørgen Modalsli, 2022. "Call the midwife. Health personnel and mortality in Norway 1887–1920," Cliometrica, Springer;Cliometric Society (Association Francaise de Cliométrie), vol. 16(2), pages 243-276, May.
    14. Omar Bamieh & Andrea Cintolesi & Mario Pagliero, 2024. "Estimating the returns to occupational licensing: evidence from regression discontinuities at the bar exam," Temi di discussione (Economic working papers) 1440, Bank of Italy, Economic Research and International Relations Area.
    15. Chung, Bobby W., 2022. "The costs and potential benefits of occupational licensing: A case of real estate license reform," Labour Economics, Elsevier, vol. 76(C).
    16. Gaetano Basso & Eleonora Brandimarti & Michele Pellizzari & Giovanni Pica, 2021. "Quality and Selection in Regulated Professions," Development Working Papers 467, Centro Studi Luca d'Agliano, University of Milano.
    17. Dustin Chambers & Colin O’Reilly, 2022. "The economic theory of regulation and inequality," Public Choice, Springer, vol. 193(1), pages 63-78, October.
    18. Yelowitz, Aaron & Ingram, Samuel J., 2021. "How Does Occupational Licensing Affect Entry into the Medical Field? An Examination of EMTs," IZA Discussion Papers 14071, Institute of Labor Economics (IZA).
    19. Kihwan Bae & Edward Timmons, 2023. "Now You Can Take It with You: Effects of Occupational Credential Recognition on Labor Market Outcomes," Working Papers 23-03, Department of Economics, West Virginia University.
    20. Xia, Xing, 2021. "Barrier to Entry or Signal of Quality? The Effects of Occupational Licensing on Minority Dental Assistants," Labour Economics, Elsevier, vol. 71(C).
    21. Lauren Hoehn‐Velasco & Elizabeth Wrigley‐Field, 2022. "City health departments, public health expenditures, and urban mortality over 1910–1940," Economic Inquiry, Western Economic Association International, vol. 60(2), pages 929-953, April.

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