The long-term health benefits of receiving treatment from qualified midwives at birth

Socio-economic differences in health and mortality are substantial and increasing today in many developed countries. The sources of these differences remain debated. There is an expanding literature showing that early-life conditions are linked to health in adulthood and old age. However, our knowledge about whether beneficial treatments in early life influence later health is still limited. Using longitudinal individual-level data from the Scanian Economic Demographic Database (Sweden) for individuals born between 1881 and 1930 and observed from birth until the age 80, this paper explores the long-term health effects of being born assisted by a qualified midwife. Treatment data is obtained from midwife reports for approximately 7,200 children, which includes information on the type of treatment at birth as well as child and mother health. In a setting of home deliveries, midwives not only provided skilled assistance at childbirth, but also strictly followed disinfection instructions and checked child and mother health within three weeks after birth. Our findings show that individuals treated by qualified midwives at birth and in the first month of life have lower all-cause mortality between ages 15 and 39 and lower mortality from cardiovascular diseases and diabetes between ages 40 and 80, compared to individuals delivered by traditional midwives. The effects are larger for individuals originating from more affluent families. These findings are linked to reductions in exposure to infectious diseases and their interplay with family responses to better infant health.