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From Home to Hospital: The Evolution of Childbirth in the United States, 1927-1940

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  • Melissa A. Thomasson
  • Jaret Treber

Abstract

This paper examines the shift in childbirth from home to hospital that occurred in the United States in the early twentieth century. Using a panel of city-level data over the period 1927-1940, we examine the shift of childbirth from home to hospital and analyze the impact of medical care on maternal mortality. Results suggest that increased operative intervention on the part of physicians and a resultant greater risk of infection increased maternal mortality prior to the introduction of sulfa drugs in 1937. However, the introduction of sulfa enabled doctors to reduce maternal mortality by enabling them to do potentially life-saving procedures (such as cesareans) without the risk of subsequent infection. Regressions estimated separately by race suggest that the impact of medical care on maternal mortality differed for blacks and whites. Relative to whites, hospitals posed a greater risk for black mothers prior to the availability of sulfa drugs in 1937, and were less beneficial for them afterwards, suggesting that blacks may have received lower quality medical care.

Suggested Citation

  • Melissa A. Thomasson & Jaret Treber, 2004. "From Home to Hospital: The Evolution of Childbirth in the United States, 1927-1940," NBER Working Papers 10873, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:10873
    Note: EH DAE
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    Cited by:

    1. Seema Jayachandran & Adriana Lleras-Muney & Kimberly V. Smith, 2009. "Modern Medicine and the 20th Century Decline in Mortality: Evidence on the Impact of Sulfa Drugs," NBER Working Papers 15089, National Bureau of Economic Research, Inc.
    2. Douglas Almond, 2006. "Is the 1918 Influenza Pandemic Over? Long-Term Effects of In Utero Influenza Exposure in the Post-1940 U.S. Population," Journal of Political Economy, University of Chicago Press, vol. 114(4), pages 672-712, August.
    3. Rexford E. Santerre, 2006. "Examining the Marginal Access Value of Private Health Insurance," Risk Management and Insurance Review, American Risk and Insurance Association, vol. 9(1), pages 53-62, March.
    4. Stoian, Adrian & Fishback, Price, 2010. "Welfare spending and mortality rates for the elderly before the Social Security era," Explorations in Economic History, Elsevier, vol. 47(1), pages 1-27, January.
    5. Stefania Albanesi & Claudia Olivetti, 2016. "Gender Roles and Medical Progress," Journal of Political Economy, University of Chicago Press, vol. 124(3), pages 650-695.

    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-

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