IDEAS home Printed from https://ideas.repec.org/p/wrk/warwec/1391.html
   My bibliography  Save this paper

Health and Labor Market Impacts of Twin Birth : Evidence from a Swedish IVF Policy Mandate

Author

Listed:
  • Bhalotra, Sonia

    (Department of Economics, University of Warwick, CEPR, IEA, IZA, CAGE)

  • Clarke, Damian

    (Department of Economics, University of Chile and IZA)

  • Mühlrad, Hanna

    (Institute for Evaluation of Labour Market and Education Policy (IFAU))

  • Palme, Mårten

    (Department of Economics, Stockholm University)

Abstract

IVF allows women to delay birth and pursue careers, but IVF massively increases the risk of twin birth. There is limited evidence of how having twins influences women’s post-birth careers. We investigate this, leveraging a single embryo transfer (SET) mandate implemented in Sweden in 2003, following which the share of twin births showed a precipitous drop of 70%. Linking birth registers to hospitalization and earnings registers, we identify substantial improvements in maternal and child health and women’s earnings following IVF birth, alongside an increase in subsequent fertility. We provide the first comprehensive evaluation of SET, relevant given the secular rise in IVF births and growing concerns over twin birth risk. We contribute new estimates of the child penalty imposed by twin as opposed to singleton birth, relevant to the secular rise in the global twin birth rate.

Suggested Citation

  • Bhalotra, Sonia & Clarke, Damian & Mühlrad, Hanna & Palme, Mårten, 2021. "Health and Labor Market Impacts of Twin Birth : Evidence from a Swedish IVF Policy Mandate," The Warwick Economics Research Paper Series (TWERPS) 1391, University of Warwick, Department of Economics.
    • Handle: RePEc:wrk:warwec:1391
    as

    Download full text from publisher

    File URL: https://warwick.ac.uk/fac/soc/economics/research/workingpapers/2021/twerp_1391_-_bhalotra.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Jérôme Adda & Christian Dustmann & Katrien Stevens, 2017. "The Career Costs of Children," Journal of Political Economy, University of Chicago Press, vol. 125(2), pages 293-337.
    2. Joseph G. Altonji & Todd E. Elder & Christopher R. Taber, 2005. "Selection on Observed and Unobserved Variables: Assessing the Effectiveness of Catholic Schools," Journal of Political Economy, University of Chicago Press, vol. 113(1), pages 151-184, February.
    3. Nancy Qian, 2017. "The effect of China's One Child Policy on sex selection, family size, and the school enrolment of daughters," WIDER Working Paper Series wp-2017-159, World Institute for Development Economic Research (UNU-WIDER).
    4. Douglas Almond & Janet Currie & Valentina Duque, 2018. "Childhood Circumstances and Adult Outcomes: Act II," Journal of Economic Literature, American Economic Association, vol. 56(4), pages 1360-1446, December.
    5. Horowitz, Joel L & Manski, Charles F, 1995. "Identification and Robustness with Contaminated and Corrupted Data," Econometrica, Econometric Society, vol. 63(2), pages 281-302, March.
    6. Claudia Goldin & Lawrence F. Katz, 2002. "The Power of the Pill: Oral Contraceptives and Women's Career and Marriage Decisions," Journal of Political Economy, University of Chicago Press, vol. 110(4), pages 730-770, August.
    7. Sandra E. Black & Paul J. Devereux & Kjell G. Salvanes, 2007. "From the Cradle to the Labor Market? The Effect of Birth Weight on Adult Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 409-439.
    8. Joelle Abramowitz, 2014. "Turning back the ticking clock: the effect of increased affordability of assisted reproductive technology on women’s marriage timing," Journal of Population Economics, Springer;European Society for Population Economics, vol. 27(2), pages 603-633, April.
    9. Dalton Conley & Rebecca Glauber, 2005. "Parental Educational Investment and Children's Academic Risk: Estimates of the Impact of Sibship Size and Birth Order from Exogenous Variations in Fertility," NBER Working Papers 11302, National Bureau of Economic Research, Inc.
    10. David S. Lee, 2009. "Training, Wages, and Sample Selection: Estimating Sharp Bounds on Treatment Effects," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 76(3), pages 1071-1102.
    11. Clément de Chaisemartin & Xavier D'Haultfœuille, 2020. "Two-Way Fixed Effects Estimators with Heterogeneous Treatment Effects," American Economic Review, American Economic Association, vol. 110(9), pages 2964-2996, September.
    12. Aldén, Lina & Björklund, Anders & Hammarstedt, Mats, 2017. "Early Health and School Outcomes for Children with Lesbian Parents: Evidence from Sweden," IZA Discussion Papers 10616, Institute of Labor Economics (IZA).
    13. Barton H. Hamilton & Emily Jungheim & Brian McManus & Juan Pantano, 2018. "Health Care Access, Costs, and Treatment Dynamics: Evidence from In Vitro Fertilization," American Economic Review, American Economic Association, vol. 108(12), pages 3725-3777, December.
    14. Jere R. Behrman & Mark R. Rosenzweig, 2004. "Returns to Birthweight," The Review of Economics and Statistics, MIT Press, vol. 86(2), pages 586-601, May.
    15. Karimi, Arizo, 2014. "The spacing of births and women's subsequent earnings - evidence from a natural experiment," Working Paper Series 2014:18, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    16. Joseph P. Romano & Michael Wolf, 2005. "Stepwise Multiple Testing as Formalized Data Snooping," Econometrica, Econometric Society, vol. 73(4), pages 1237-1282, July.
    17. Sonia Bhalotra & Martin Karlsson & Therese Nilsson, 2017. "Infant Health and Longevity: Evidence from A Historical Intervention in Sweden," Journal of the European Economic Association, European Economic Association, vol. 15(5), pages 1101-1157.
    18. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    19. Berniell, Inés & Berniell, Lucila & Mata, Dolores de la & Edo, María & Marchionni, Mariana, 2021. "Gender gaps in labor informality: The motherhood effect," Journal of Development Economics, Elsevier, vol. 150(C).
    20. Anna Aizer, 2010. "The Gender Wage Gap and Domestic Violence," American Economic Review, American Economic Association, vol. 100(4), pages 1847-1859, September.
    21. Marianne Bitler & Lucie Schmidt, 2012. "Utilization of Infertility Treatments: The Effects of Insurance Mandates," Demography, Springer;Population Association of America (PAA), vol. 49(1), pages 125-149, February.
    22. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    23. Sonia Bhalotra & Martin Karlsson & Therese Nilsson & Nina Schwarz, 2022. "Infant Health, Cognitive Performance, and Earnings: Evidence from Inception of the Welfare State in Sweden," The Review of Economics and Statistics, MIT Press, vol. 104(6), pages 1138-1156, November.
    24. Shelly J. Lundberg & Robert A. Pollak & Terence J. Wales, 1997. "Do Husbands and Wives Pool Their Resources? Evidence from the United Kingdom Child Benefit," Journal of Human Resources, University of Wisconsin Press, vol. 32(3), pages 463-480.
    25. מחקר - ביטוח לאומי, 2006. "Summary for 2005," Working Papers 29, National Insurance Institute of Israel.
    26. 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.
    27. Rosenzweig, Mark R & Wolpin, Kenneth I, 1980. "Life-Cycle Labor Supply and Fertility: Causal Inferences from Household Models," Journal of Political Economy, University of Chicago Press, vol. 88(2), pages 328-348, April.
    28. Bhalotra, Sonia R. & Clarke, Damian & Mühlrad, Hanna & Palme, Mårten, 2019. "Multiple Births, Birth Quality and Maternal Labor Supply: Analysis of IVF Reform in Sweden," IZA Discussion Papers 12490, Institute of Labor Economics (IZA).
    29. Douglas Almond & Joseph J. Doyle & Amanda E. Kowalski & Heidi Williams, 2010. "Estimating Marginal Returns to Medical Care: Evidence from At-risk Newborns," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 125(2), pages 591-634.
    30. Rossin-Slater, Maya, 2013. "WIC in your neighborhood: New evidence on the impacts of geographic access to clinics," Journal of Public Economics, Elsevier, vol. 102(C), pages 51-69.
    31. Philip Oreopoulos & Mark Stabile & Randy Walld & Leslie L. Roos, 2008. "Short-, Medium-, and Long-Term Consequences of Poor Infant Health: An Analysis Using Siblings and Twins," Journal of Human Resources, University of Wisconsin Press, vol. 43(1).
    32. Joyce P. Jacobsen & James Wishart Pearce III & Joshua L. Rosenbloom, 1999. "The Effects of Childbearing on Married Women's Labor Supply and Earnings: Using Twin Births as a Natural Experiment," Journal of Human Resources, University of Wisconsin Press, vol. 34(3), pages 449-474.
    33. Petter Lundborg & Erik Plug & Astrid Würtz Rasmussen, 2017. "Can Women Have Children and a Career? IV Evidence from IVF Treatments," American Economic Review, American Economic Association, vol. 107(6), pages 1611-1637, June.
    34. Alderman, Harold & Lokshin, Michael & Radyakin, Sergiy, 2011. "Tall claims : mortality selection and the height of children," Policy Research Working Paper Series 5846, The World Bank.
    35. Gordon B. Dahl & Enrico Moretti, 2008. "The Demand for Sons," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 75(4), pages 1085-1120.
    36. Alderman, Harold & Lokshin, Michael & Radyakin, Sergiy, 2011. "Tall claims: Mortality selection and the height of children in India," Economics & Human Biology, Elsevier, vol. 9(4), pages 393-406.
    37. Henrik Jacobsen Kleven & Claus Thustrup Kreiner & Claus Thustrup Kreiner, 2003. "The Marginal Cost of Public Funds in OECD Countries. Hours of Work Versus Labor Force Participation," CESifo Working Paper Series 935, CESifo.
    38. Bronars, Stephen G & Grogger, Jeff, 1994. "The Economic Consequences of Unwed Motherhood: Using Twin Births as a Natural Experiment," American Economic Review, American Economic Association, vol. 84(5), pages 1141-1156, December.
    39. Martha J. Bailey, 2006. "More Power to the Pill: The Impact of Contraceptive Freedom on Women's Life Cycle Labor Supply," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 121(1), pages 289-320.
    40. McElroy, Marjorie B & Horney, Mary Jean, 1981. "Nash-Bargained Household Decisions: Toward a Generalization of the Theory of Demand," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 22(2), pages 333-349, June.
    Full references (including those not matched with items on IDEAS)

    Citations

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


    Cited by:

    1. Bhalotra, Sonia & Clarke, Damian, 2022. "Analysis of Twins," The Warwick Economics Research Paper Series (TWERPS) 1428, University of Warwick, Department of Economics.
    2. Bhalotra, Sonia & Clarke, Damian & Walther, Selma, 2022. "Women's Careers and Family Formation," GLO Discussion Paper Series 1120, Global Labor Organization (GLO).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bhalotra, Sonia R. & Clarke, Damian & Walther, Selma, 2022. "Women's Careers and Family Formation," IZA Discussion Papers 15639, Institute of Labor Economics (IZA).
    2. Simon Bensnes & Ingrid Huitfeldt & Edwin Leuven, 2023. "Reconciling estimates of the long-term earnings effect of fertility," Discussion Papers 1004, Statistics Norway, Research Department.
    3. Bhalotra, Sonia & Venkataramani, Atheendar & Walther, Selma, 2018. "Fertility and labor market responses to reductions in mortality," ISER Working Paper Series 2018-15, Institute for Social and Economic Research.
    4. Bhalotra, Sonia & Clarke, Damian, 2022. "Analysis of Twins," The Warwick Economics Research Paper Series (TWERPS) 1428, University of Warwick, Department of Economics.
    5. Albanese, Andrea & Nieto, Adrián & Tatsiramos, Konstantinos, 2022. "Job Location Decisions and the Effect of Children on the Employment Gender Gap," GLO Discussion Paper Series 1113, Global Labor Organization (GLO).
    6. Damian Clarke & Gustavo Cortés Méndez & Diego Vergara Sepúlveda, 2020. "Growing together: assessing equity and efficiency in a prenatal health program," Journal of Population Economics, Springer;European Society for Population Economics, vol. 33(3), pages 883-956, July.
    7. Damian Clarke, 2018. "Children And Their Parents: A Review Of Fertility And Causality," Journal of Economic Surveys, Wiley Blackwell, vol. 32(2), pages 518-540, April.
    8. Gershoni, Naomi & Low, Corinne, 2021. "The power of time: The impact of free IVF on Women’s human capital investments," European Economic Review, Elsevier, vol. 133(C).
    9. Nieto, Adrián, 2021. "Native-immigrant differences in the effect of children on the gender pay gap," Journal of Economic Behavior & Organization, Elsevier, vol. 183(C), pages 654-680.
    10. Semih Tumen & Belgi Turan, 2023. "The effect of fertility on female labor supply in a labor market with extensive informality," Empirical Economics, Springer, vol. 65(4), pages 1855-1894, October.
    11. Huang, Wei & Liu, Hong, 2023. "Early childhood exposure to health insurance and adolescent outcomes: Evidence from rural China," Journal of Development Economics, Elsevier, vol. 160(C).
    12. Stefan Bauernschuster & Michael Grimm & Cathy M. Hajo, 2023. "The Impact of Margaret Sanger’s Birth Control Clinics on Early 20th Century U.S. Fertility and Mortality," CESifo Working Paper Series 10421, CESifo.
    13. Hamid Noghanibehambari & Farzaneh Noghani, 2023. "Long‐run intergenerational health benefits of women empowerment: Evidence from suffrage movements in the US," Health Economics, John Wiley & Sons, Ltd., vol. 32(11), pages 2583-2631, November.
    14. Sviatschi, Maria Micaela & Trako, Iva, 2024. "Gender violence, enforcement, and human capital: Evidence from women’s justice centers in Peru," Journal of Development Economics, Elsevier, vol. 168(C).
    15. Sonia Bhalotra & Damian Clarke, 2019. "Twin Birth and Maternal Condition," The Review of Economics and Statistics, MIT Press, vol. 101(5), pages 853-864, December.
    16. Schmieder, Julia, 2021. "Fertility as a driver of maternal employment," Labour Economics, Elsevier, vol. 72(C).
    17. Julia Schmieder, 2020. "Fertility as a Driver of Maternal Employment," Discussion Papers of DIW Berlin 1882, DIW Berlin, German Institute for Economic Research.
    18. Sonia Bhalotra & Martin Karlsson & Therese Nilsson & Nina Schwarz, 2022. "Infant Health, Cognitive Performance, and Earnings: Evidence from Inception of the Welfare State in Sweden," The Review of Economics and Statistics, MIT Press, vol. 104(6), pages 1138-1156, November.
    19. Gabriella Conti & Mark Hanson & Hazel Inskip & Sarah Crozier & Cyrus Cooper & Keith Godfrey, 2018. "Beyond Birth Weight: The Origins of Human Capital," Working Papers 2018-089, Human Capital and Economic Opportunity Working Group.
    20. Finlay, Jocelyn E., 2021. "Women’s reproductive health and economic activity: A narrative review," World Development, Elsevier, vol. 139(C).

    More about this item

    Keywords

    twins ; IVF ; single embryo transfer ; career costs of children ; child penalty ; gender wage gap ; fertility ; maternal health ; neonatal health ; gender JEL Classification: J13 ; I11 ; I12 ; I38 ; J24;
    All these keywords.

    JEL classification:

    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wrk:warwec:1391. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Margaret Nash (email available below). General contact details of provider: https://edirc.repec.org/data/dewaruk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.