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Cutting Fertility? The Effect of Cesarean Deliveries on Subsequent Fertility and Maternal Labor Supply

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  • Martin Halla
  • Harald Mayr
  • Gerald J. Pruckner
  • Pilar Garcia-Gomez

Abstract

The incidence of Cesarean deliveries (CDs) has been on the rise. The procedure’s cost and benefits are discussed controversially; in particular, since non-medically indicated cases seem widespread. We study the effect of CDs on subsequent fertility and maternal labor supply. Identification is achieved by exploiting variation in the supply-side’s incentives to induce nonmedically indicated CDs across weekdays. On weekends and public holidays obstetricians’ are less likely to induce CDs (due tighter capacity constraints in hospital). On Fridays and other days preceding a holiday, they face an increased incentive to induce CDs (due to their demand for leisure on non-working days). We use high-quality administrative data from Austria. Women giving birth on different weekdays are pre-treatment observationally identical. Our instrumental variable estimates show that a non-planned CD at parity one decreases life cycle fertility by almost 17 percent. This reduction in fertility translates into a temporary increase in maternal employment.

Suggested Citation

  • 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," Economics working papers 2016-03, Department of Economics, Johannes Kepler University Linz, Austria.
    • Handle: RePEc:jku:econwp:2016_03
    Note: English
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    3. Ana Costa-Ramón & Mika Kortelainen & Ana Rodríguez-González & Lauri Sääksvuori, 2022. "The Long-Run Effects of Cesarean Sections," Journal of Human Resources, University of Wisconsin Press, vol. 57(6), pages 2048-2085.
    4. Dehos, Fabian T. & Paul, Marie & Schäfer, Wiebke & Süß, Karolin, 2024. "Time of Change: Health Effects of Motherhood," IZA Discussion Papers 16942, Institute of Labor Economics (IZA).
    5. Costa-Ramón, Ana María & Rodríguez-González, Ana & Serra-Burriel, Miquel & Campillo-Artero, Carlos, 2018. "It's about time: Cesarean sections and neonatal health," Journal of Health Economics, Elsevier, vol. 59(C), pages 46-59.
    6. Tonei, Valentina, 2019. "Mother’s mental health after childbirth: Does the delivery method matter?," Journal of Health Economics, Elsevier, vol. 63(C), pages 182-196.
    7. David Card & Alessandra Fenizia & David Silver, 2023. "The Health Impacts of Hospital Delivery Practices," American Economic Journal: Economic Policy, American Economic Association, vol. 15(2), pages 42-81, May.
    8. Hanna Mühlrad, 2022. "Cesarean sections for high‐risk births: health, fertility, and labor market outcomes," Scandinavian Journal of Economics, Wiley Blackwell, vol. 124(4), pages 1056-1086, October.
    9. David Card & Alessandra Fenizia & David Silver, 2018. "The Health Effects of Cesarean Delivery for Low-Risk First Births," NBER Working Papers 24493, National Bureau of Economic Research, Inc.
    10. Valentina Tonei, 2017. "Mother’s health after childbirth: does delivery method matter?," Discussion Papers 17/11, Department of Economics, University of York.
    11. Maria Koch Gregersen, 2024. "Earlier routine induction of labor—Consequences on mother and child morbidity," Health Economics, John Wiley & Sons, Ltd., vol. 33(10), pages 2399-2418, October.
    12. Pilvar, Hanifa & Yousefi, Kowsar, 2021. "Changing physicians’ incentives to control the C-section rate: Evidence from a major health care reform in Iran," Journal of Health Economics, Elsevier, vol. 79(C).

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    More about this item

    Keywords

    Caesarean delivery; Caesarean section; fertility; female labor supply;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure

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