Delivering Privately: Cesarean Practice and Long-Term Maternal Health

Ramiro de Elejalde () and Eugenio Giolito ()
Additional contact information
Ramiro de Elejalde: Banco Central de Chile
Eugenio Giolito: Universidad del CEMA

No 18877, IZA Discussion Papers from IZA Network @ LISER

Abstract: We study the causal effect of delivering in a private rather than a public hospital on maternal outcomes in Chile. We exploit a 2003 copayment reduction that expanded access to private hospitals for women insured by the public system as an instrument for private delivery. Combining administrative birth records with hospital discharge data, we estimate an instrumented difference-in-differences model that follows mothers for up to fifteen years after the first birth. Private hospital delivery improves short-term outcomes, reducing prolonged hospitalizations and 30-day readmissions. The offsetting risks come with later pregnancies: women induced to deliver in private hospitals face higher rates of repeat C-sections, cesarean-scar complications, and hysterectomy. Subsequent fertility is unaffected. The results point to a trade-off between short-run improvements and long-run maternal health risks from hospital practices that favor planned cesarean delivery.

Keywords: cesarean section; maternal health; private hospitals; provider incentives (search for similar items in EconPapers)
JEL-codes: I11 I12 I13 I18 J13 (search for similar items in EconPapers)
Date: 2026-08
References: Add references at CitEc
Citations:

Downloads: (external link)
https://docs.iza.org/dp18877.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:iza:izadps:dp18877

Access Statistics for this paper

More papers in IZA Discussion Papers from IZA Network @ LISER Contact information at EDIRC.
Bibliographic data for series maintained by Mark Fallak ().