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Low-risk isn’t no-risk: Perinatal treatments and the health of low-income newborns

N. Meltem Daysal, Mircea Trandafir and Reyn Van Ewijk

Journal of Health Economics, 2019, vol. 64, issue C, 55-67

Abstract: We investigate the effects of perinatal medical treatments on low-income newborns who are classified as low-risk. A policy rule in The Netherlands states that low-risk deliveries before week 37 should be supervised by physicians and later deliveries only by midwives with no physician present. This creates large discontinuities in the probability of receiving medical interventions only physicians are allowed to perform. Using a regression discontinuity design, we find that babies born slightly before the week-37 cutoff are significantly less likely to die than babies born slightly later. Our data suggest that physician supervision of birth reduces the likelihood of adverse events such as fetal distress or emergency C-section. Our results indicate that low-income women benefit from receiving a higher level of medical care even if no explicit risk factors have been recognized, pointing to challenges in identifying all high-risk pregnancies. “Back-of-the-envelope” calculations suggest this additional care is highly cost-effective.

Keywords: Perinatal care; Prematurity; Mortality; Midwives; Birth; Medical treatments; Medical interventions (search for similar items in EconPapers)
JEL-codes: I11 I12 I18 J13 (search for similar items in EconPapers)
Date: 2019
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Journal of Health Economics is currently edited by J. P. Newhouse, A. J. Culyer, R. Frank, K. Claxton and T. McGuire

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