The Long-Run Effects of Cesarean Sections

Lauri Saaksvuori , National Institute for Health and Welfare, Finland
Ana Maria Costa-Ramon, University of Pompeu Fabra
Mika Kortelainen, VATT Institute for Economic Research
Ana Rodriguez-Gonzalez, University of Pompeu Fabra

Cesarean delivery for low-risk pregnancies is associated with several adverse health outcomes for infants and mothers. The interpretation of these correlations is, however, confounded due to the selection of birth mode. We use high quality administrative data which includes detailed birth and health records for all children born in Finland from 1990 to 2014 to study the causal effects of cesarean delivery on infants’ long-term health. We show that physicians are more likely to perform C-sections during their regular shift on Fridays and working days that precede public holidays and use this variation as an instrument for unplanned C-sections. We supplement our instrumental variables estimates using variation within sibling pairs and between families where the second child is born either by unplanned C-section or vaginal delivery. Our results suggest that avoidable unplanned C-sections increase the risk of asthma, but do not affect the probability of being diagnosed with other immune and metabolic disorders previously associated with C-sections.

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 Presented in Session 173. Long-Term Effects of Early-Life Circumstances