From Home to Hospital: The Evolution of Childbirth in the United States, 1927-1940

Working Paper: NBER ID: w10873

Authors: Melissa A. Thomasson; Jaret Treber

Abstract: This paper examines the shift in childbirth from home to hospital that occurred in the United States in the early twentieth century. Using a panel of city-level data over the period 1927-1940, we examine the shift of childbirth from home to hospital and analyze the impact of medical care on maternal mortality. Results suggest that increased operative intervention on the part of physicians and a resultant greater risk of infection increased maternal mortality prior to the introduction of sulfa drugs in 1937. However, the introduction of sulfa enabled doctors to reduce maternal mortality by enabling them to do potentially life-saving procedures (such as cesareans) without the risk of subsequent infection. Regressions estimated separately by race suggest that the impact of medical care on maternal mortality differed for blacks and whites. Relative to whites, hospitals posed a greater risk for black mothers prior to the availability of sulfa drugs in 1937, and were less beneficial for them afterwards, suggesting that blacks may have received lower quality medical care.

Keywords: No keywords provided

JEL Codes: I12; N32


Causal Claims Network Graph

Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.


Causal Claims

CauseEffect
sulfa drugs introduction (Y20)hospital beds per 100,000 population (I11)
sulfa drugs introduction (Y20)maternal mortality (J16)
race (black mothers) (J15)maternal mortality (J16)
race (white mothers) (J79)maternal mortality (J16)
hospital beds per 100,000 population (I11)maternal mortality (J16)
hospital beds per 100,000 population + pre-1937 dummy variable (C21)maternal mortality (J16)

Back to index