Working Paper: NBER ID: w21022
Authors: Sara Allin; Michael Baker; Maripier Isabelle; Mark Stabile
Abstract: Drawing on administrative records of nearly 4 million births in Canada as well as macro data from the US and Australia, we provide a comprehensive account of rising C-section rates. We explicitly consider the contributions of the changing characteristics of mothers, births, and physicians as well as changing financial incentives for C-section deliveries. These factors account for at most one-half of the increase in C-section rates. The majority of the remaining increase in C-sections over the period 1994-2011 occurred in the early 2000s. We overview the relative contributions that the Hannah Breech Trial and technological change may have played in this development.
Keywords: C-section; public health; physician incentives; health care system; Canada
JEL Codes: I11; I12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| maternal age (J13) | probability of c-section delivery (C46) |
| previous c-section (Y50) | probability of c-section delivery (C46) |
| multiple gestation (J12) | probability of c-section delivery (C46) |
| fetal distress (J13) | probability of c-section delivery (C46) |
| financial incentives (M52) | probability of c-section delivery (C46) |
| Hannah Breech trial (K36) | c-section rates (J13) |
| changes in maternal and delivery characteristics + physician incentives (I11) | increase in c-section rates (J19) |