The Labor Market and Health Impacts of Reducing Cesarean Section Deliveries

One in three births in the United States is delivered by cesarean section (c-section). This paper studies the labor market and health effects of c-sections, using newly linked administrative data that combines the universe of California birth records with mothers’ quarterly earnings. We analyze the impact of an intervention that reduced c-section rates among low-risk first-time births, and find that mothers exposed to the intervention appear to have a higher likelihood of employment in the quarter following birth, as well as a higher likelihood of returning to their pre-birth employer. These impacts attenuate over time—suggesting that a c-section primarily delays return to the labor market following childbirth—but attachment to the pre-birth employer remains higher five quarters post-birth. We find no evidence of significant impacts on maternal or infant health, indicating that the intervention-induced decline in c-sections did not come at the cost of worse outcomes. Further, among mothers who have another child, we find that exposure to the intervention at the first birth leads to a lower likelihood of c-section and preterm delivery at the second one, implying that both the economic and health benefits of reduced c-sections may compound with birth order.