Scandinavian Working Papers in Economics

HERO Online Working Paper Series,
University of Oslo, Health Economics Research Programme

No 2024:2: Maternity ward closures and infant health outcomes, maternal health outcomes, and birth procedures

Astrid de Linde (), Jostein Grytten, Irene Skau and Jonas Minet Kinge
Additional contact information
Astrid de Linde: Department of Health Management and Health Economics, Postal: HERO / Department of Health Management and Health Economics, P.O. Box 1089 Blindern, NO-0317 Oslo, Norway
Jostein Grytten: Department of Community Dentistry, University of Oslo, Norway
Irene Skau: Department of Community Dentistry, University of Oslo, Norway
Jonas Minet Kinge: Centre for Disease Burden, Norwegian Institute of Public Health, Postal: HERO / Department of Health Management and Health Economics, P.O. Box 1089 Blindern, NO-0317 Oslo, Norway

Abstract: We analyze the short- and long-term impacts of maternity ward closures on health and education outcomes, hospital procedures, and fertility. Our study makes use of registry data that covers every delivery in Norway from 1981 through 2019. Among those directly experiencing a closure, we find in the short-term a small decline 5-minute Apgar score and increased probability of birth outside institution. This slight drop in Apgar is not reflected in the other available health indicators and we therefore hypothesize it reflects different institutional scoring standards as opposed to a health effect. For long-term outcomes, we find that experiencing a closure as an infant results in a 1 percentage point increase in beginning high school by 16, but does not lead to a change in the likelihood of graduating by age 22. Furthermore, for those infants assigned female at birth, experiencing closures as an infant does not change the likelihood of giving birth as an adult or experiencing negative health conditions during pregnancy. Given that these conditions are themselves potential risk factors for newborn health, our results do not point to evidence for an intergenerational effect of closures. We hypothesize that an effective prenatal screening process and robust health and social services may mitigate the effect of closures and thus account for a limited treatment effect. Our paper is among the first to look at both the short and long-term implications of closures and suggests further avenues to study among labor, education, and health outcomes.

Keywords: maternity care; closures; centralization; registry data

JEL-codes: I11; I14; I18; J13

Language: English

64 pages, June 12, 2024

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