The Health Outcomes of Cesarean Section

In this study we used the variation in the c-section rate following a health reform in Iran, to identify the causal effect of cesarean delivery on health outcomes of the neonates as well as the effect of supply and demand side on the use of this procedure. By lowering the cost of vaginal delivery, increasing the wages of performing doctors and defining a quota for the maximum rate of annual cesarean delivery, the cesarean rate in Iran among first birth young women decreased from 48% to 33% in less than 3 years. We showed that the main driving force of this reduction is supply side incentives. We also showed that cesarean significantly increases the probability of infant's death by 5% and decreases the Apgar score by 10%.