%0 Report
        %A Elejalde, Ramiro de
%A Giolito, Eugenio
        %T Delivering Privately: Cesarean Practice and Long-Term Maternal Health
        %D 2026
        %8 2026 Aug
        %I Institute of Labor Economics (IZA)
        %C Bonn
        %7 IZA Discussion Paper
        %N 18877
        %U https://www.iza.org/publications/dp18877
        %X We study the causal effect of delivering in a private rather than a public hospital on maternal outcomes in Chile. We exploit a 2003 copayment reduction that expanded access to private hospitals for women insured by the public system as an instrument for private delivery. Combining administrative birth records with hospital discharge data, we estimate an instrumented difference-in-differences model that follows mothers for up to fifteen years after the first birth. Private hospital delivery improves short-term outcomes, reducing prolonged hospitalizations and 30-day readmissions. The offsetting risks come with later pregnancies: women induced to deliver in private hospitals face higher rates of repeat C-sections, cesarean-scar complications, and hysterectomy. Subsequent fertility is unaffected. The results point to a trade-off between short-run improvements and long-run maternal health risks from hospital practices that favor planned cesarean delivery.
        %K cesarean section
%K maternal health
%K private hospitals
%K provider incentives