Analyzing data spanning three decades covering the near universe of births, we study county-level differences in Cesarean section (C-section) rates among first-time mothers of singleton births. Our research reveals persistent geographic variation in C-section rates for both low- and high-risk groups. Counties with elevated C-section rates consistently perform more C-sections across mothers at all levels of appropriateness for the procedure. These elevated rates of C-section in high C-section counties are associated with reduced maternal and infant morbidity. We also find that C-section decisions are less responsive to underlying risks for Black mothers relative to white mothers, suggesting potential welfare-reducing disparities.

Fewer births occur on major US holidays than would otherwise be expected. We use California data to study the nature and health implications of this birth date manipulation. We document 18% fewer births on the day of and just after a holiday. Cesarean sections account for roughly half of the decline. “Missing” holiday births are displaced to a window of time 11 days before the holiday through 16 days after the holiday. High-risk births are more likely to be rescheduled. Despite the change in timing, we find little evidence of any adverse health consequences for babies born around a holiday.

We estimate the effect of a female employee giving birth and taking parental leave on small firms and coworkers in Denmark using a dynamic difference-in-differences design. We find little evidence that parental leave take-up has negative effects on firms and coworkers overall. This is because most firms are very effective in compensating for the worker on leave by hiring temporary workers and by increasing other employees’ hours. In contrast, we do find evidence that parental leave has negative effects on a small subsample of firms that are less able to use their existing employees to compensate for absent workers.