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Selma Walther, Ph.D.

University of Warwick, United Kingdom

Authors: Sonia Bhalotra, Atheendar Venkataramani, and Selma Walther

Abstract: The introduction of the first antibiotics in the United States in 1937 led to sharp drops in child mortality from pneumonia and maternal mortality from puerperal sepsis. We leverage this plausibly exogenous medical innovation to examine fertility responses among women giving birth in this era. The decline in child mortality led women to delay childbearing and have fewer children overall, with fewer women having three or more children, and a larger share remaining childless. We present a new theory of the extensive margin response, where reductions in child mortality reduce the time women need to achieve their target number of children. This prompts fertility delay and labor market entry which, coupled with wage or fecundity shocks, can result in childlessness. We show that reductions in child mortality increased women’s labor force participation, improved their occupational status and reduced their chances of ever having married. Maternal mortality decline had opposing effects on all of these outcomes. Keywords: fertility timing, childlessness, child mortality, maternal mortality, women’s labor force participation, medical innovation

JEL Classification: J13, I18

Full Text:  “Fertility Responses to Reductions in Mortality: Quasi-Experimental Evidence from 20th Century America”