Modern obstetric practice gives parents and doctors some control over when a baby is born. That flexibility can be valuable when there is a medical reason to intervene, but it also raises an important question: does bringing delivery forward by just a few days matter for children later on?
In BSE Working Paper 1539, “Born Too Soon? The Educational Costs of Early Elective Deliveries,” Libertad González and Parijat Maitra study this question by exploiting an abrupt policy change in Spain at the end of 2010. They show that even modest shifts in birth timing, within otherwise healthy pregnancies, can have lasting consequences for children’s health and school performance.
Policy Change Led to a Spike in the Number of Births
Spain’s universal baby bonus paid mothers 2,500 euros after the birth of a child. When the government announced that the benefit would end for babies born from January 1, 2011 onward, families expecting a baby in early January suddenly had a strong incentive to move delivery into late December. The data show a clear spike in births just before the deadline and a corresponding drop just after it, consistent with induced labor (Figure 1).
Implications for the Children
The shift in timing made babies slightly lighter at birth and shortened gestation, even though most were still born within the normal range. The affected children were also more likely to experience respiratory problems in infancy. In particular, bronchiolitis diagnoses before age one increased by nearly 10 percent for children born in the narrow window (± 7 days) around the policy cut-off.
More strikingly, the children most exposed to this birth-shifting episode went on to do worse in school. Using administrative records from Catalonia, the authors find significantly lower second-grade scores (Figure 2) among children born in the final days of December 2010. This pattern remains after accounting carefully for “age at testing”, which suggests that the results are not simply driven by these children being younger than their classmates.
Note: The dependent variable is the average second grade test score (standardized grade) of child i, born in month m of year t. The specification includes week-of-birth fixed effects. The reported coefficients refer to indicators for whether a child was born in each of the 10-day intervals. We control for year-of-birth fixed effects, child’s gender, municipality population size, and parental background, including educational attainment, country of birth, and indicators for missing values on parental characteristics. Robust standard errors are reported.
Why the Findings Matter
The broader message is that small changes in gestational length can matter, even within births that would usually be considered low-risk or close to full term. Policies with sharp eligibility cut-offs can unintentionally encourage families to change the timing of delivery, and the short-run financial gain may come with long-run costs for children. The findings, therefore, speak not only to medical practice, but also to the design of public policy.
Key Findings
- The end of Spain’s baby bonus led to a clear shift in births into the last days of December 2010
- Children affected by this shift were slightly smaller at birth and more likely to suffer respiratory problems in infancy
- Those same children later performed worse in primary school, suggesting that early elective delivery can have lasting educational costs
