Women’s Fertility and Labor Market Responses to a Health Innovation
OFH Contributors
Key Takeaways
New medical innovations that increase infant and child survival rates can empower women to join the labor force, work more hours, and pursue higher-skilled occupations.
The key mechanism is that increased child survival allows women to delay fertility, reducing total births. and increasing time available to invest in careers.
Fertility timing is a crucial, previously underappreciated channel linking child health improvements to women’s economic outcomes.
Policies that boost child health can promote women’s economic independence.
Executive Summary
Introduction
Better health can boost opportunity in several ways. This paper examines how declines in child mortality driven by new medical technologies impact women’s economic outcomes and fertility. It focuses on a historical episode – the arrival of the first antibiotics in the late 1930s – and uses census data to answer this question.
Main Findings
- Antibiotic driven declines in child mortality led women to delay childbearing, reducing fertility at both the intensive margin (fewer children among mothers) and the extensive margin (higher childlessness). Immediately after the arrival of antibiotics, women experienced a lower annual probability of giving birth. Over the life course, this translated into fewer total children and a persistent increase in childlessness.
- At the same time, women exposed to larger child mortality declines increased their labor force participation, worked more hours, and moved into higher-skill occupations. The rise in employment was driven primarily by a reduction in stay-at-home motherhood rather than shifts among already-working women. Marriage rates declined modestly, indicating that delayed or reduced fertility weakened the necessity of early marriage, but marriage was not the dominant channel through which fertility and labor outcomes changed.
- We reconcile these findings by creating an economic model in which fertility timing mediates the trade-off between achieving a desired number of surviving children and investing in labor market opportunities. When child mortality falls, women need fewer pregnancies to reach their fertility goals and can postpone childbearing, increasing the option value of investing in their careers.
Conclusion
The paper concludes that technology and policy-driven improvements in child survival can expand women’s opportunities to participate in the labor market and pursue higher-skilled occupations. These findings underscore the importance of health as a driver of economic opportunity and how interventions in one sector (health) can have important spillover consequences in another (labor markets)