Are some Irish mothers "too posh to push"?

The use of C-section to deliver babies has tended to go up over time and has generated some concern. It is, after all, a significant operation and can have negative consequences. For example mothers are less likely to breastfeed after a C-section.

It is sometimes argued that mothers elect to have C-sections as they are “too posh to push”. Leaving aside the question of whether this is a good or bad thing: is it actually true? Using the Growing Up in Ireland data I estimate some simple probit models predicting the probability of elective and emergency c-sections. Household income (equivalised & in log form) is positively associated with having a C-section. But the coefficient for emergency c-section is almost twice as big as that of elective. This doesn’t fit in with a simple story of affluent mothers choosing to have c-section. I have no idea why income would have such an effect on emergency C-sections.

Mother’s education, interestingly, seems to have no effect (& remember education is generally seen as a better measure of socio-economic status than income) nor does a measure of social class (not shown here) nor does whether the mother smoke or drank during pregnancy. Factors that do predict a c-section include the mother’s BMI and her age (for the elective case) and the baby’s birth-weight (for the emergency case). Clearly many other factors may influence these outcomes & not all of which are in this data.

So while there is clearly a connection between how well-off a mother is and whether she delivers via a C-section its not at all clear that it is a simple case of "money talks".

	(1)	(2)
	elective	emergency
log income	0.0168*	0.0292***
	(2.41)	(3.96)
mother's educ	-0.00209	0.00246
	(0.73)	(0.81)
birthweight	-0.0101	-0.0322***
	(1.77)	(5.20)
born on time	0.0693***	-0.0590***
	(8.73)	(6.58)
" early	0.193***	-0.00267
	(7.86)	(0.23)
" very early	0.126*	0.214***
	(2.44)	(4.26)
partner	0.0186	-0.0114
	(1.82)	(0.96)
girl	-0.00154	-0.0202**
	(0.24)	(2.95)
Mothers BMI	0.00346***	0.00427***
	(5.32)	(6.22)
" smoke	-0.00852	-0.00414
	(1.62)	(0.78)
" drink	-0.0121	-0.00234
	(1.93)	(0.35)
Age	0.00565***	-0.000325
	(8.71)	(0.48)
N	7020	7020
pseudo R2	0.065	0.055

Marginal effects; Absolute t statistics in parentheses

^{* p<0.05,**p<.01,***p<.001}