Birth Order Effects in Maternal Health-Seeking Behavior: Evidence from India

Abstract

Can maternal health-seeking behavior change with subsequent births? We find a 5 percentage point decline in the likelihood of a mother delivering her later born in an institutional facility compared to her first born. We also observe a 4 percentage point decline in medically supervised births for higher birth order children. These effects seem to be driven by changed risk perceptions associated with a complication free first child's delivery and increased financial constraints. Improvements in roads and banking infrastructure attenuate this negative birth order gradient. Results highlight the importance of birth order as an important determinant of maternal health-seeking behavior.

Keywords: Birth order, institutional delivery, prenatal investments, India

JEL Classification: I12, I15, I18