From home to hospital: The evolution of childbirth in the United States, 1928-1940

This paper examines the shift in childbirth from home to hospital that occurred in the United States in the early 20th century. Using a panel of city-level data over the period 1928-1940, we examine the impact on maternal mortality resulting from the shift of childbirth from home to hospital. Results suggest that until the late 1930s when sulfa drugs were developed, medical intervention had a limited impact on maternal mortality. Post-sulfa, the medicalization of childbirth reduced maternal mortality. Regressions estimated separately by race provide mixed evidence as to whether blacks and whites benefited differentially from medical intervention.     

CONSTRAINING COMPETITION WITH STATE MANDATED FACILITY REQUIREMENTS

We find that state mandated facility requirements may constrain the size and location of funeral homes. Many states have funeral regulations that require funeral homes to have embalming rooms, chapels, and casket display rooms. Often these facilities go unused, providing no discernible benefit to consumers while imposing unnecessary costs on firms. Using a case study, we present evidence that Arizona's more extensive facility requirements reduce the number of small funeral homes relative to Florida and prevent them from locating in shopping centers. We estimate that eliminating Arizona's cumbersome facility requirements would save consumers approximately 14% on their funeral expenditures. (JEL L51, L84, L88)