Working Paper No. 1289

Multiple Births, Birth Quality and Maternal Labor Supply: Analysis of IVF Reform in Sweden

Published: June 25, 2019Pages: 66Keywords: IVF; Fertility; Maternal health; Neonatal health; Career penalty; Human capital formationJEL-codes: J13; I11; I12; I38; J24

Multiple Births, Birth Quality and Maternal Labor Supply: Analysis of IVF Reform in Sweden Sonia Bhalotra, Damian Clarke, Hanna Mühlrad and Mårten Palme


In this study we examine the passage of a reform to in-vitro fertilization (IVF) procedures in Sweden in 2003. Following publication of medical evidence showing that pregnancy success rates could be maintained using single rather than multiple embryo transfers, the single embryo transfer (SET) was mandated as the default IVF procedure.

Using linked registry data for the period 1998-2007, we find that the SET reform was associated with a precipitous drop in the share of multiple births of 63%. This narrowed differences in health between IVF and non-IVF births by 53%, and differences in the labor market outcomes of mothers three years after birth by 85%. For first time mothers, it also narrowed the gap in maternal health between IVF and non-IVF births by 36%.

Our findings imply that more widespread adoption of SET could lead to massive gains, reducing hospitalization costs and the foregone income of mothers and improving the long-run socioeconomic outcomes of children. This is important given that the share of IVF facilitated births exceeds 3% in several industrialized countries and is on the rise.

Interdisciplinary European Studies

The European Union in a Changing World Order

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This book explores how the European Union responds to the ongoing challenges to the liberal international order. These challenges arise both within the EU itself and beyond its borders, and put into question the values of free trade and liberal democracy. 

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