To-Do List: Wrap Gifts. Have Baby. - Intermountain Healthcare
“It’s phenomenal what’s happening in late December,” said Amitabh Chandra, a Harvard economist who provided many of the numbers here. “December is not really a particularly busy time for babies to be born. So to see a spike that’s equal to September is astounding.” Obviously, there are reasons beside taxes that someone might prefer having a baby in late December rather than early January. Many people will be on vacation next week, with extended family in town to see a new baby and help around the house. The stress of having relatives visit may also be enough to send some expectant mothers into labor. So to see if taxes were truly the culprit, Mr. Chandra and another economist, Stacy Dickert-Conlin of Michigan State, devised some clever tests. They found that people who stood to gain the most from the tax breaks were also the ones who gave birth in late December most frequently. When the gains were similar, high-income parents — who, presumably, are more likely to be paying for tax advice — produced more December babies than other parents. It’s also telling that the year’s final week was not the first part of the calendar to replace September. For a few years in the mid-1990s, a day on either side of the long July 4 weekend was National Birth Day. But July lost the honor as the tax code became ever kinder to families with children. The child tax credit, now worth $500, made its debut in 1998, and the earnedincome tax credit, an anti-poverty policy that’s more generous to families with at least two kids, became much larger in the 90s. The personal exemption, for its part, has risen along with inflation, reaching $3,300 this year. By my calculations, about 5,000 babies, of the 70,000 or so who would otherwise be born during the first week in January, may have their arrival dates accelerated partly for tax reasons. When Mr. Chandra interviewed one mother in central Kentucky, she told him her doctor encouraged her to schedule a late-December birth well in advance, to be sure she got a delivery room. Anecdotes aside, Mr. Chandra thinks my estimate of 5,000 is conservative, based on his own more sophisticated statistical analysis. In addition to being an entertaining bit of trivia, the end-of-the-year baby boom also raises a legitimate policy question: just because we have the medical ability to do something, does that necessarily mean it’s such a good idea? Induced births and Caesarean sections are considerably more expensive than natural births on average. There are clearly cases when labor needs to be induced for a baby’s health or the mother’s. It’s much less clear, however, that the health care system should be subsidizing parents’ desire for a smaller tax bill.
The health effects of scheduled births are also murky. A big study led by a researcher at the Centers for Disease Control and Prevention found that voluntary Caesareans increase the risk of infant mortality. Another study found that weekday births are slightly more risky than weekend ones, all else equal, suggesting that a drug-induced birth can also cause health problems. The differences are small, but the stakes are big enough to take any change seriously. “When you induce labor, you compress this long process into a few hours,” said Dr. Emmet Hirsch, the director for obstetrics at Evanston Northwestern Healthcare near Chicago. “When you do that, you can run into all sorts of problems.” To minimize those problems, the largest medical provider in Utah, Intermountain Healthcare, now discourages women from electively inducing labor before their 39th week of pregnancy. “This is what’s best for moms and babies,” said Janie Wilson, a nurse who helps run the newborn program at Intermountain. “It just seems like a no-brainer.” Before the policy went into effect in 2001, Intermountain, based in Salt Lake City, had more December births than January births. It doesn’t anymore. The solution to this situation seems simple enough to me, and it comes back to the tax code. If Congress changed the all-or-nothing aspect of the child tax breaks, it would reduce the incentive to rush a fetus along in the final days of the year. A child born in December could be eligible for one-twelfth of a deduction or a credit rather than the whole thing. But maybe I’m just biased. When my mother was getting ready to give birth to her first child, she would tell friends and family that Jan. 1 was the only day she didn’t want the baby to arrive. She figured the hospital would be dealing with the aftermath of New Year’s Eve, and she couldn’t stand the idea of giving birth to New York’s much-publicized first baby of the year. I suspect most people thought she didn’t have much to fear, given that the due date — my due date — was Dec. 22. But she apparently knew what she was talking about. I arrived late on the afternoon of Jan 1. The doctor complained about missing the Rose Bowl, and my parents missed out on one of the few ways that a child can be a financial windfall. E-mail: firstname.lastname@example.org http://www.nytimes.com/2006/12/20/business/20leonhardt.html?_r=1&ref=business &oref=slogin