Srsly.

The ABC News is quoting economist Andrew Leigh as saying that the “delayed” interventions around baby bonus time is causing fatter children.

A Canberra economist says an increase in the baby bonus could lead to unhealthier children.

Research by the Australian National University’s (ANU) Andrew Leigh and a colleague suggests the introduction of the baby bonus in 2004 led to more children being born overweight, because their deliveries were deliberately delayed to obtain the bonus.

Dr Leigh says a planned increase in the baby bonus from July 1 this year could produce a similar outcome.

“I think people are very familiar with the fact that premature and very light babies tend to have worse health outcomes,” he said. “But it’s actually also the case that very heavy babies also have worse health outcomes. Undercooking is bad and overcooking is bad too.”

Since we know that most C sections and inductions performed in Australia aren’t medically necessary, the contention that there were any adverse health outcomes from the “delayed” (hrm) interventions around baby bonus cutoff times is a remarkable claim. I have seen zero medical evidence that there were any adverse outcomes. None, zip, nada. Since there was plenty of scareloring before the cutoff date, it was interesting to see that the issue sank like a stone afterwards. Could there have been no effect from the backing off on interventions? Could there, perhaps, have been a little improvement, with less iatrogenic prematurity, fewer failed inductions, fewer unnecessary operations? We don’t know. No-one seems to have looked, or if they have, they haven’t published anywhere I read.

Not only that, but Leigh is quoted as making a very specific claim: that “overcooked” babies are fatter, that “overcooked” babies grow up into obese, unhealthy children. No evidence. None.

Leigh’s agenda is that the baby bonus be abolished. Whatever; he can argue that in economic terms as much as he likes, that’s his specialty, and it’s not what this post is about. But he isn’t making an economic argument; he is making a medical one. This requires that pesky little thing called a critical examination of the scientific evidence.

I hope he is being badly misquoted, because this is a pretty extraordinary claim to be making, and superficially it looks like one designed to get sensationalist headlines and spread serious misinformation about birth.

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Addit: Yes, I have more to say. This sort of thing bothers me on other levels too: primarily, from a feminist point of view, because it rests on the assumption that women are gold-digging infants who need to be told what to do. That if there is a financial incentive to decline a medical recommendation, women everywhere will cavalierly be taking risks with their pregnancy in order to grab at the cash.

There is no examination of the incentives doctors have to intervene early and without a thorough discussion of the evidence with the woman concerned; just the assumption that each and every one of the interventions performed currently is being performed at exactly the right medical time for exactly the right medical reason, and that women declining birth interventions is OMG BAD.

There is no examination of which births were “delayed”. You know, there are still obstetricians who say that “Nothing good happens after 38 weeks”. It has taken a long and bitter struggle just to get most “routine” C sections (most of which are unnecessary, for example for twins, previous C section, well controlled gestational diabetes and so on) shifted forward to 39 weeks – a time still 3 weeks before the earliest that any informed birth attendant would consider a pregnancy to be “postmature”. Which births were shifted a few days around baby bonus time? Were they social inductions, no longer quite so wanted with the few thousand dollars looming? Elective C sections shifted from 39 weeks to 40 weeks? Inductions and sections that would otherwise have been booked just before the long weekend? Or were they women with fulminating pre-eclampsia? Hmmm? What do you think? Where is the evidence?

And certainly there is no look at any of the other issues: for example, the fact that unnecessary C section before term is more likely to lead to breastfeeding difficulties, and that breastfeeding reduces the rates of childhood and adult disease.

Seriously, postdates = obese unhealthy child? Does anyone believe this? Are even any rabidly insane control-freak obstetricians suggesting that we start forcing all births to happen by 39 weeks to prevent childhood obesity? No.

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Edit 21 March 2008 to add references: The paper and various conversations around it can be found here:

Original paper, self-published

“The baby bonus and obesity” on one co-author’s blog (Joshua Gans)

Discussion on the other co-author’s blog (Andrew Leigh)

The World Today: “Call to drop baby bonus”, an interview with Andrew Leigh

Peter Martin: “Tuesday column: Axe the baby bonus”

etfb: “If Only Erudito Were Into Chicks…”

Joyous Birth: “Baby bonus leading to fatter kids: economist”

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[H/T to baroquestar, who summed this up so much more succintly than I: “hilarious bollocks”.]

Categories: economics, gender & feminism, health, medicine

Tags: baby bonus, C section, cesarean, childhood obesity, health outcomes, moral panics, reproductive justice