Childbirth Effects of the 2004 Indian Ocean Tsunami

This paper evaluates the effect of in utero exposure to the 2004 Indian Ocean Tsunami on birth outcomes in Indonesia. Exploiting variation in the timing of exposure, we find that the probability of a successful pregnancy drops by 5.4 percentage points (pp), while miscarriages increase by 5.0 pp for those exposed in the first trimester of pregnancy. Gestation length shortens by 0.28 months, and the likelihood of preterm birth rises by 5.4 pp. We find suggestive evidence that post‐disaster health investments by households may have shielded later cohorts from harmful effects, while measures of maternal health and socioeconomic status have limited explanatory power. Our results suggest the importance of considering fetal loss as a first‐order cost in natural disasters and highlight that facilitating household investment in health through various policies may mitigate negative birth effects in the aftermath.