The Effect of Co-Payments on the Take-Up of Prenatal Tests

Prenatal screening tests can identify genetic disorders in a fetus, but their take-up remains low in several countries. Using a Regression Discontinuity Design, we test the causal effects of a policy that eliminated co-payments for noninvasive prenatal screening tests in Italy. We find that the policy increases the probability of pregnant women’s undergoing prenatal tests by 7 to 10 percentage points, and the effect varies by socioeconomic status. We do not find evidence of substitution effects with invasive tests or that the tests affect the termination of a pregnancy and newborn health. We do find evidence of positive effects on mothers’ health behaviors during pregnancy.