Do Mothers Decide? The Impact of Preferences in Healthcare Jostein Grytten Irene Skau Rune Sørensen ABSTRACT In this study we analyze whether immigrant mothers in Norway can influence their mode of delivery. Patient preferences were measured as the rate of Caesarean section from their home country, and by a survey question measuring the extent to which people believe they have freedom of choice and control over their lives in their home country. Preferences have a causal effect on the likelihood of Caesarean section. Medical risk factors are still the most important reasons for having a Caesarean section, but our regression estimates show that a substantial share of Caesarean sections is due to preferences as well. I. Introduction Almost nothing is known about the influence that patients have on medical treatment. For many types of treatment, physicians are expected to discuss op- tions with their patients, and allow patients to influence choice of procedure. Assessing the influence of patients is methodologically challenging. Our interest was triggered by the current debate about the position of mothers in maternity care, and whether they can request a Caesarean section in the absence of clinical indications (Wax et al. 2004, Young 2006). This topic has received a great deal of attention, partly because it highlights the Jostein Grytten is professor in community dentistry at the Faculty of Dentistry, University of Oslo, and a researcher in the Department of Gynecology and Obstetrics, Akershus University Hospital. Irene Skau is a researcher in community dentistry at the Faculty of Dentistry, University of Oslo. Rune Sørensen is profes- sor of political economy at BI Norwegian Business School, Oslo. This study received financial support from the South-Eastern Norway Regional Health Authority (research grant number 2709002), and was approved by the Regional Committee for Medical and Health Research Ethics. The authors wish to thank Linda Grytten for translation and language correction, and the Medical Birth Registry of Norway and Statistics Norway for providing the data. The data used in this article can be obtained beginning July 2013 through June 2016 from Jostein Grytten, josteing@odont.uio.no. [Submitted July 2011; accepted March 2012] SSN 022 166X E ISSN 1548 8004 8 2013 2 by the Board of Regents of the University of Wisconsin System THE JOURNAL OF HUMAN RESOURCES  48  1