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External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
Does a Cesarean section delivery always cost more than a vaginal delivery?
Vahé A Kazandjian1, C Patrick Chaulk, Sam Ogunbo
1LogicQual Research Institute, Elkridge, MD 21075, USA. vkazandjian@mhaonline.org
Journal of Evaluation in Clinical Practice
|February 9, 2007
Summary
Average total charges for vaginal births with neonatal intensive care unit (NICU) stays may exceed those for Cesarean sections with NICU stays. Managing maternal comorbidities during prenatal care could reduce NICU admissions and associated costs.
Area of Science:
- Obstetrics and Gynecology
- Health Economics
- Neonatal Care
Background:
- Cesarean section rates are increasing globally and in the USA.
- Limited research exists on the clinical, demographic, and economic differences between Cesarean and vaginal deliveries.
- This study investigates the economic consequences, including total hospital charges and neonatal intensive care unit (NICU) length of stay, comparing Cesarean and vaginal birth episodes.
Purpose of the Study:
- To compare the total hospital charges and NICU utilization for Cesarean sections versus vaginal deliveries.
- To identify factors influencing birth episode costs, such as maternal characteristics, mode of delivery, and NICU admission.
- To inform healthcare policy and obstetrical practices regarding the cost-effectiveness of different delivery methods.
Main Methods:
- A retrospective chart review was conducted in three urban Baltimore hospitals in 2004.
- 1172 randomly selected mother-child hospital records were analyzed.
- Data extracted included maternal comorbidities, age, infant weight, NICU transfers, and economic charges.
Main Results:
- Average total charges for vaginal deliveries with NICU utilization ($17,624.38) were higher than for Cesarean sections with NICU utilization ($13,805.47).
- African American maternal race was indirectly associated with higher overall charges via delivery mode and NICU utilization.
- Maternal comorbidities (Herpes Simplex Virus, hypertension, diabetes) influenced infant hospital and NICU charges for both delivery types.
Conclusions:
- Vaginal deliveries, particularly those requiring NICU care, may incur higher total charges than Cesarean sections requiring NICU care.
- Prenatal management of maternal comorbidities can potentially decrease newborn NICU transfers, reducing length of stay and associated costs.
- Healthcare policies and obstetrical practices should not universally assume Cesarean sections are more expensive than vaginal deliveries.
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