Average charges for uncomplicated vaginal, cesarean and VBAC deliveries: regional variations, United States, 1996

Average charges during 1996 among women insured under MetraHealth group health contracts were analyzed for three methods of childbirth. Among the 40,697 study women who had an uncomplicated vaginal birth with no prior cesarean the total charge to insurance was $7,090. For the 10,305 study women who had a cesarean delivery, the average charge totaled $11,450, in comparison with the 887 women who had a vaginal birth after a previous cesarean (VBAC), whose average charge was $7,730. The Pacific and Middle Atlantic regions reported higher-than-average charges for each of the three delivery methods, whereas the New England area had higher-than-average charges for both vaginal methods of delivery but charges just below the norm for cesarean births. New York and New Jersey had the two highest total charges as well as the two highest average charges by physicians for each method of delivery. North Carolina and Indiana had the lowest charges for vaginal births, Tennessee and Ohio had the lowest cesarean charges and Ohio and Washington reported the lowest total VBAC charges. Ancillary fees accounted for just under two-thirds of the total hospital charges for all three birthing methods. Women with an umcomplicated vaginal delivery. remained in the hospital, on average, for 1.71 days, those with a cesarean birth for 3.01 days and those undergoing a VBAC for 1.76 days. By insurance coverage, the women with an indemnity plan had the longest hospital stays across each method of delivery. Women in HMOs had the shortest average length of stay (ALOS) for routine vaginal as well as cesarean deliveries, while the VBAC women with point-of-service coverage had the shortest ALOS.