Trial of labour versus elective repeat caesarean section:A cost-effectiveness analysis

Abstract

For subsequent births, women who have experienced previous caesarean section facea choice between elective caesarean section and trial of labour. The study reported inthis paper utilises Australian hospital data to compare birth outcomes and healthsystem costs of these two options. Although trial of labour is more expensive if the resultis an emergency caesarean section, high rates of successful vaginal delivery mean that,overall, trial of labour is found to be 30- per cent less expensive than elective caesareansection. It is estimated that trial of labour remains the most cost-effective option aslong as less than 68- per cent of women require emergency caesarean section. This studyhighlights the potential importance of more accurate information about a broaderrange of costs and outcomes in order for stronger conclusions to be drawn.