Pelvic floor complications: elective c-sections may be cheaper in the long run.(Obstetrics)

NEW ORLEANS -- Elective cesarean section may actually be the most cost-effective mode of delivery for primigravidas when taking into account the expense of long-term pelvic floor complications that can occur after vaginal birth, Dr. Nora M. Doyle reported in a poster presentation at the annual meeting of the Society for Maternal-Fetal Medicine.

"Of course, women need to be aware that this is surgery and that any surgery is serious," Dr. Doyle, of the University of Texas, Houston, said in an interview. "It takes longer to recover from than [does] vaginal birth, and there can be complications."

Dr. Doyle's cost-benefit analysis compared the strategies of vaginal delivery, cesarean section reserved for indications, and elective cesarean delivery. The analysis assumed a spontaneous vaginal delivery rate of 75%, an operative vaginal delivery rate of 10%, and a cesarean-after-labor rate of 15%.

A vaginal delivery was priced at $780, an operative vaginal delivery at $810, a cesarean delivery after labor at $1,240, and an elective cesarean at $920.

Dr. Doyle then figured in the cost of short- and long-term complications: $360/day for short-term complications extending hospital stay and $700/year for 20 years of long-term complications, including incontinence.

In patients delivering their first baby, elective cesarean was the most cost-effective ...