The economic costs of alternative modes of delivery during the first two months postpartum: results from a Scottish observational study.

A study was conducted to estimate the economic costs of alternative modes of delivery during the first two months postpartum. Hospital and community health service utilisation data for 1242 women were extracted from self-completed questionnaires, medical case notes and computerised hospital discharge records. Unit costs (1999-2000 prices) were collected for each item of resource use and combined with resource volumes to obtain a net cost per woman. There were significant differences in initial hospitalisation costs between the three mode of delivery groups (spontaneous vaginal delivery pounds sterling 1431, instrumental vaginal delivery pounds sterling 1970, caesarean section pounds sterling 2924, P < 0.001). There were also significant differences in the cost of hospital readmissions, community midwifery care and general practitioner care between the three mode of delivery groups. However, total post-discharge health care costs did not vary significantly by mode of delivery. Total health care costs were estimated at pounds sterling 1698 for a spontaneous vaginal delivery, pounds sterling 2262 for an instrumental vaginal delivery and pounds sterling 3200 for a caesarean section (P < 0.001). It is imperative that hospital and community health service providers recognise the economic impact of alternative modes of delivery in their service planning.