Economic evaluation of elective cesarean versus vaginal delivery on cost of future pelvic floor disorders in the United States

Abstract

Aim: To analyze the cost impact of cesarean versus vaginal delivery in the United States on the development of stress urinary incontinence (SUI) and pelvic organ prolapse (POP). Methods: We compared average cost of delivery method to the lifetime risk and cost of pelvic floor disorders (PFDs) in women < 65 years. Costs of maternal care, obtained from the MarketScan® database, included those incurred at delivery and 3 months post-partum. Future costs of PFDs included those incurred after delivery up to 65 years. Previously reported data on the prevalence of POP and SUI following cesarean and vaginal delivery was used to calculate attributable risk. An incremental cost of illness model was used to estimate costs for SUI. Direct surgical and ambulatory care costs were used to determine cost of POP.

Ethical Issues Which Have Prevented the U.S. from Maximizing Quality of Life Years

“…An example is the increase in the United States of C-section deliveries, compared to vaginal births, which rose from ~20% in the late 1990s to over 30% 15 years later [51]. In 2010 cesarean deliveries were 40% more expensive than vaginal deliveries, $9,905 versus $7,089 respectively [52]. Cesarean deliveries can reduce the incidence of pelvic floor disorders…”

Relationship between abnormal pelvic floor electromyography and obstetric factors in postpartum women: a cross-sectional study

“…[ 4 – 6 ]. According to Kuhlmann et al, the absolute risks of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) after cesarean section are estimated to be 7% and 5%, respectively, and 13% and 14% after vaginal delivery, respectively [ 7 ]. However, we still don’t know much about the relationship between exposure of various obstetric delivery activities as well as the course and progress of pelvic floor diseases in women’s lives.…”