The true relative financial cost of Planned Caesarean Birth (PCB) versus
Planned Vaginal Birth (PVB) in England for the year 2018/19 taking into
account litigation and compensation for harm: a sensitivity analysis.
OBJECTIVE: To determine the true financial costs of Planned Caesarean
Section and Planned Vaginal Birth in England for the year 2018/19 after
accounting for litigation and compensation for harm (LCFH) DESIGN:
Sensitivity analysis BACKGROUND: Average base costs per delivery
remitted to NHS maternity providers for Planned Caesarean Birth (PCB)
and Planned Vaginal Birth (PVB) in 2018/19 were £3,948 and £3,270
respectively leading to a perception that PCB is more costly than PVB.
Indemnity costs potentially related to planned mode of delivery,
however, add an average of £1,571/delivery to overall costs. METHOD:
Retrospective analysis of costs according to planned mode of birth was
performed based on data and previous research published by NHS
Resolution and NHS England. Weighting of results according to PCB and
PVB rates was performed in a manner similar to the sensitivity analysis
of PCB v PVB (without accounting for LCFH) performed by the National
Institute for Health and Care Excellence (NICE) in 2011 RESULTS:
Additional costs of LCFH resulted in revised costs of £4,245 and £5,030
for PCB and PVB respectively – a cost advantage of £785 per delivery in
favour of PCB. CONCLUSION: Providers should not be discouraged from
offering or women refused PCB on grounds of cost.