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For subsequent births, women who have experienced previous caesarean section face a choice between elective caesarean section and trial of labour. The study reported in this paper utilises Australian hospital data to compare birth outcome and health system costs of these two options. Although trial of labour is more expensive if the result is 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 caesarean section. It is estimated that trial of labour remains the most cost-effective option as long as less than 68 per cent of women require emergency caesarean section. This study highlights the potential importance of more accurate information about a broader range of costs and outcomes in order for stronger conclusions to be drawn.

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