An analysis of the economic implications of elective induction of labour at term

Summary The economic implications of induction of labour were assessed by scrutinizing the case records of 228 women who participated in a randomized controlled trial. The trial group of 111 women who had elective induction of labour performed at between 39 and 40 weeks was compared with 117 controls who were managed expectantly until 41 weeks. The trial and control groups had induction rates in excess of 90 per cent and 45 per cent respectively. As approximately 50 per cent of the total hospital population was excluded from the study, however, the figures when expressed as a percentage of the hospital population would reflect induction rates of approximately 45 per cent and 23 per cent respectively for the alternative management approaches. The only economic resources used more frequently by the trial group were those associated with the induction procedure itself. The patients managed expectantly required significantly more subsequent visits to the antenatal clinic but the additional costs were insignificant when related to total expenditure. Induction of labour did not increase the use of paediatric facilities or prolong postpartum stay in hospital. The patients in the trial group had significantly fewer procedures performed on them during the hours between 1 a.m. and 9 a.m. but the changes were insufficient to lead to cost saving. It was concluded that decisions to induce labour or to manage patients conservatively had negligible economic consequences.