Childbirth Complications Boost Hospital Costs by 20%

Rise in childbirth complications is increasing overall hospital costs. But US hospitals could save nearly 20 percent of these costs by addressing serious conditions linked to preventable harm and preexisting chronic conditions, according to a recent Premier report. 

The report examined childbirth hospital costs from 2008 through 2018 and how the costs varied for providing childbirth care for women who experienced complications or had pre-existing conditions and uncomplicated procedures. Uncomplicated vaginal delivery cost nearly $5,700, while cesarean delivery was about $8,500, Premier stated.

Overall, complications added on an average 20 percent to the costs to the hospitals to perform a vaginal delivery and 23 to the cost to perform a cesarean. 

More specifically, the report found that vaginal delivery with severe maternal morbid (SMM) – the most serious type of childbirth complication – cost hospitals 88 percent more to perform compared to an uncomplicated delivery, and hospitals saw a 111 percent rise in costs for a cesarean with SMM. Women who experienced SMM factors in the hospital had a 70 to 75 percent longer stay than those with uncomplicated deliveries.

In addition, obesity, behavioral health disorders, diabetes, and chronic pain were reported to add between 11 to 36 percent to hospital costs compared to uncomplicated vaginal and cesarean deliveries.

The findings indicate a need to approach childbirth differently at hospitals to avoid excess hospital costs, especially as the number of pregnant women presenting with chronic conditions, SMM factors, and other symptoms leading to complications increases, said Deb Kilday, MSN, who leads Premier's Women, Infants and Children Service Line.

“Mothers and their babies are arguably our most important population. When providers are armed with the tools to identify pre-existing conditions and early warning signs, and commit to providing highly reliable care, they raise the quality of care for mothers and babies,” she said in a press release. 

“This analysis clearly demonstrates a need to approach labor and delivery with standardized, coordinated care practices in order to better identify and manage potential complications, reduce costs and, most importantly, help mothers recover faster,” she continued. “This is why Premier is working across its alliance of hospitals and health systems to improve maternal outcomes and overall healthcare quality – and subsequently bring down the ever-rising cost of having a baby.”

In order to successfully decrease childbirth costs, hospitals can work across provider networks to ensure care before childbirth and standardize processes to identify and prevent labor and delivery complications.

“Today’s maternal patient population has more complex conditions than previous years. By identifying cases that are at higher risk of complications during delivery and ensuring evidence-based practices are in place to prevent them, we can make a real impact on maternal harm and mortality,” Kilday emphasized. “Both providers and patients stand to benefit, not only in terms of outcomes, but also cost, efficiency and experience.”

New childbirth care standards could not only benefit patient outcomes, but also their wallets, according to a new Health Affairs analysis.

Researchers from the University of Michigan found that average out-of-pocket spending for maternity care rose among women with employer-based insurance. The analysis studied data from 657,061 women who were enrolled in 84,178 employer sponsored plans from 2008 to 2015.

This increase was primarily driven by a rise in spending among women with deductibles, researchers found. Out-of-pocket spending was higher for lower-income working women in 2008 through 2013, but discrepancies disappeared in 2014 to 2015 due to a continued rise in spending among higher-income working women. Specifically, out-of-pocket spending for vaginal birth increased from $2,910 to $4,314, and for a cesarean birth, patient expenses increased from $3,364 to $5,161. 

Although out-of-pocket costs rose during the study period, the standardized cost of maternity care saw little changes. Vaginal birth was $24,317 in 2008 versus $23,148 in 2015, and cesarean birth saw $39,702 in 2008 compared to $43,774 in 2015.

Overall, women paid more in standardized maternity care costs in 2015 than in 2008. Vaginal birth was at 13.6 percent versus 21.7 percent and cesarean birth was 10.0 percent versus 14.6 percent.