title: Active management of labor: a cost analysis of a randomized controlled trial.
abstract: OBJECTIVE
  To compare the costs of a protocol of active management of labor with those of traditional labor management.
  
  
  METHODS
  Cost analysis of a randomized controlled trial.
  
  
  METHODS
  From August 1992 to April 1996, we randomly allocated 405 women whose infants were delivered at the University of New Mexico Health Sciences Center, Albuquerque, to an active management of labor protocol that had substantially reduced the duration of labor or a control protocol. We calculated the average cost for each delivery, using both actual costs and charges.
  
  
  RESULTS
  The average cost for women assigned to the active management protocol was $2,480.79 compared with an average cost of $2,528.61 for women in the control group (P = 0.55). For women whose infant was delivered by cesarean section, the average cost was $4,771.54 for active management of labor and $4,468.89 for the control protocol (P = 0.16). Spontaneous vaginal deliveries cost an average of $27.00 more for actively managed patients compared with the cost for the control protocol.
  
  
  CONCLUSIONS
  The reduced duration of labor by active management did not translate into significant cost savings. Overall, an average cost saving of only $47.91, or 2%, was achieved for labors that were actively managed. This reduction in cost was due to a decrease in the rate of cesarean sections in women whose labor was actively managed and not to a decreased duration of labor.
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque 87131, USA. rrogers@obgyn.unm.edu
authors.forename: R G
authors.initials: RG
authors.lastname: Rogers
authors.forename: M O
authors.initials: MO
authors.lastname: Gardner
authors.forename: K J
authors.initials: KJ
authors.lastname: Tool
authors.forename: J
authors.initials: J
authors.lastname: Ainsley
authors.forename: G
authors.initials: G
authors.lastname: Gilson
mesh_terms: D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000191:economics* / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors