|Benefit-Cost Summary Statistics Per Participant|
|Taxpayers||$86||Benefits minus costs||($277)|
|Participants||$0||Benefit to cost ratio||($0.03)|
|Others||$0||Chance the program will produce|
|Indirect||($92)||benefits greater than the costs||1 %|
|Net program cost||($270)|
|Benefits minus cost||($277)|
|Detailed Monetary Benefit Estimates Per Participant|
|Benefits from changes to:1||Benefits to:|
|Health care associated with Cesarean sections||$86||$0||$0||$43||$128|
|Adjustment for deadweight cost of program||$0||$0||$0||($135)||($135)|
|Detailed Annual Cost Estimates Per Participant|
|Annual cost||Year dollars||Summary|
|Program costs||$257||2014||Present value of net program costs (in 2018 dollars)||($270)|
|Comparison costs||$0||2014||Cost range (+ or -)||10 %|
|Estimated Cumulative Net Benefits Over Time (Non-Discounted Dollars)|
|The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in non-discounted dollars to simplify the “break-even” point from a budgeting perspective. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.|
|Meta-Analysis of Program Effects|
|Outcomes measured||Treatment age||No. of effect sizes||Treatment N||Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis||Unadjusted effect size (random effects model)|
|First time ES is estimated||Second time ES is estimated|
Campbell, D.A., Lake, M.F., Falk, M., & Backstrand, J.R. (2006). A randomized control trial of continuous support in labor by a lay doula. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35(4), 456-464.
Gagnon, A.J., Waghorn, K., & Covell, C. (1997). A randomized trial of one-to-one nurse support of women in labor. Birth, 24(2), 71-77.
Gordon, N.P., Walton, D., McAdam, E., Derman, J., Gallitero, G., & Garrett, L. (1999). Effects of providing hospital-based doulas in health maintenance organization hospitals. Obstetrics & Gynecology, 93(3), 422–426.
Hodnett, E.D., Lowe, N.K., Hannah, M.E., Willan, A.R., Stevens, B., Weston, J.A., . . . Nursing Supportive Care in Labor Trial Group. (2002). Effectiveness of nurses as providers of birth labor support in North American hospitals: a randomized controlled trial. Jama, 288(11), 1373-1381.
McGrath, S.K., & Kennell, J.H. (2008). A randomized controlled trial of continuous labor support for middle-class couples: Effect on cesarean delivery rates. Birth, 35(2), 92-97.