Fobelets M, et al. - As a part of OptiBIRTH project, a health economic evaluation on mode of birth was challenging, especially in the context of a multi-country study. Hence, researchers performed an analysis of a hypothetical cohort estimating the costs and health effects of vaginal birth after caesarean section (VBAC) compared to elective repeat caesarean delivery (ERCD) for low-risk women in 4 European countries prior to developing a robust standardised model to conduct the health economic analysis. As per findings, VBAC was cost-effective in all four countries compared to ERCD for low-risk women. Findings seem to be significant for health service managers, economists and policy makers concerned with maximising health benefits within limited and constrained resources.