Purpose <p>Labor analgesia is recommended for pain relief during childbirth. In settings with limited medical resources, elective induction with epidural analgesia is often adopted; however, this may increase healthcare costs and prolong hospitalization. The impact of different approaches to labor analgesia on delivery-related charges, epidural-to-delivery interval, and hospitalization remains unclear.</p> Methods <p>This retrospective study evaluated 252 full-term pregnant women who received epidural labor analgesia at a Japanese university hospital. Parturients were categorized into elective induction (EI) and on-demand (OD) groups. Inverse probability of treatment weighting with stabilized inverse propensity scores was applied to minimize bias. After adjusting for patient data, the mean ratios of the outcomes of interest for EI and OD were estimated using a generalized estimating equation. The primary outcome was delivery-related charges, while secondary outcomes included epidural-to-delivery interval and length of hospital stay.</p> Results <p>Among eligible parturient, 62.3% (157/252) underwent EI, while 37.7% (95/252) received OD. After weighting, the mean delivery-related charges, epidural-to-delivery interval, and length of hospital stay were 621,380 yen, 37.0&#xa0;h, and 7.5&#xa0;days in the EI group, compared with 594,408 yen, 14.6&#xa0;h, and 6.5&#xa0;days in the OD group, respectively. The mean ratios (95% confidence interval) for delivery-related charges, epidural-to-delivery interval, and length of hospital stay were 1.04 (0.98, 1.10), 2.52 (1.90, 3.20), and 1.15 (1.08, 1.22), respectively.</p> Conclusion <p>Elective induction with epidural labor analgesia was associated with longer labor duration and hospital stay, while no statistically significant difference in delivery-related charges was observed compared with the on-demand approach.</p>