Hospital Stay After Having a Baby

Is there a right time to leave?

USA, Utah, Salt Lake City, Portrait of newborn girl (0-1months) with mother
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Having a baby is a miracle. But the length of stay in your hospital or birth center after giving birth has been a long-standing battle. The good news is that the current recommendation by the American Academy of Pediatrics (AAP) is that it shouldn't be one size fits all. Your medical team should evaluate you and your baby together to determine when you are ready to go home.

History of Hospital Stays After Birth of Healthy Newborns

The length of hospital stays for mothers and their newborns declined steadily from the 1970s until the 1990s.

Many hospitals implemented early newborn discharge policies in the 1990s and most mothers were discharged 24 hours after delivery. 

By 1996, most states and the U.S. Congress passed a laws to ensure a woman could stay in the hospital 48 hours after an uncomplicated vaginal birth and 96 hours after an uncomplicated cesarean section. Health plans and HMOs were required to cover this length of stay and not give incentives or disincentives to discharge you earlier.

The Newborn's and Mothers' Health Protection Act was applauded by many women, but others wanted to maintain their rights to go home as soon as possible after having a baby. Some birth centers routinely send mothers and their newborns home after a mere six to eight hours. These mothers are prepared, know ahead of time, and welcome the early discharge.

Discharge Timing Should Meet Individual Needs

A study showed that the problem is not necessarily how long women are or are not staying postpartum but that maternity care systems often use a one size fits all policy when it comes to how long mothers and babies stay after birth.

A study published in 2007 found that 17 percent of mothers were not ready to leave the hospital at the time of discharge. Some mothers are ready to go home in far fewer than 48 hours, while others mothers need more time.

The American Academy of Pediatrics published a Safe and Healthy Beginnings toolkit with a discharge-readiness checklist to be used by doctors to prepare the mother and baby for discharge.

Factors that can influence the need to spend more time in the hospital can include:

  • Having a baby for the first time
  • Insufficient education on breastfeeding or baby care
  • Giving birth during non-routine hospital hours
  • Having a chronic condition or complicated birth
  • Less or inadequate prenatal care
  • Certain ethnicities

The AAP recommendations are that women and their care practitioners have a say in the length of time they stay in the hospital. Giving a family a say in how much help they need, can make the difference in women and babies being healthier and getting the proper support postpartum. Factors that must be considered include the medical condition of the mother and infant, that the mother has confidence in her ability to care for her infant, that she has adequate support systems at home, and that she will be able to get appropriate follow-up care. They also emphasize that the mother and baby should be discharged at the same time.

The AAP recommendations call for institutions to develop policies that will implement these guidelines so care can be individualized without a struggle.

Sources:

Bernstein HH, et. al. Decision-Making for Postpartum Discharge of 4300 Mothers and Their Healthy Infants: the Life Around Newborn Discharge Study. Pediatrics. 2007 Aug;120(2):e391-400. Epub 2007 Jul 16.

Technical Report: Hospital Stay for Health Term Neonates. Pediatrics. 2010;125(2):405–409. Reaffirmed October 2014

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