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c section question

Posted

Specializes in MS Home Health.

My niece was in Florida and gave birth, pit did not help so she had an emergency c section. After 24 hours they demanded she go home, baby not nursing right, no bm and very uncomfortable with gas and surgical pain and she is living in a motel (long story).

I think that is way to soon. Is it nowadays? I am just getting back into acute care after a 10 year hiatus and I have never done OB. I just wanted to know if this is standard practice?

Yes she has insurance. I told her if she is not ready she can call her insurance company and find out if they are pressuring the hospital to get her out and if she feels she is not ready she can ask for another day. When I had my hysterectomy the Dr/hospital wanted me to do it outpatient which I am glad I did not as I had complications and ended up staying for three days. My Dr. and I called the insurance company and got it approved.

renerian

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

Two days are the MINIMUM after a C/S where I live, and it's usually three. I don't know if insurance companies have rules about that, but it's common practice....the doctors here don't like to discharge pts. until they've got good bowel tones and are able to pass flatus, and that just doesn't happen in 24 hours most of the time!

24 hours is ridiculous and most likely grounds for a lawsuit if anything went wrong. I have NEVER seen a mom d/c ed that soon after major abdominal surgery (cause that's what a c/section is!!!). I can't believe anyone would want you to do it as an outpatient either?! Please tell me where this is, so I know where not to go.

SmilingBluEyes

Has 20 years experience.

waYYYYYYYYYYYYYYYYYYYYYYYYY TOO DAMN SOON

regardless of time, no other criteria were met. lady can't move bowels or gas. baby is not eating well (even more important)!!

WOW---they are setting her and her baby up for multiple problems. This sounds like a shoddy place. OUR sections stay no less than 48 hours, and more if nursing or baby care are not proceeding normally.

WHO IS THERE TOHELP HER???? ANYONE????? was she given warning signs/symptoms of infection????? I can't believe this, either. I am disgusted. SOMEone has gone too far to save a buck or two.

OMG!!!

Wow, this is pretty scary! Usual stay at our for C-section is 3-4 days, 2 under unusual circumstances i.e. baby transported to another facility and mother is stable. Is there home care f/u? I just wondered what AWOHNN says about recommendations? I'll have to look up-what is the standard of care?

YIKES!!! 48-72 hrs. is standard here. We even see an occasional 96 hr. stay w/ a few of the insurance plans. Really it is awfully soon. Once in awhile we see self-pays (usually Mennonite pt's) go home 24 hrs. post-op c/s. They have great support systems, though. I feel very sad for your niece. She is probably exhausted and her head is spinning. Lack of support is a prime set-up for post-partum depression along w/ all of the other problems the other posts already mentioned. A friend of mine works in Orlando and they are so very busy that as soon as a labouring mom delivers, there is usually another ready to climb into her bed. They do 600+/deliveries per month.

renerian, BSN, RN

Specializes in MS Home Health.

Thanks everyone for posting. Her mom went down there to stay until Sunday( she left last night). This is a hospital in Lakeland I think. I have the name but am reluctant to list it.

I told my sister last night to get the number of her insurance company and call them, call the DR. and anything else you can do to keep her until at least 72 to 96 hours. Your right on saving a buck.

I thought it was horrible too. I cannot remember who sent me the link on the website but I gave that information to my niece and sister as well.

Thanks again for responding. We all are specialists in what we do and I appreciate you all sharing with me in a field that is certainly not mine.

renerian

mother/babyRN, RN

Specializes in cardiac, diabetes, OB/GYN. Has 27 years experience.

Sounds VERY fishy to me..I hope you will keep us posted.

im an RN from Oz, most of our c sections stay in for 5 days ... certainly until babe is feeding well and mum can MOVE!! We have medicare here though, so everyone is entitled to basic health care and if you have private health insurance, reasonable cost, you can stay in for up to 7 nights for first time mum!

Renerian, I hope your niece is doing ok despite her bad experience. I would not name my friend's hopsital, but I wanted to make the point that there are some mega-sized ob units there in FL and pt's can easily get lost in the shuffle esp. WNL moms w/ WNL needs who haven't been id'd w/ problems by social work or high risk by their dr's or cnm's, but of course have the potential to have problems. I hate the birth factory revolving door mentality. Having a baby is such a signifigant experience, that no mom should be rushed or pushed along in an impersonal mega-system. I think there's many large units which do a good job w/ their pt's, but also many who just get 'em in and get 'em out, because there is no time or room for more personal care.

SmilingBluEyes

Has 20 years experience.

i agree with imenid. this sounds like a factory....not a birth place. and we wonder why so many fear the hospital birthing experience.just sickening.

I know everyone has already posted on this. But again where I worked in CA it was at the very very minimum 2 days, and that was even rare. Insurance out there covers a max of 4 days, unless mom is having severe medical problems, in which they will continue the stay. That is just ridiculous that they kicked her out sooner, and the sad thing is the dr. wrote the order, I would seek to question the dr before insurance companies......they don't call patient by patient and say so and so has to stay and so and so has to go. It starts with the dr.'s order and lastly the nurses should have reinforced the stay with not only the fact of a c/s but that the baby wasn't feeding well either.

tntrn, ASN, RN

Specializes in L & D; Postpartum. Has 34 years experience.

I work in Washington State, and c/s patients here are usually so happy to be going home on PO Day 2. Some need to stay longer and we have to convince them to stay and others must be pried from the bed, but most are ready to get that baby home.

It's hard for me to believe that ANY insurance companies pay for 5-7 days stays for a "routine" c/s mom and babe! Even if our babes are NICU babes, the moms are discharged at day 2 and provided a complimentary room on the floor, but with the understanding that the staff no longer is responsible for the mom's care. ..available for assistance with baby once it comes out to room in, but that's it. And if the room is needed for a patient, the room must be vacated.

Actually, our unit is not physically big enough to keep all the c/s moms 7 days! Around here you'll see new moms, including c/s moms out and about downtown the day after discharge, so I can't imagine keeping them hostage as a patient and tying up nursing hours.

This further emphasizes how different standards of care can be depending on where you live.

hi I'm not a nurse yet but I have had 3 friends in the past 2 years who have diff. insurances and delivered at the same local hospital and the stay for all 3 was 5 days! I stayed 2 days after delivery and it was fairly normal. I am shocked at this. I felt like a truck had hit me 24 hours after the vaginal birth and can only imagine how the surgery would feel. This seems completely wrong

Mimi2RN, ASN, RN

Specializes in NICU. Has 27 years experience.

Didn't we have a Federal Law passed a few years ago r/t early discharges? My understanding is that Insurance Companies MUST provide coverage of up to 48 hours post delivery for vaginal births, and 96 hours for c/s.

The law was passed because the ins companies were trying to limit coverage. If a mom is feeling fine, no problem, but 24 hours post c/s is ridiculous.

72 hours MINIMUM is the standard in Connecticut for a post c/section stay. I hope you are able to get some help for your sister. The fact that she is living in a hotel shoudl have sparked someone in Social Services to see her and make sure she is okay.

Sorry I said sister. I know it's your niece.

renerian, BSN, RN

Specializes in MS Home Health.

THank you everyone for posting. She did go home on day three less than three full days post op. She is miserable. My sister and my niece did not want to call the insurance company nor did they want me to call for them to go to battle. The baby is taking to a bottle now, only took to the breast once, her bowels moved and she is better but very tired.

I appreciate everyone's input.

renerian

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