Early Release of Mom's and Infants

Specialties Ob/Gyn

Published

I am requesting that any one who works at a facility that releases early, i.e. 6 hours or less, please contact me. I am researching to create a policy at the facility currently working. We have had a rash of expectant mom's who want to go home in 2 - 4 hours after birth with infants.

Any help would be appriciated.

kelly

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I have two teens, and I kept them in my room. The nurses knew I was breastfeeding, and never asked about taking them out of my room.

Specializes in Nurse-Midwife.

I think the policy would need to include a provision for 24-36 hour follow up (in home is always nice!). Also there needs to be clear education on self care in the first 24 hours, warning signs for mom and infant - and a contact person to address any questions or concerns the parents may have in that first 24 hours - preferably not some random telephone nurse triage line.

I think early discharge is appropriate in certain situations, but hospital-based practices are not very good at providing home-based follow up. There need to be good resources for these patients who are discharged early.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I could t imagine discharging 2-6 hours after labor! I'm not a fan of the hospital but after I had my son I wasn't ready to go home that soon. I had already been in the hospital 6 days by the time I delivered, 7 days by the time I was discharged.

Specializes in Med-Surg, OB, ICU, Public Health Nursing.

Years ago we saw Moms and babes being pushed out way too early. Eventually government became involved and required insurance companies to authorize a minimum length of stay. The exception is if Mom and Medical Provider agree to early discharge.

http://www.ncsl.org/research/health/final-maternity-length-of-stay-rules-published.aspx

I do billing for homebirths so I usually get the while maternity coverage run down. Many insurances will authorize a home visit if there is an early discharge. If I God forbid have to birth in a hospital again I would definitely see myself trying to check out after 4 hours, I wanna be in my comfortable bed with my own blankets and good food, lol.

Specializes in Nurse-Midwife.

I don't think the OP was talking about making all women go home early from the hospital - but was asking about policies for those women who would want to be discharged within hours of birth.

Then the re-admission rates will sky rocket, and guess who is going to eat that entire hospital bill ( before, after and re-admission stay ) the hospital. If you want to leave 2-4 hours after delivery, either have your baby at home, or at a birthing center.

In Australia we have a growing number of mums who leave at the 4-6 hour mark, but they are followed up by a community or domicillary midwife at home. To discharge they have to meet certain criteria, usually an uncomplicated delivery. We haven't seen an increase in readmissions. Many mothers find it more pleasant to be home. Having said that there is still a number of mums that stay longer, but we seem to have much shorter postnatal stays, usually 24-48 hours for a NVD or 3-5 days for a LSCS (Tending more towards the 3 days). But most women (if they choose) by a midwife at home for between 2-6 weeks. We also have, at least in my state a child and family health nurses who mums can access after the midwives finish.

Specializes in OB.
Then the re-admission rates will sky rocket, and guess who is going to eat that entire hospital bill ( before, after and re-admission stay ) the hospital. If you want to leave 2-4 hours after delivery, either have your baby at home, or at a birthing center.

Just curious, what do you feel will be the cause of "skyrocketing" readmissions in women who meet criteria to be discharged early?

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Then the re-admission rates will sky rocket, and guess who is going to eat that entire hospital bill ( before, after and re-admission stay ) the hospital. If you want to leave 2-4 hours after delivery, either have your baby at home, or at a birthing center.

Delivering at home or at a birth center is not often a viable option for many women, in many communities. MANY communities do not have FSBCs, or good homebirth midwife options, and a hospital is the only option, short of moving to a different city for 6 months.

I think it's perfectly valid to want to go home shortly after delivery in a low risk dyad. In many instances, it would avoid interventions and distractions that can sabotage breastfeeding and healing. I think it would be ideal to have an infrastructure in place where these mothers/babies could be visited at home by a home-health nurse at, say, day 2 and day 7.

Specializes in Community, OB, Nursery.
I think it's perfectly valid to want to go home shortly after delivery in a low risk dyad. In many instances, it would avoid interventions and distractions that can sabotage breastfeeding and healing. I think it would be ideal to have an infrastructure in place where these mothers/babies could be visited at home by a home-health nurse at, say, day 2 and day 7.

I think home f/u is key as well. Depending on if it's 1st baby or 4th, if mom is breastfeeding, what kind of delivery, etc. I think algorithms could be set up depending on each dyad's clinical picture that would inform follow-up.

Specializes in Eventually Midwifery.

Anecdotal, I know, but I had my son in a hospital and was begging to go home in 10 hours and was finally let go at just over 24 hours. Later, I had my daughter at a FSBC and was home 4 hours later nursing my baby. They did do a F/U 24 hours in my home and there was plenty of Pt education. I was much, much happier with that experience over my first. Why not discharge early if mom/baby are healthy? It was so much more comfortable to take care of my baby with my own stuff in my own environment.

+ Add a Comment