Early Release of Mom's and Infants

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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 NICU, Trauma, Oncology.

I wish in home f/u was more of a "thing" in the states. It would be great on so many levels.

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Specializes in Eventually Midwifery.

Actually here in south carolina, all medicaid patients have the option to have a post partum home visit by a nurse. I wish all insurance providers would di that

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Specializes in Reproductive & Public Health.

If I had another hospital birth (my kids were born at home, the surrotwins I carried were born in the hospital), I would probably stay as long as they would let me because it would be a nice break from the craziness at home! But I also strongly understand the motivation to hurry up and get home, for many different reasons.

I agree that the key is making sure in-home follow up is available and accessible.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
If I had another hospital birth (my kids were born at home, the surrotwins I carried were born in the hospital), I would probably stay as long as they would let me because it would be a nice break from the craziness at home! But I also strongly understand the motivation to hurry up and get home, for many different reasons.

I agree that the key is making sure in-home follow up is available and accessible.

I was ready to get home after I had my son, but once I got home I wanted to go back! Haha.

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I delivered at a birth center and was released 6 hours after birth. It was wonderful. I think as long as baby is seen the next day or two it is safe for low risk situations.

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Infection rates for mom, PPH, pre-eclampsia, hyperbiliremia. Anything can go wrong after leaving 2-4 hours after delivery.

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Specializes in Nurse Leader specializing in Labor & Delivery.
Infection rates for mom, PPH, pre-eclampsia, hyperbiliremia. Anything can go wrong after leaving 2-4 hours after delivery.

Actually, infection rates would probably go DOWN by leaving early.

Hyperbilirubinemia - that's why prompt follow-up is needed for the infant - most infants have a 2-3 day f/u with ped in office, particularly after a 24-hour discharge, which many low-risk SVD moms get anyway.

PPH - the vast majority of PPH happens in the first hour after delivery. What percentage of PPH have you seen where the first sign was 6+ hours after delivery?

Pre-eclampsia - well, the risk for pre-eclampsia in general is about 7%, I believe. Of those 7% of cases, only about 5% develop it post-partum, with no previous risk factors. So out of 1000 pregnant women, only about 3-4 will develop pre-eclampsia postpartum. And of those 4 women, how many do you think had no previous risk factors? Probably even fewer. A woman who has risk factors for pre-eclampsia is probably not going to be a candidate for early discharge.

I think the benefits of early discharge outweigh the 0.3% risk of developing postpartum pre-eclampsia. And that's why good discharge instructions and, again, postpartum home nurse visits are so important.

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Specializes in Maternal - Child Health.

There are exceptions to every "rule," but in my experience, the parents who requested early discharge were usually very well educated and well prepared to take care of themselves and their newborns at home. Most had older children and had support at home.

That said, the biggest issue we had was getting an accurate newborn screening done. By law, our state required a newborn screening to be done prior to discharge from the birth facility. This applied to neonatal transports and early discharges alike. The thought process was that it was better to send in an invalid study that got the baby entered into the books, so to speak, which lessened the risk that a follow up screening would be overlooked. Arranging for the baby to be seen at 3 days of age or so, either with a home visit or in an office allowed for an accurate repeat newborn screening, as well as weight check and bili screen.

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Specializes in Nurse-Midwife.
There are exceptions to every "rule," but in my experience, the parents who requested early discharge were usually very well educated and well prepared to take care of themselves and their newborns at home. Most had older children and had support at home.

Well, for people who are well educated and prepared, it's called "early discharge" and for those people that are not, it's called "leaving AMA" and they're threatened with holding the baby until 24 hours of age, and/or sending social services after them for being unfit parents.

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I have a life so I'm not going to write a novel. I still stand by my opinion.

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Specializes in OB.
I have a life so I'm not going to write a novel. I still stand by my opinion.

So then I'm confused as to why you state people who want to leave the hospital early should have opted for a birth center or homebirth, if being sent home early is so inherently fraught with danger.

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Specializes in Nurse Leader specializing in Labor & Delivery.
I have a life so I'm not going to write a novel. I still stand by my opinion.

Yikes, just saw this. I have a life, too. And I took time out of it in order to give you some actual data and statistics.

On what is your opinion based, other than just...opinion?

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