Early Hospital Release for New Mothers

In this era of downsizing and cost-cutting even childbirth is taking a hit.

In what some complain is an attempt by insurance companies to save money, a trend toward earlier release of new mothers from hospitals has begun. Women are being discharged as early as eight hours after giving birth.

Social activists complain that these new policies are particularly harmful to poor mothers released without the proper support and guidance. A bill before the state Legislature would require a 48-hour hospital stay for new mothers.

Critics complain that such a bill is an unnecessary government intervention and that mothers should be allowed to go home early because of the convenience and ease for mother and child.

When should new mothers be released from the hospital?

John Medders, chief of obstetrics and gynecology, Kaiser Foundation Hospital in Woodland Hills:

“We don’t send a patient home in less than 24 hours without an assessment as to whether they need home health care follow-up. Not everyone is a candidate to leave in 24 hours . . . I support families going home who can go home. You must look at the readmission rate [for medical problems] of babies going home. It is extremely low. It may be in the 1% or 2% range . . . We have a lot of patients who want to go home early. There are patients who have children at home. There are patients who prefer to be in the comfort and convenience of their own home. . . . The days spent in a hospital are costly, but that’s not what drives it. The driving force is to keep the mother and babies in an environment that is safer.”

Michael Broder, resident in obstetrics-gynecology at UCLA Medical Center and Olive View-UCLA Medical Center:

“Sometimes the patients will have a delayed onset of the ability to breast feed, where if they are in the hospital, they could have the support they need. There could be a delayed hemorrhaging, or a condition of high blood pressure that usually happens before delivery can happen late. These are the kinds of things that people need to study in a more controlled environment . . . The length of stay . . . is approaching the point that it’s not enough to see what’s happening . . . There are certain cases when the patient might prefer it . . . But as a blanket policy, it’s not a good policy.”

Kit Costello, president of California Nurses Assn.:

“First of all, I really dispute the control of costs issue . . . Many [hospitals] are sitting on large reserves. . . . We’re finding, frankly, there is a lot of pressure on when to release them. We are putting them out of recovery too soon.”

Lynn Kersey, director of Maternal and Child Health Access:

“The woman and her provider need to make the decision and not the hospital by any economic concern. [The legislation] would cover it pretty much for most situations in normal births. Forty-eight hours should be considered adequate.”

Dr. Chuie Yuen, chief medical officer and vice president of Cigna Healthcare of Southern California:

“Our answer to the decision of when to leave a hospital is entirely up to the attending physician and the mother. While many women and infants are ready to leave the hospital after 24 hours, we do not question the judgment of our doctors . . . At Cigna there is no special program in which we are rewarding those who are released early.”