SO, who has actually left hospital early AMA?

[WindyCityMom]

I've asked tons of questions about this, but I'd like to hear your personal stories of leaving the hospital early postpartum AMA. What about your child? Did you sign them out AMA as well?

If I could afford it, I'd be homebirthing. My current situation is this: I would like to be out of the hospital before the 12 hour mark. Maybe around 6-12 hours, just so I can meet with the LC and get breastfeeding established since DD1 wasn't BFed (*cries*). I've spoken with two of the midwives in our practice (I think there are six or seven total that could potentially be at our birth).

How it went with Midwife #1: I told her that the PKU and bilirubin blood draws (which are mandatory at our hospital at 24hours) would be done with our family doctor 1-2 days after the birth. I told her that just as I do for the vaxes, I will have an exemption for those procedures. She said that that's fine, but no pedi will release the baby before then and that she won't release me before 24 hours.

How it went with Midwife #2: I asked her, and she said 24-48 hours. She told me that since our doc is with a diff. hospital, we would need an in-house pedi at this hospital to release the baby. She told me 24 is minimum for me, and no one will release the baby before I get the PKU and bilirubin (she kind of cut me off before I could explain my exemption stuff). She actually smirked at me and said, "24 hours- unless you'd like to stay the entire 48." She then said something about "it's not exactly 24hours". For instance- you birth your baby at 1am, you don't leave at 1am the next morning because they discharge in the mornings (I believe around 10-12ish). She said that then it would be pushed over a day because of the PKU and bilirubin, and then I mentioned our "prearrangement" to have it done in a few days. She ignored that, and said that it's at least 24 hours. So basically, to leave in 24 hours, I'd HAVE to have my baby at 10am-12pm the day before discharge. I can say that she is easily not my favorite midwife.

SO- it is looking more and more that I'll just say "see ya, bring me my AMA forms" and leave.

I have heard stories about people getting in trouble for this with CPS (or DCFS, as it is here in Chicago). I don't think I'd get in much trouble and I'd be able to fight it, since I'll have a note ahead of time from our family doctor. KWIM? I could always use that to back me up. (she's non-vax, extended breastfeeding, and homebirth supportive. she'd probably even get on the phone and speak with them).

I've ALSO heard about them not allowing the baby to go with you if you try to sign them out AMA. What is the deal with this? My baby, not yours, so why not? Could somebody please explain this part to me? Thanks in advance- a ton!

[Yew]

@}-`-}-,-'-

[jecombs]

I'm interested to hear others' experiences with AMA, too. I also want to leave the hospital ASAP after LO is born (I was thinking 6-12 hrs after the birth). I'd be having a HB if I could afford it.

[buckeye_bebe]

I left with my first early. There just wasn't any reason to stay in the hospital for the minimum that my insurance would cover. I got the baby checked out by the hospitalist pedi.

[WindyCityMom]

If there were any cause for concern with either the baby or myself I'd want us to stay. If everything is totally fine... then I don't see the need in staying.

[annekh23]

I did, but it was in England, so things might be a bit different. I'd been in hospital for a week before the birth and had a horrific time on the postnatal ward with my previous baby, so I was very clear with everyone right from the start that I was going straight home from the delivery unit. DD was born at 6.08pm on a Friday night. We got ready to leave and were told to wait until the paperwork was done, then about 5 hours after the birth a new midwife came and told us we had to stay in because there had been meconium in the waters, I protested and said I was going anyway, they said I'd have to sign that I was doing it against advice, so I did, there was some discussion about did I have to sign for the baby separately and they decided I didn't and off we went.

I found out later that the midwife had called social services, but they had ignored it, I also found out that the midwife then got a warning because she shouldn't have told us we couldn't go and I got an apology without even asking for it!

There was no bother about any tests, homebirths are relatively common in that area, so GPs and some midwives do newborn checks, so our GP came to our house to do it. They don't do the heelprick for PKU etc until day 7 anyway and again, a midwife came to our house to do it. Hearing screening only happens in the hospital on weekdays, so again, they have a community system for doing that and we were sent an appointment to go to a local clinic to get it done.

[caned & able]

My grandmother left the hospital within hours of birth in the days when women spent a week in the hospital after a normal birth. It was Mother's Day. She had no insurance.

[Lucky Charm]

You might want to check with your insurance to make sure they will pay your bill if you leave AMA.

Good luck!

[WindyCityMom]

Originally Posted by caned & able

My grandmother left the hospital within hours of birth in the days when women spent a week in the hospital after a normal birth. It was Mother's Day. She had no insurance.

That is truly inspiring

[zookeeper]

I left AMA with #6. I had an appt already with our dr, but it didn't help any. They still called CPS. Granted, it all worked out ok and the CPS worker was very nice, but it was 2 of the worst weeks in our lives. My OB didn't have a problem with me leaving, but our family dr didn't have privileges (he doesn't at any of the hospitals that do L&D) so we had to use the on-call ped. That's where the trouble was.

With #7, born last Friday, I had my ducks in a row better. Again, the OB didn't have a problem, but this time I found a ped who didn't have a problem with it either. I'm not particularly thrilled with seeing a ped because we've always just used a family dr, but it sure beat a CPS threat and visit!!

[WindyCityMom]

Zookeeper-If you don't mind me asking, how long was your stay the time CPS was called? Were you able to get them to release your baby, or did they have to stay in the hospital? Sorry if I'm being too nosy

[elanorh]

I didn't leave AMA, my OB and our Ped both know that we pay out of pocket (self-employed, self-insured) and they both arranged their schedules to be able to release me early so we didn't have to pay for more than the one day that's charged for essentially, as soon as you walk in the door.

If there's a next time, I think I will talk to both of them about whether I can get approval from them to leave straight from the delivery room (no midwives here, so no homebirth for me unless I UC). Leaving straight from the delivery room *ought* to save us at least $1000, I think.

[Novella]

We left much earlier than "policy" with all babes, but only had to do AMA with the last two (twins).

AMA situation arose due to doc's dishonesty. We had all discussed at 6am (before she left the hospital after their birth) that we intended to go home that same day and would like to leave later that morning after resting a few hours. Doctor said that if we waited for her to examine them during her morning rounds, she would agree to release all of us.

We waited until 3:00 pm because apparently she forgot to mention that she does rounds later on Sundays. Then she refused to release us and said we would have to do it AMA b/c it was under 24 hours. Could have just "played nice" and explained that policy back during the 6:00 am conversation. Since it came to AMA anyway, it was a waste of time to hang out in the hospital waiting for her between 9am and 3 pm.

[thefreckledmama]

[noobmom]

I've been thinking about this and wow, I'm surprised at the CPS calls. I just had no idea. My only reason to leave early is to get back to DS #1 as soon as possible, but perhaps it's not worth the headache. I've been told I could leave after 24 hours, assuming nothing was wrong.

[KristyDi]

I seriously considered it, but wound up staying for fear of cps. DD was born at 1:31 am on Tues and I couldn't leave until Thurs morning.

My water was broken for something like 40 hours before dd was born so she was obviously infected with the plague They made us stay 48 hours waiting on blood cultures. DD had no fever, the 24 hours cultures were clear and she was doing great I'd had antibiotics in labor b/c of GBS. If, on the off chance something had shown up on the 48 hour culture, then of course we'd have brought dd back right away. The MW was ready to release me before 24 hours were up but the ped (not ours, ours didn't have privileges where I birthed) wouldn't release dd and I was told they'd have to call cps if I went ama.

[bethanyclaire]

I did. It went fine, really.

DD was born at 11:15pm. I needed some preventative IV meds for a bleeding disorder, so we stayed that night while I got them. At 8am I was ready to sign out. I told the nurses (who had already been informed that we were planning early discharge) and they got the paperwork within an hour or so. They did call the social worker that worked at the hospital, though. She came up at about 9 with concerns about our leaving so soon. I actually found her to be really nice. She was all excited about our cloth diapers and ran around the L&D floor showing them to the nurses! When I explained our plan and she saw that I wasn't nuts she said "Congratulations!" and went on her way.

I had agreed to wait for the ped. even though my mw was coming to my house later that day for the PKU, etc. He purposely avoided coming to see us and, at 10, I said I was going home either way. I agreed to wait 30 minutes for him to come and told them if he wasn't there by 10:30 I was leaving anyway. He came, checked DD out, said she was fine and we were on our way by 11... so it ended up being 12 hours but most of that was overnight and honestly, I was TOO tired to go home then anyway!

Overall, I think they were glad to have the room empty... it was getting busy!

[meganmarie]

Signing out yourself AMA is no problem (other than checking with the insurance company, who should be thrilled not to pay for your whole hospital stay, but insurance companies are not famous for their logic). Signing out the baby is where it gets tricky if the hospital has strict policies.

Suggest you ask your family doctor to refer you to an in-house ped who can do the sign-out for your babe. If your family doc explains the situation directly to the ped, with the agreement that the 24 hour tests will be done later in the office, hopefully the ped will agree to work with you. That's the only way I can see this succeeding without tears.

Oh, and maybe don't be too hard on the midwives. CNMs in hospitals are put in an impossible situation - their presence in many cases is barely tolerated and they are at risk of losing privileges if they don't toe the line on hospital policies. It seems to me they pick their battles on where they can bend the rules and do things that are mother-baby friendly and then on other things, perhaps they know from hard experience that its a losing battle.

You might be better off taking on this whole issue with the hospital rather than the CNMs - again, they are probably not the decision makers on what is policy and what is permitted.

[zookeeper]

Originally Posted by WindyCityMom

Zookeeper-If you don't mind me asking, how long was your stay the time CPS was called? Were you able to get them to release your baby, or did they have to stay in the hospital? Sorry if I'm being too nosy

Baby was born about 2:45pm and we FINALLY left about 10:30pm. I think they were pushing things back hoping I'd just say it was too late and stay. I would never have left if it meant leaving baby!!! They did release baby and the nurse who brought me the paperwork thought it was the stupidest thing she'd heard. It was the on-call ped who was the problem.

[emnic77]

We left 10 hours after birth, he was born at 6:12 am and we left at around 4pm.

My disclaimer is that the hospital was TEEMING with babies, most of them c-sections, and there were no rooms available for us. I got to the hospital at 3am, he was born 3 hours later, natural birth, no heplock, IVs, or anything of that sort.

We were in the labor/delivery room for a few hours after his birth, then they needed that so they moved us to an ultrasound room - a tiny exam room with two beds and no bathroom, I had to walk out past the waiting room to use the bathroom.
They kept coming in to tell me that they were trying but had no rooms and had none on the horizon. I was under the impression that we were required to stay 48 hours because I was GBS+ and I did not take the antibiotics during labor. But, I volunteered anyway - jokingly said "hey, I'll go home" and they were like "Oh, really? Um, hang on" and pretty much just got a bunch of paperwork, called the pediatrician to check him out, run the PKU and the hearing tests, and sent us on our way. They were so happy to be rid of us that I actually had to ASK for a wheelchair, because I was still a little wobbly on my feet. DH says that we signed an AMA, but I have no idea, I was just over the moon about being able to go home, because I had been planning on leaving early but was told by my midwives that it was a no go because of the GBS.

edit: insurance was never an issue, they paid it and never batted an eye or asked any questions.