Hospital Birth & Leaving Shortly Afterwards

[jeminijad]

First off, I am not yet pregnant. We are planning baby #2 (for us) and the goal is home birth.

That said, if I get zero insurance reimbursement, OR if unexpected complications show up, I don't want to be thrown unexpectedly and unpreparedly into another hospital birth, with all of its regulations and restrictions.

So what is your experience with normal vaginal delivery, either completely natural or with only managed 3rd stage, and leaving within 12 - 24 hours?

What I hear is that it is generally no problem for the healthy mother to check herself out of the hospital when she chooses. The problem is getting a pediatrician to sign off on having the baby released, and that you run the very real risk of having CPS called if you take your baby home AMA.

I am looking for a crunchier pedi with privileges in a nearby hospital, but am not having luck presently.

[jecombs]

I'm presently working on this same issue, too. My MW said my early release will not be a problem (assuming this birth is similar to my DD's), it's the new babe that could present a problem. Hospital policy is for Mom and baby to stay at least 24 hours after the birth. I want to leave after 6-12 hours. If your ped has "privileges" at the hospital you're birthing at, early release should be easy. You just have to arrange it before the birth with the ped.

There is a risk that CPS could be called if you take baby home AMA, it just depends on what "hospital policy" is. This does not mean that CPS will accept the report for investigation. I'm a social worker and I call in reports frequently that are not accepted for investigation. I have a pretty strong feeling that my local CPS would see the report and throw it out immediately. They just don't have time around here to mess around will piddling little crap like that. That said, I am not afraid of CPS coming to my house. I know everything would be fine. But, I'm still gonna try to work something out with the hospital ped. to arrange for babe's early release to limit the amount of stress we all have to go through.

[maritimemum]

i am in canada but we had hospital transfer for PPROM at 36weeks in nov and left 4.5 hours after delivery.. we did sign out ama but havent had any visits not even a call?

[lunita1]

Originally Posted by jeminijad

First off, I am not yet pregnant. We are planning baby #2 (for us) and the goal is home birth.

That said, if I get zero insurance reimbursement, OR if unexpected complications show up, I don't want to be thrown unexpectedly and unpreparedly into another hospital birth, with all of its regulations and restrictions.

So what is your experience with normal vaginal delivery, either completely natural or with only managed 3rd stage, and leaving within 12 - 24 hours?

What I hear is that it is generally no problem for the healthy mother to check herself out of the hospital when she chooses. The problem is getting a pediatrician to sign off on having the baby released, and that you run the very real risk of having CPS called if you take your baby home AMA.

I am looking for a crunchier pedi with privileges in a nearby hospital, but am not having luck presently.

I had no trouble getting the on-call pediatrician to release my baby the same day she was born. It was a pretty "crunchy" hospital, though. She was born early in the morning (3??) and then released before 5:00pm. My middle was born at about 2:30pm and by the time we got done with suturing me and moving to the postpartum recovery wing it was too late to get the pediatrician to sign off on baby so we left first thing the next morning, as soon as everything could be processed. I'd say we out of there by 9:00 am.

[jeminijad]

So far, so good then.

DD would not have been released early- they wanted to keep her even longer b/c of what I knew was normal, physiologic jaundice. This is what I fear, I think- even though the treatment of sun & lots of feeding can be done at home, they wanted her under the bili lights.

[2sweetboysmom]

A difficulties I encountered with early check out were
1. In our hospital Ped's only do rounds thru postpartum from 6-9am. If you miss that window you wait till tomorrow.
2. The birthclerk only worked til noon. If you did not have your birth cert done and signed before you left the hospital it meant a trip to the main county records building (2 hours each way with SoCal traffic) not to mention the stack of paperwork there.

Just some things to check on.


We did best to let them know checking in that we were anticipating and working for early release. Ped saw us first thing in the morning, and birth clerk put our birth cert papers on the FRONT burner. With all mid afternoon deliveries we were out in about 18-20 hours from birth.

[emnic77]

My disclaimer is that our hospital was knee deep in babies that day, and literally had nowhere for us to go. DS was born at 6am, we were in the delivery room until noon, because there were no post partum rooms available and they were all c-section moms that could not be released early, and were not leaving anytime soon. Then they stuck us in the ante-partum testing room - tiny, cramped, hot, no bathroom, no tv, nothing. I had to walk down the hall through the waiting room to use the bathroom. Not cool. So at 3pm a nurse came in and made a sort of half-joke about us leaving early, and I jumped at the chance. I had been told that because I was GBS+ and had refused antibiotics, that we would be unable to check out early and had to be there for a mandatory 48 hours. But, since they had nowhere to put us and we had checked out fine, they magically found a pediatrician to sign off on us that very minute and were out the door and home by 4pm, 10 hours after giving birth. DH says we had to sign a bunch of releases but I don't think we left AMA.

From other people's stories, we just got lucky that day since there were so many c-section moms that were unable to be checked out early, and literally no room available to us.

[MegBoz]

I started with asking my MW & she said it would be no problem to sign me out after less than 12 hours (assuming all went well, of course), but the pedi might not want to sign out DS. So I called the pedi & she said, "Well, yeah, I could sign him out after less than 24 hrs, but I don't know that your OB would sign you out so soon."

Anyway, turns out I was GBS+ & didn't have time for the IV antibiotics. (What I know now, I'd decline them anyway in the absence of a 2nd risk factor & opt for hibiclens vaginal wash, but I digress.) Hospital policy in that case was to keep baby for 48 hours minimum. Idiotic too because early-onset GBS infection shows signs within 24 hours like 90-some% of the time (Whereas "late-onset" can not show up for 3weeks!) But, it's the policy of AAP, I believe, so I didn't try to fight it.

The nurses were cool though, they offered to have paperwork all ready to go so we could walk out the door at 48 hours PP on the dot (which we did.)

Had it not been for the GBS+ (or if I'd received the ABTs) I do think I would have been able to leave less in than 24 hours.

[katec67]

My midwife for my second birth was a homebirth midwife with hospital privileges, so she encouraged discharge after 12 hours. I thought it was a great idea (was a VBAC so she wouldn't do a homebirth for the first VBAC, otherwise I would have been home).

Everything went smoothly, the ped discharged our baby, and we were home by the evening of the day DS was born. A few hours later, I started shaking uncontrollably and had a fever and terrible, teeth-chattering chills. After hours of suffering, we went to the emergency room. Many hours later, I was taken back to the hospital by ambulance for a uterine infection. I couldn't be readmitted to the maternity ward, though, so ended up on a much less pleasant ward with a lot of very sick women. My baby was no longer a patient, so he was only allowed to stay in my room if my husband was there to care for him. This meant that we were separated from our older DD for several days. I was on IV antibiotics for about 3 days before they finally released me. Oh, and the final insult was I had to pay a second $500 insurance co-pay for the readmittance.

If I had opted to stay at least 24 hours, they would have caught the fever and my infection would have been treated on the maternity ward. So for me, leaving after 12 hours just wasn't worth it. This time I'm doing an HBAC.

[organicpapayamama]

I was actually talking about this with my ddc. I think every hospital has its "policy". mine is a min of 48 hours. Im a doula and have been to several hospitals and some vary from 6 hours to 24 hours... its different everywhere. Having said that someone suggested speaking to you OB about leaving early if you feel good and no complication have come up. I hear most are ok with this. Though, keep in mind I tried this with DS and they said I could go but that DS could not. They even went on to say that if I pushed the matter that their protocol is to contact CPS saying that I was refusing needed medical care...yeah, so no way in heck i was leaving without my baby. Even if the hospital ok's leaving with baby most will have you wait till the baby sees the pediatrician which I have also seen is pretty much an all day wait...

[rebeccalizzie]

I haven't read the other responses, but really quick--I live in a very intervention-happy area, and I had no problem leaving right at 24 hours. They wanted me to wait that long because there was a test they needed to do on DS right at the 24 hour mark. Maybe PKU? I don't remember. Anyway, in order to leave before that I had to leave AMA and they would have reported me to CPS, who wouldn't have done anything because I would have done PKU at my peds office a day or two later, but it wasn't worth the headache to me.

My OB and the staff ped had already signed off on my release orders since I asked to leave right away, so I left immediately after they finished the test. It helped that I had DS at 7 PM after a long labor so I wouldn't have left before afternoon anyway, I was resting!

[happyblessedmama]

I left at 16 hours post delivery after #2 because they wanted me to move to a med-surg ward as I had an "easy delivery". I refused. I said they could send me home but I would NOT move to a ward with sick people in it with my healthy newborn. Everyone signed us out.

Baby #3 was in NICU, so n/a.

Baby #4, I left at 24h post delivery as discussed with my doc (who is family practice, and also the baby'd soc)
Baby #5, I left at 24h post delivery. Same doc, same situation as #4.

Hoping for the same with #6. I never had to "threaten" to sign out AMA. I just expressed my desire, during pregnancy, to be discharged ASAP after the birth. I'm OK with a 24 hour stay, which is what they requested.

[freistms]

48 hours is standard of care for newborn observation with GBS if you don't get the antibiotics - both CDC and AAP guidelines. 24 hours in that circumstance makes a lot of sense to me, but after that, the risk drops considerably. Anyway, I missed the antibiotic window in both births. We had a FP doc who didn't have privileges at our maternity hospital, but we were able to get the ped. attending to sign off on early discharge at about 40 hours out both times, with the agreement that we would see our doc within 24 hours. It was pretty generous of them, actually, though both times our doc opted to wait a week to see the baby.

My midwives were ready to discharge me at 6 hours out both times, despite the fact that I hemorrhaged in the second birth.

[ShadowMoon]

I had a natural hospital birth at midnight on Dec 23rd and I left around noon the following day. It may have helped that Christmas was approaching and my babe was doing wonderfully, but no one put up a fuss over me leaving when I wanted.

[1babysmom]

Well, I didn't have a natural birth. I got an epidural and all the "joys" that come with that , she was born, I got up and moving about 45 minutes later. I left the hospital about 12 hours after she was born. We did not have to sign out AMA, my OB thought I was doing wonderfully and didn't mind a bit. We refused most of the newborn testing/screening that would have "required" us to wait, and her ped did come in and check on her (and approve her leaving, too).

[jeminijad]

So far, no firsthand stories of pediatricians viciously demanding to keep babies. Good stuff.

[zookeeper]

We've always used a family dr. and he doesn't do rounds so baby has always been signed out by the on-call ped. With baby#6, he was born about 1:45pm and we wanted to go home that evening. We had declined abx during labor (GBS statuse unknown), vit K, HepB and eye stuff. We were prepared to sign out AMA and the on-call ped called CPS. Nothing came of it except a lot of unnecessary worry and grief.

Baby #7, planning on a HB but circumstances led to a hospital birth. We met with a ped so as not to have the same problem. Baby was born about 1:30pm, we were home no problem at 8pm. Go figure! One instance we're a threat to our baby and the other we're perfectly fine parents.

[Peony]

DD1 was born at 10pm and I wanted to go home the next day. I was finally released at 7pm. It wasn't that they did want me to go, pedi came in and said baby could go, MW signed all my papers, and then it was discovered that pedi didn't sign all the papers he needed to. It took 6 hours to get him back in to sign. They kept trying to get me to stay another night since we lived so far away but I was going home!