Early Discharge

[Azreial]

Hello,
I think this is the right place to post this.....

We are going to be having a hospital birth in MA. Pretty much I just want to go in have the baby and leave a few hours later.
Anyone done this, have any advice on this? Am I going to have a hard time? With DS I did have stitches, and infections (uetrine) afterwards. So I am worried that I may have problems trying to leave before 24hrs. Any input at all would be nice.

[weebitty2]

I'm not sure about hospitals down on the cape, but I know when oldest DS was born, we went home about 12 hours later.. (He was born at 6:23AM, we were home at 7PM, even with stitches)(Umass/Memorial in Worcester) .. We had to sign all these silly release forms and whatnot, but it was allowed.

[pamamidwife]

I've had clients (and friends) go home within four hours after birth. It's your right - if everything is fine, there's no reason to stay.

[Artisan]

You have the right to leave whenever you want. However, I have heard of people having difficulties with doctors (OBs/peds) "releasing" you as a patient. Some people are required to sign release forms stating that they knowing they're leaving against medical advice. And some insurance companies will not pay for the birth if you do this. Sigh.

[pageta]

Well, we only lasted 36 hours with ds and next time I won't last even that long. Half of my friends swore I should stay in the hospital as long as possible because you can rest because everyone is waiting on you, but I found it hard to rest due to all of the interruptions (nursery nurse, my nurse, lactation constulant, picture people, photo people, birth cert people, cleaning people, menu people, food people...to say nothing of my own guests). My ob told me last time that I could go home as soon as the ped released us. DS was born at 10:00 p.m. Thurs. and we left at 10:00 a.m. Sat. which was basically how long it took me to get dressed and dh to the hospital to pick me up, etc. Next time I'll do harder negotiating with the doctor's ahead of time - I don't think I should have any problems with either of them, especially since I have a track record now. But like reader said, I don't want to leave without being discharged because of insurance reasons. The insurance obviously would have paid for us to stay longer, but I didn't care as long as they paid - KWIM?

[Azreial]

hmm, would the insurance company tell me if I called, if they would pay if I left early? I really don't want to have a hospital bith, but DH doesn't want a home birth, plus the $$
So leaving asap is the best plan I could come up with. I really don't know what I will do if that doesn't work

[Amydoula]

Considering hiring a postpartum doula! That would be a great person to have when having an early discharge, I'm one so I guess I would know
If money is an issue I know I do gift certificates and you can find doulas in training who work for free or reduced costs. You can find one by sending an email to [e-mail] or www.dona.org or www.cappa.net
Best,
Amy

[pageta]

Originally Posted by Azreial

hmm, would the insurance company tell me if I called, if they would pay if I left early? I really don't want to have a hospital bith, but DH doesn't want a home birth, plus the $$
So leaving asap is the best plan I could come up with. I really don't know what I will do if that doesn't work

I don't think the insurance company cares when you leave as long as you have your walking papers from your doctor (aka discharge orders). So it's your doctor or midwife that you need to negotiate with.

[Kerlowyn]

I had DS2 at Mt Auburn Hospital in Cambridge MA. I could leave any time I wanted to. They would like you to stay at least 8 hours if you can. I decided to stay for 24 hours and wait so they could do the newborn exam, we left moments after they were done. We live near Rhode Island, over an hour away, and did not want to deal with going back to the hospital and the traffic on Rt 128, KWIM? :LOL

[hipmamawnc]

When I had my DD, my first, it was a transfer to the hospital from an intended homebirth. I got there around midnight and birthed my DD at 10:03 am. By 9:00pm I was at home in the shower with my new babe sleeping on her daddy's chest in the next room. I had to sign her out "against medical advice", but no one really gave me too much trouble, they just said there piece and then we were gone.

Good luck to you, hope you don't have too much hassle to get what you want.

[Artisan]

Originally Posted by pageta

I don't think the insurance company cares when you leave as long as you have your walking papers from your doctor (aka discharge orders). So it's your doctor or midwife that you need to negotiate with.

The problem lots of people seem to run into is getting the pediatrician to release the baby without at least a 24 observation.

http://www.mothering.com/discussions...hospital+early

[pageta]

I meant doctorS - including the ped. I know my ob told me it was up to our ped. Good point, reader.

[Azreial]

thanks for all the advise everyone. I'm going to talk to my midwife next visit and see what she has to say. I'm thinking of changing peds so I'll have to look into that.

Oh and its comforting to hear that no one had any horror stories about wanting to leave early

[jraohc]

This is an old thread, but it looks like your baby is still due in the future, so I thought I'd add my two cents. I also had my baby in a hospital and I wanted to leave early, but I was convinced to stay at least 24 hours and even at that point it took something like 5 hours for us to finally get out of there. I don't know if this was just random or if they were really trying to keep us there longer. Not a horror story, but it certainly wasn't as easy to leave as I had been lead to believe. I was okay with sticking around, well dh convinced me that we were going to stick around, but looking back, I really don't think they were going to "let" us go any earlier if I had stuck to my guns about leaving a few hours after dd was born.

[Quindin]

Originally Posted by jraohc

This is an old thread, but it looks like your baby is still due in the future, so I thought I'd add my two cents. I also had my baby in a hospital and I wanted to leave early, but I was convinced to stay at least 24 hours and even at that point it took something like 5 hours for us to finally get out of there. I don't know if this was just random or if they were really trying to keep us there longer. Not a horror story, but it certainly wasn't as easy to leave as I had been lead to believe. I was okay with sticking around, well dh convinced me that we were going to stick around, but looking back, I really don't think they were going to "let" us go any earlier if I had stuck to my guns about leaving a few hours after dd was born.

Same here - I was shocked at how difficult they made everything when we reminded them we wanted to leave early. They went as far as lying about some lab results to convince me I needed to stay all the time they usually keep women there

This time I will be giving birth at a Birth Center - women only stay there from 4 - 12 hours after delievery!! It is just awesome considering I have 3 small kids!

Edited to add: ANd no, you just CAN'T rest in a hospital. There is people knocking on your door ALL THE TIME for God knows what

[anothermama]

I've heard of doctors refusing to sign discharge papers and therefore insurance having issues with it.

I've also heard of hospitals calling CPS on parents who left AMA (against medical advice). I would ask around your area and even askt he hospital.

[TiredX2]

With DD we planned on a birth center birth and ended up in the hospital. We confirmed we could leave directly after the birth (in the 4-7 hour range) and were reassured.

After the birth they almost immediately insisted on a catheter (which I agreed with--- I was pretty out of it at that point, DD was around 2 hours old!) and once they put it in, revealed that meant I "had" to say 24 hours

Definely ask for clarification while you can still think!

[srain]

For us, the only obstacles were getting my midwife and the baby's doctor to sign off on us. The hospital staff was kind of freaked out, but what the doctors said was what was important. We discussed it in advance with the midwife, and actually asked her for a recommendation of a doctor that would release our baby early. We left less than 5 hours after birth.

[catnip]

My cousin was told by the hospital that if she signed out AMA, her insurance would not pay for any of it. (this turned out to be untrue) I have heard rumors of insurance companies not paying for readmission due to complications. There is NO substitute for checking with your insurance company before you enter the hospital. If you don't check ahead of time you could wind up on a holiday weekend unable to get that info. So check it out. My policy has no such conditions on it, and I feel better knowing it.

[LEAW]

Legally in the US, the insurance will pay even if you leave AMA. The hospitals/docs just tell you they won't. Anyone can walk out at any time.

I don't know about policies if you have to readmit for problems, that'd have to be checked with the insurance carrier. Your doc can always refuse to come back for you, but any doc on call in the ER has to see you.