12 November 2012

Early discharge with C-Section

Some women who deliver their babies by C-Section may be able to check out of the hospital the next day without raising their risk of problems, according to a Malaysian study.


Some women who deliver their babies by caesarean section may be able to check out of the hospital the next day without raising their risk of problems, according to a Malaysian study.

The study, which appeared in the journal Obstetrics & Gynecology, looked at 360 women in Malaysia, who were randomly assigned to go home either one or two days after having a C-section.

Both groups were equally satisfied with their care, and the women who were discharged sooner seemed to have no more problems with breast feeding or mental well-being.

"Day 1 discharge compared with day 2 discharge after a planned caesarean delivery resulted in equivalent outcomes," wrote lead author Peng Chiong Tan, at the University of Malaya in Kuala Lumpur.

Most women stay in for 3 days

Those results don't mean that hospitals should start discharging women the day after a C-section, but they do suggest that a next-day discharge is something women can talk about with their doctors, researchers said.

In the United States, where C-sections are done in about one-third of births, women typically stay in the hospital for three to four days after the procedure. That compares with about two days for women who deliver vaginally.

In the past, there were concerns about insurers pushing mothers to leave the hospital before they're ready. That led to a 1996 law requiring insurers to pay for a 48-hour hospital stay after a vaginal delivery and a 96-hour stay after a C-section.

Still, the American College of Obstetricians and Gynecologists (ACOG) says a shorter stay after a C-section is an option if the baby is ready to go home, though the mother should meet certain requirements first such as normal blood pressure, no signs of infection and adequate pain control.

At Tan's hospital in Malaysia, women who have a C-section are routinely told to expect just a two-day stay, and some providers there have discharged new mothers the day after.

How the study was done

Tan's team randomly assigned the 360 women having a planned C-section to go home either one or two days after delivering. In the end, 16% of the women in the day-after group were not discharged that early, because either they or their babies were having problems.

But when they did go home the day after, there didn't seem to be a greater risk of difficulties. When the women were interviewed two weeks later, 87% were happy with their discharge timing.

The same was true for almost 86% of women who went home two days after their C-section.

While the findings would likely extend to women in other countries too, these Malaysian women typically went home to a lot of support - often, an extended family network, Tan said.

"Where this support is not available, next-day hospital discharge may not be associated with the same degree of satisfaction, acceptability and good outcome as we have found," she added.

(Reuters Health, November 2012)

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