Early postpartum discharge at a university hospital. Outcome analysis

To determine whether implementation of an early hospital discharge policy was effective in safely reducing hospital stay and acceptable to patients.

The study was a prospective, observational trial. Early discharge was defined as discharge from the hospital either on the first day after vaginal delivery or on the second day after delivery by cesarean section. A "stayover mom" policy was subsequently implemented to allow a mother the option to remain in the hospital overnight after discharge. This prospective study was divided into three consecutive three-month periods: (1) routine care (n = 576), (2) early discharge (n = 622), and (3) early discharge with stay-over mom (n = 574). Primary outcome measurements were length of hospital stay and patient willingness.

With proper review of written instructions, all eligible patients were willing to be discharged early. As compared with the routine care group, the length of hospital stay was shorter by 0.8 days (95% CI, 0.4-1.2 days) in the early discharge group (P < .01) and by 1.1 days (95% CI, 0.5-1.7 days) in the early discharge with stayover mom group (P < .005). The stayover mom policy was more desirable because of limitations in obtaining timely transportation and concern about the infant warranting continued observation. The need for maternal readmission was rare (15 cases, 0.8% of total), with endometritis equally common (n = 3 in each group).

Early postpartum discharge, especially including a stayover mom policy, was acceptable to our predominantly Medicaid population. The reduced hospital stay was not associated with increased maternal morbidity.