How Early Discharge Affects Women and Babies After Birth

Women who stayed in hospitals for shorter length of time may have received inadequate care and support.


Around the world, women who have just had a baby may stay in the hospital for varying lengths of time. The question is whether that affects the quality of their care.

A new study from the London School of Hygiene & Tropical Medicine found that in high-income countries, the length of stay after childbirth has been steadily decreasing since the 1970s. Shorter stays are also becoming more common in low-income countries. The researchers noted that a shorter length of stay increases the risk of complications after discharge.

The immediate postnatal period is an opportunity to detect, diagnose and treat complications in mother and child. It is also a time when mothers, especially first-time mothers, can obtain education and support in child care.

A short hospital stay can lead to problems with breastfeeding or make new mothers feel insecure about their child care skills. Factors that may influence length of stay include health care payment systems, child care issues, transportation and cultural norms.

"Our new findings suggest that a substantial proportion of women around the world are leaving childbirth facilities too soon after giving birth," study lead author Oona Campbell, PhD, said in a press release. "This is especially alarming in low-income countries where access to care after being discharged is often limited.

"It is crucial we make sure not only that childbirth facilities have skilled care attendants and effective monitoring and treatment, but also that women stay in the hospital long enough so that they and their newborn babies can benefit from these,” Campbell said.

Dr. Campbell is a professor of Epidemiology and Reproductive Health at the London School of Hygiene & Tropical Medicine.

Dr. Campbell and colleagues examined data from 92 different countries.

Length of stay varied from half a day in Egypt to 6.2 days in the Ukraine for a single vaginal birth. For women who delivered by caesarian section, length of stay varied from 2.5 days in Egypt to 9.3 days in the Ukraine.

The World Health Organization recommends a minimum stay of 24 hours for a single vaginal birth. In the US, the minimum recommended length of stay after a c-section is 72 hours.

Altogether, more than 20 percent of women in 30 of the countries studied stayed for too short of a period after childbirth based on those recommendations.

"Ultimately, length of stay is an approximation of what we are really after, which is high-quality care for women and babies," Campbell said.

The study was published online in the March PLOS Medicine.

No outside funding was provided for the study and none of the authors reported a conflict of interest.