Patient preference and postnatal hospital stay

Burnell, Ioanna; McCarthy, Michaël; Chamberlain, Geoffrey; Hawkins, D. F.; Elbourne, Diana

doi:10.3109/01443618209083086

Cited by 15 publications

(24 citation statements)

References 1 publication

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“…27 In one of the three reported randomised trials of early obstetric discharge, women in the early discharge group reported being more confident at 1 week after the birth than women discharged later, although there were no differences between the groups by 1 month after the birth. 25 Depression after birth has been found in three studies to be more prevalent among women staying longer, than among those discharged early, 22,25,26 one of these being a randomised trial. 25 No differences in prevalence of depression were found in an earlier cross-sectional survey conducted by the authors that compared women going home within 4 days with those staying longer, 21 nor in one of the other randomised trials.…”

Section: Discussionmentioning

confidence: 99%

Early obstetric discharge: does it make a difference to health outcomes?

Brown¹,

Lumley²,

Small³

1998

Paediatr Perinat Epidemiol

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Clinicians in several countries have expressed concerns about possible adverse effects of shortening obstetric length of stay. A population-based survey of 1366 mothers who gave birth in Victoria, Australia, in 1993 was used to investigate social and obstetric characteristics of mothers discharged home 'early', and to assess whether shorter stays were associated with adverse health outcomes, or a lesser degree of satisfaction, or both. Women's views and experiences of length of hospital stay were gathered via a statewide postal survey of women who gave birth in a 2-week period; 62.5% (n = 1336) responded. Assessment of the relationship between length of stay (1-2 days vs. > or = 5 days, and 3-4 days vs. > or = 5 days) and four main outcome measures (infant feeding at 6 weeks, period prevalence of feeding problems, maternal confidence and depression) showed no association between these variables and length of stay after adjusting for other obstetric and social factors in separate regression analyses. For stays of 3-4 days, the adjusted odds ratio (OR) for formula feeding at 6 weeks was 1.35 [95% confidence interval (CI) 0.9-1.9]; for feeding problems OR = 0.87 [0.7-1.2]; for lacking confidence OR = 0.81 [0.6-1.2]; and for depression OR = 0.96 [0.7-1.4]. Large randomised trials of early obstetric discharge are required to resolve continuing uncertainties about the safety, and possible benefits of shorter hospital stays.

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Section: Discussionmentioning

confidence: 99%

Early obstetric discharge: does it make a difference to health outcomes?

Brown¹,

Lumley²,

Small³

1998

Paediatr Perinat Epidemiol

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show abstract

“…Postpartum studies have reported early-discharge programs to be a safe, cost-effective and satisfying alternative to the standard length of hospital stay among low-risk mothers and their infants. [1][2][3][4][5] While these studies have shown that early discharge has no adverse physical effects, the only psychological effects examined have been women's satisfaction about making a choice or taking control of discharge rather than psychological morbidity. 5,6 As postnatal depression is a common disorder which may have a long-term impact on the mother and her infant," the psychological outcome after childbirth is increasingly being recognised as important."…”

mentioning

confidence: 99%

Early discharge and risk for postnatal depression

Hickey¹,

Boyce²,

Morris-Yates³

et al. 1998

Medical Journal of Australia

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“…Arthurton & Bamford (4) found a higher breastfeeding rate in a long-stay group compared with a short-stay group when studying breastfeeding for one week or more (73.8% vs. 67.5%)-yet the relationship was the reverse when the breastfeeding period studied was 6 weeks or more (31.9% vs. 23.1%). In a study by Burnell et al (5) no difference was found between women discharged before vs. after S days, when the breastfeeding period was 3 weeks or more (52% vs. 55%). In a German study (6) 56.4% of a group of women discharged early were still breastfeeding 6 months after delivery, compared with only 16% in a matched control group with later discharge.…”

Section: Discussionmentioning

confidence: 86%

“…When the Bradford experiment with early discharge started 25 years ago the same anxiety was expressed in an editorial in the British Medical Journal (2). Many reports have been published since then, showing no negative effects of early discharge on the duration of breastfeeding-rather the contrary (3)(4)(5)(6). However, most studies have lacked a control group obtained by randomization, thus making valid conclusions difficult.…”

mentioning

confidence: 99%

Early and Late Discharge after Hospital Birth: Breastfeeding

1987

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Breastfeeding was studied among women discharged early and late after normal delivery in a hospital. Early discharge was defined as leaving the hospital 24-48 h after delivery in combination with domiciliary visits, and late discharge as the regular hospital postpartum care (mean 6 days). 164 women interested in participating in the early discharge study were randomly allocated in late pregnancy to a group offered early discharge (Experimental group = EG) or a group offered the traditional later discharge (Control group = CG). After medical exclusions and non-medical withdrawals, 50 mother-infant couples remained in EG and 54 in CG. Regular breastfeeding at 6 months after birth was reported by 63% of the multiparae in EG and 41% in CG (p = 0.06). Thirty-three per cent of the primiparae in each group were still breastfeeding at 6 months. 2% of the infants in EG and 72% in CG received supplementary breastmilk at least once during their first week of life. Infants discharged early were breastfed more often on the 2nd (NS), 3rd (p less than 0.05) and 4th day (p less than 0.001) after birth, compared with infants who stayed longer in hospital. There were no statistically significant differences between EG and CG women in their experience of success in breastfeeding according to daily records from the first 14 days after the birth.

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Patient preference and postnatal hospital stay

Cited by 15 publications

References 1 publication

Early obstetric discharge: does it make a difference to health outcomes?

Early obstetric discharge: does it make a difference to health outcomes?

Early discharge and risk for postnatal depression

Early and Late Discharge after Hospital Birth: Breastfeeding

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