Early Hospital Discharge -- WWYD?

[snapdragon]

I'm planning to deliver at a birth center that operates within a hospital.  I love everything about it, except that they discharge you after 12 hours.  Now, I know that the freestanding birth center in my city discharges after 2 hours, so that's not something I'm side-eyeing them for, and I still plan to deliver there.  When I asked, they said you have the option of being kept for the standard hospital stay, but they'd transfer you to the hospital and your insurance would be billed.  I happened to have been looking forward to staying at the hospital just to get the quiet bonding time with my third LO and not to be distracted by household chores, but that in itself wasn't reason enough for me to choose to stay.  Besides, there's some benefit to being home and not having to worry about how my other kids are doing without me.

But a couple of people I've mentioned this to expressed concern over an early discharge, like something could easily go wrong in the first couple of days with either myself or the baby, and it's important to be at the hospital already and to be monitored.  What do you think?  Is that really a serious enough problem to make it worth paying for the hospital stay?  Does anyone have experience with this, or has anyone done their research and found anything compelling either way?

[shmee]

honeylemon probably has good input on this

[shmee]

If you did transfer to the hospital, wouldn't your insurance pick it up anyway or no?

[mpiemont]

I know a lot of people who have had birth center births or home births without any hospital stay afterwards. Most midwives will see you for a follow up at home in the first day or so and also check on the baby. For me personally, I would like to do a birth center birth, but the fact that they don't include the hospital stay is the prime reason I won't do it. Not necessarily that I am afraid of something being wrong after the birth, but especially with my 3rd baby, I need that 1 on 1 time with someone taking care of me/my meals etc so that I can focus 100% on that new baby. I know that regardless of how much help I were to have at home, I'd fall right back into my role as the primary caregiver for the boys, housekeeper, etc.

Also, both of my babies did have minor things after birth that would not have been as quickly caught or taken care of if we werent in the hospital (DS1 had jaundice and some difficulty peeing, DS2 had a fractured collarbone).

[stargazerlily]

I'm using a doula - in - training but other than that hospital/obgyn route. I have a few higher risk factors which contributed to that decision. I'm also a worrier so I like the fact that I'll be someplace prepared for just in case issues. My obgyn told me to expect to stay 2 nights, 3 if c-section. I'm looking forward to having the extra LC help if needed, and not having to get bombarded with housework and all the pets right away, just having that time to relax and bond. I definitely wouldn't want to go home in less than a day

[mpiemont]

Feb 2, 2015 21:15:07 GMT -5 stargazerlily said:

I'm using a doula - in - training but other than that hospital/obgyn route. I have a few higher risk factors which contributed to that decision. I'm also a worrier so I like the fact that I'll be someplace prepared for just in case issues. My obgyn told me to expect to stay 2 nights, 3 if c-section. I'm looking forward to having the extra LC help if needed, and not having to get bombarded with housework and all the pets right away, just having that time to relax and bond. I definitely wouldn't want to go home in less than a day

Oh yes the lactation consultant thing too!

[la79al]

When I was being discharged after my 2nd, my DH mentioned to the nurse that I was feeling dizzy.  They really talked to me about it and pointed out that if I went home and something happened and I had to come back to the hospital, the baby would not be able to stay with me whereas if I needed to not be discharged and stay a little longer, the baby could stay with me.  

[viola]

I'll be discharged within 6 hours if I end up delivering at my birth center. I don't see a problem with this at all. I hate sleeping at hospitals and would worry about my dog and house if I wasn't there. Like PP said, you should have a checkup 1-2 days after birth anyways.

I can see wanting alone time with your new baby because you have 2 other LOs at home, but other than that, I can't think of a good reason to pay for a hospital stay.

[miraclebbye]

Personally I would want atleast 24hrs monitored. With my 2nd I lost a lot of blood and was very weak, being at the hospital they were able to keep a close eye on that incase of the need for a transfusion. I also appreciate the quiet time with the baby without all the normal home life hustle.

[soyboy]

My baby had a blood condition that could potentially cause early problems, so we had to stay 48 hours after he was born so he could be monitored (he was totally fine). I personally liked staying at the hospital for a few days. The help with meals, assist with the baby, 3 LC visits, and visits from my MW and the pedi all factored into me liking our stay there.

Will you have help (besides your sig other) if you return home shortly after the birth? Like previous posters have mentioned, it might be hard to relax and not jump right back into the mommy/wife role. Some people love being home, in their own environment right away. If you think you will be more comfortable there, then by all means go home. Your MW and pedi will be just a phone call away.

[cheechee]

Feb 2, 2015 21:24:23 GMT -5 viola said:

I'll be discharged within 6 hours if I end up delivering at my birth center. I don't see a problem with this at all. I hate sleeping at hospitals and would worry about my dog and house if I wasn't there. Like PP said, you should have a checkup 1-2 days after birth anyways.

I can see wanting alone time with your new baby because you have 2 other LOs at home, but other than that, I can't think of a good reason to pay for a hospital stay.

Me too. It will be a lot different than the 2 days in the hospital with DS #1. I was miserable at the hospital, I had bitchy nurses and the food was gross so I was ecstatic to go home. But yeah, it is nice to have the help and alone time with the new lil one.

If you feel you need the extra time then I say do it! You will be more rested and able to tackle life with another kid in tow.

[snapdragon]

Thank you for all the input, ladies--you are making me feel less selfish about wanting to stay at the hospital for purely non-medical reasons.  shmee, I have had nothing but headaches with my insurance ever since we got on a marketplace plan, so I would have to look into whether or not the hospital stay would be covered under "maternity" or if it would be billed as a regular hospital stay.  Maternity would be cheaper for me, as my plan covers maternity, but we'd still have to pay for part of it because even maternity isn't covered 100%.  I'd also have to check to see if I would hit my deductible before then, because nothing is paid for at all until I do.  

If I thought it was a serious risk for myself or the baby to go home early, I would find a way to do it regardless of cost.  I'm low risk (so far), and of course they would not discharge me or the baby after 12 hours if there was something they felt needed to be monitored, and we would be coming back to the hospital in the next 1-2 days for a checkup.  So it seems like in my case the biggest argument for the hospital stay is just mental health, which I feel is silly, but then again if I were giving the advice to someone else I would tell them sternly that PP mental health is not to be taken lightly.  My sister lives in town and I'm sure she will come and help if I ask, and I have very wonderful friends and neighbors who will cook for us.  DH and I are required to take an early discharge care class at the birthing center, so hopefully that will give us more information on what we should do.

[ksmith0803]

With DS, I cried when it was time to get discharged. For me, I loved the hospital stay. I had someone to bring me my meals and my baby. I had my LC and nurses that could help. I knew when I returned home, life was back to normal. In fact that night, I cooked supper and did a load of laundry. If it were me, I'd take the extra hospital stay.

[Deleted]

As many PP have said I have two boys that I would find difficult not to cater to at home and the urge of doing chores would be too big. The hospital stay guarantees us a 48 hour uninterrupted bonding Window that we wouldn't get at home. My boys will of course be with us at times during the hospital but will be cared for by my mom most of the time at her home. Now I could just go home and have DH take care of all that (boys, chores etc.) but then that would cut into his binding time. So I rather have those 48 hours for us to bond together and then go home and adjust to life.

Also the LC and monitoring after birth makes me feel more comfortable even though I've been through this before.

[silentsara]

Feb 3, 2015 4:36:57 GMT -5 @nevertoomanyshoes said:

I'm kind of looking forward to not having to worry about cooking, cleaning etc., and just bonding with baby during my hospital stay, I imagine when I am a STM I'll look forward to it even more! If you can stay for an extra day or so without it costing too much, then I say go for it.

This exactly. My mom is going to stay at my house with the other kids, I know they'll be fine without me for that day or so. I'm actually planning to make my husband go to work during the day because he gets stir crazy and will be begging me to go home early. Then I can cuddle my new squish and rest.

[CTri17]

Feb 2, 2015 21:09:27 GMT -5 mpiemont said:

I know a lot of people who have had birth center births or home births without any hospital stay afterwards. Most midwives will see you for a follow up at home in the first day or so and also check on the baby. For me personally, I would like to do a birth center birth, but the fact that they don't include the hospital stay is the prime reason I won't do it. Not necessarily that I am afraid of something being wrong after the birth, but especially with my 3rd baby, I need that 1 on 1 time with someone taking care of me/my meals etc so that I can focus 100% on that new baby. I know that regardless of how much help I were to have at home, I'd fall right back into my role as the primary caregiver for the boys, housekeeper, etc.

Also, both of my babies did have minor things after birth that would not have been as quickly caught or taken care of if we werent in the hospital (DS1 had jaundice and some difficulty peeing, DS2 had a fractured collarbone).

I have had 2 homebirths so far and am planning a 3rd. My mw stays for a number of hours after the birth to make sure all is well, monitor bleeding etc
Then she comes back at 24 and 48 hours and she is on call. I also have a sheet that would be reasons to go to the hospital.
 
A 12 hour stay seems perfectly fine to me and I wouldnt think twice about going home then. But dh or IL's keep the kids more ccupied than normal so baby and I can rest

[yianna]

With my first, I was so torn (stitching took 45 minutes, I pushed in 30..) I was not going anywhere and they did not offer an early discharge. I stayed my full 2 nights and enjoyed having the help from the well baby nursery, and the postpartum nurses.

With my second, he was born at 10:30am, and the following morning at 8am, the OB asked me if I wanted to go home, in fact, she was pushing that I go. I told her, no thank you, I would prefer to stay here and have the help. I stayed my full two nights, again, and I'm happy that I did.

With this one, I'll stay my full two nights again - I like having the ability to send the baby away for a few hours the first night so get some rest after birth, plus it gives me some one on one time with the baby without the chaos of home (almost like a vacation from reality, not worrying about who needs to eat, other than her, or the house needing to be picked up, etc).

[jezebk]

If it were me, I would definitely stay at the hospital but that is completely based on my personal experience. I was diagnosed with preeclampsia at my 38 week appt and induced later that day. I didn't have DS until 2 days later and because of the pre-e I had to stay on the magnesium drip 24hr after delivery. I pulled something during labor and I could hardly walk after plus I tore so I was extremely thankful to have the nurse there to assist me in the bathroom. I was in a lot of pain..plus my blood pressure never went down. I ended up being discharged 3 days after delivery day and actually had to go back to the hospital a couple of days later due to high blood pressure.

la79al, maybe your hospital has different policies but when I went back to the hospital for my high blood pressure, my baby was allowed to stay with me. I just had to have someone else in the room to take care of him since I was incapacitated.

[psmomma718]

I'm not a fan of hospitals, but I had a lot of complications with my delivery and recovery with DD so I was glad to be there. Although after day 6, I was begging to go home. I guess it depends on your experience. If everything had gone according to plan, I probably wouldn't have minded being sent home after 12 hours.

[amelandre]

I had a c section and wanted to go home after 12 hrs. I was able to shuffle on my own, an DH had the week off of work to help me out. They kept me the whole next day and then were trying to get so many people discharged at once the following morning that I didn't get to leave until 2 in the afternoon. DH and I were both sooooo stir-crazy!

This time we are paying out of pocket, and our dr's fee only covers 24hrs total at the hospital (and it's $100/hr to stay longer) so I'm excited to have that kind of built-in excuse to not get stuck there for a lot of extra time

[pinkiemo]

Like I said in the T-GIF thread, hospital time is mommmy relaxation time. Somehow when you're in the hospital, everyone understands you can't do what you normally do. But the second you walk out it's business as usual.

Stay in the bubble!!

[smilz4782]

Without reading all the responses...
My freestanding birth center we were using last time d/C's within 12 hours. You get a home visit in the 24 hours after and then you go back at 2 weeks.
I think if you will be seen 24 hrs after discharge it is perfectly safe to leave 2-12 hours after.
Of course call if you experience excessive bleeding or any other concerns. My center educated us on what to look for in the first few days.
I would think armed with knowledge and at least one visit with a provider 24 hours post d/c would be safe enough.

My hosp will d/c w/in 24 hours if all is well. And even my c section on a mon I was home thurs. And my fever kept
Coming back. (Minor complication).

[snapdragon]

Thanks again, everyone. It sounds to me like it's perfectly safe to be discharged, but it's just a personal preference. I appreciate the input so much!!