Going home after delivery

Dr. Parang Mehta, MD.

What's the right time?

You've endured 280 days of pregnancy, been through the birthing process, and now it's time to go home with your new baby!

But before you leave the hospital, make sure you're ready.  Make sure you're well, your baby's well, and you have all the information and support information that will be needed.

Once upon a time, women would stay in the maternity home for a week after a delivery, resting and recuperating, while the hospital staff took care of both mother and baby.  These few days of rest and relative peace were invaluable for a new mother, as she also learnt about baby care from the nurses and other health professionals.  Breast feeding was established under expert guidance, the baby was observed for the many problems that newborns can have, and the mother was spared the fatigue of domestic chores.

Nowadays, however, a week's stay seems like a luxury.  There are other children at home, leave is scarce, the insurance plan allows only a short stay -- more and more babies are being sent home soon after birth.

Haste can be dangerous.  Though there is less disruption of family life, and saving on costs, an early discharge after childbirth can be risky. There are several conditions of the baby that can appear after 24 or even 48 hours, and may be difficult to detect at home.  Lifelong disabilities, and even death, can result from these.

So when is it right to go home?  No one can answer that, because every baby and mother is different.  However, what is important is that the hospital staff is sure that the baby is normal, has adapted well to life in our world, and is likely to be normal in all ways at home.

Criteria for safe discharge

A normal child means a child born after a full nine months pregnancy, and who was born normally, and established respiration and other body functions after birth.  This baby should be able to maintain body temperature in a crib, have normal breathing and heart rate, and be free of obvious birth defects.  The hospital staff would like to ensure that the baby is taking breast feeds well, and tolerating the feeds.  Urine and motions should have been passed at least once each.  It usually takes 48-72 hours to ensure all this.

Apart from this, your doctor would probably like to have the baby examined by a child specialist.  Discharge also depends upon your ability to care for the baby at home, the support avavilable at home, and the access to health care personnel in case of problems.

It is always possible to pressurise a doctor to discharge you.  With health insurance plans and managed care becoming more and more aggressive about cost cutting, these decisions are often not up to us anyway.  However, we need to be aware of the problems, and not contribute to them.  It's inconvenient to stay in hospital, but compromising a baby's safety is a terrible risk to take.

Hospital Discharge Policy

It's best to find out about your hospital's discharge policy well in advance.  Not knowing about a rule or procedure can create a roadblock on this happy occasion.  For example, depending on local laws, the hospital will not discharge a baby unless an infant car seat is in place in your car.  Arranging such things at the last moment can be difficult -- asking in advance for all the requirements is a good policy.

Find out also, about the hospital's check-out time.  Your family should be there a little before that time.  Else, many hospitals move mother and baby to a waiting room, which may not be very comfortable.

Things to Collect

Problems for the baby with an early discharge

Several problems that are common in babies appear only after two or three days.  Babies that are sent home early after birth are at risk.  These problems, not recognised and treated quickly, can have terrible consequences.

Safety Measures

Medication

Most normal babies require no medication when they go home.  However, if your baby has had to start some medication while in hospital, you should have clear information on what is to be continued at home.  Ask about the dose, timing, and method of administration of any medicines, and also how long they have to be continued.

If baby is not fully well at discharge (and this does happen -- babies are being discharged earlier and earlier) then you should have information not only about medication, but about special needs also.  You may need to learn about the use of an apnea monitor or oxygen device, if your baby has a breathing problem.  Infant cardiopulmonary respiration is one of the skills you may be taught before going home, under some circumstances.

Last Revision: May 12, 2020