Self discharge from hospital after birth?

[Lozzateex]

I’m due to give birth in 2 weeks, and I’m dreading it. Not the birth as such, but the staying in hospital after! I originally wanted a home birth because hospital was the only thing I hated the idea of, but I have a number of mental health issues and I’m on medication for them so Iv been told that the baby will need to stay in for monitoring for a few days after to make sure he doesn’t have any withdrawals.
The idea of being away from my partner and people I know for that long surrounded by strangers in a busy hospital ward in this boiling heat for that long just makes me panic and cry and think all sorts of things. I’m in a frenzy about it now and I’m not even there yet! I know it seems trivial and it’s only a few days, but I’m still in a very fragile state of mind and that will push my over the edge!

Iv been researching and legally, they can’t force me to stay in hospital and I can self discharge myself after so many hours. I could also self discharge baby if there were no issues, but because he needs to be monitored I realise that I can’t and it’s better for him to stay in.
So my question is... can I discharge myself while baby stays in to be monitored? I understand that they could try to talk me out of it and advise that I didn’t, but if I’m INSISTENT what are the laws on it?
It might sound mean to leave him in alone but please don’t judge me. You don’t know how my mind works and I’m getting a lot of professional help right now and trying to get better, but I know that will set me off and send me straight back to square 1 again. I couldn’t find any definite answers online, so I thought I’d see if you have any wisdom to share with me on the whole subject.
Thankyou all so much in advance!

To all those posters asking the op who will look after her baby.. it is clear from her op that she has home support (her partner and her family as well as health professionals involved). This is a case where the who support network need to shoulder this responsibility, this baby has two parents, one of whom cannot stay in hospital after the birth, the support network needs to work together to find a way to support the Op so that she can get through this. Hopefully her partner will be able to step up to the parent role and take care of the baby.

In other situations, temporary foster carers are put in place if there are no parents who can look after a newly born baby, the op needs support, not judgement.

Christ there are some people being very harsh and judgey here. Which is irresponsible given the OP has severe mental health issues. Piling pressure on her when she is already struggling to cope, telling her she will be "red flagged" and that she is a bad mum if she doesn't put her baby ahead of her own mental health...do you actually want her to do herself a mischief or disengage from the help she is already accessing?

OP, your baby would not be in danger without you in a hospital. He will be cared for. It will not be classified as abandonment. But when the time comes I don't think you will want to leave him. Just give yourself a chance, continue to talk to your team about your concerns, book a private room, and make sure you have lots of family support for you and your baby in case the worst should happen and you can't stay in the hospital with baby. You cannot be a good mum ti your baby if you have a mental breakdown. Do not push yourself beyond that point to fill someone else's narrow-minded view of perfect, self-sacrificing motherhood.

The OP quite obviously has a serious mental health condition, she is unwell, victim-blaming doesn't help.

Absolutely. I’m gobsmacked at some of the replies here. It really brings it home that even today, many people know fuck-all about mental health problems. Would you say to someone with, say, diabetes or IBS that she had to stop being selfish and put her baby first? Jesus wept. My friend collapsed with pre-eclampsia, can you believe how selfish she was? Not thinking of her baby at all

Hopefully her partner will be able to step up to the parent role and take care of the baby

I’m sure he would if the baby was at home, but the reality is that the baby is staying in for monitoring and the father (or grandparents) will not be able to stay on the postnatal ward. Which is why the OP needs to talk to someone in advance to find out what her options are.

You really need to talk this through with someone - I don't think you sound prepared to be having a baby or being a mum at all

Oh to be the perfect mother. I thought I would be - but without family support network I'd have struggled. After having 1st DC I found hospital overwhelming , that's something I didn't account for. We do not know it all, even if we think we do.

OP you have a support network, and I hope good people to talk to whenever you feel the need. As you've concerns is there anyone, or even 2 people who can spend a lot of time at hospital with you once baby arrives? Any chance of a private room?

Good luck OP. You're going to have your baby soon no matter what, so try to calm down and make the best of it. Good luck & enjoy your little one💐

Psych meds can affect the babys heartrate after they are born which is why they need to stay in. You cant really take them home, they need to be monitored. So that can be with you, on the poatnatal ward, or on the neonatal unit.
You will stay because your baby needs you please dont panic x

I've no advice to give you in terms of discharge however I would ask if you could have a private room. Some hospitals have midwifery led units attached and it may well be possible if you speak to your consultant and mental health team that you could be transferred into one of those rooms after giving birth and in my area certainly not sure about other areas partners are allowed to stay over in midwifery led rooms as they are seperate ensuite bedrooms essentially like hotel rooms And it could be arranged that the paeds and nurses come to monitor your baby in there.
Also I'm not sure if you have had other babies before but if you haven't and are just aware of the horror stories of hospital wards rest assured this isn't always the case.
I had to stay for a week after I had my 2nd on a hospital ward and was quite frankly terrified of even having to stay a night on there before I gave birth because I had previously given birth in a stand alone midwife unit where my partner stayed with us the entire time but this time he was needed at home for our 2nd child.
I had heard all the horror stories about wards but it really wasn't that bad at all and infact I quite enjoyed my extra long stay with plenty of time to bond with my baby uninterrupted. It was busy yes but it was clean and generally quite peaceful and quiet. The nursing staff were excellent I always had the pain relief I needed and they called doctors in the middle of the night to discuss increasing my pain relief and there was no waiting around. My dd was in an incubator at the side of my bed she needed some monitoring and help and phototherapy but not enough to require a bed in the NICU. Each night she was taken by the staff down to the NICU for all her blood samples and checks and 2 of the nights the nursing staff kept her with them for a few hours afterwards so I could get some rest because she was very unsettled and wasn't doing a lot of sleeping. All in all I had a very positive postnatal experience in what is the biggest maternity hospital in my area and it was also incredibly busy infact completely full up when I was there but I didn't feel like my needs were neglected at all

OP

Please speak to your midwife about your fears and get some extra support, which you clearly need. They might be able to sort things out like a side-room, if possible (which it isn't always, but they would try their best to get you one in these circumstances). It has hard to guarantee side rooms in some hospitals, depending on layout and demand (e.g. infection control purposes). I think you need to think carefully about doing so- who is going to look after your baby if he has to stay in for monitoring for instance? I think that being separated from your baby would be very hard on your mental health too.

But if you were to decide to discharge yourself against medical advice, you could do so- as long as you were deemed competent. The only way they could prevent you from leaving is if you were assessed as lacking capacity and detained under the mental health act. This is rare in your situation and detaining someone under section is NEVER done lightly. In addition, there is a strong legal framework in place when it comes to detaining patients.

It is a slightly different situation with regards your baby though. If your baby needs to be in for monitoring and you try to remove the baby against medical advice, then they could take action to prevent you from doing so. There would be likely to be social services involved if that were to be the case as it would be a child welfare issue.

In short- as long as you are not deemed to be medically incapable of making an informed decision due to your mental health, then you can discharge yourself against medical advice. You do not have quite the same rights when it comes to your baby.

Wards are awful. In local hospital u can pay fee for a private room which prob help hugely with mental health

Surprised at people saying their local hospitals allow you to pay a fee for a private room. Are these NHS hospitals? Got any links?

My NhS hospital did let you pay for a private room - Heartlands hospital in Birmingham. They were really quiet though so didn't actually end up charging me but would have done if it was at capacity and I requested the room specifically.
However if you pay for a room but then a patient with a medical need requires it, you're moved out (understandably!).

@LyndseyKola - www.ruh.nhs.uk/patients/services/maternity/documents/Patient_Information_Amenity_Beds.pdf

Did this with both DC (two different hospitals but same idea) both times I had a private single en suite room (with an extra mattress for DH the second time which was great). Nhs hospitals both times, private room was worth every single penny and I will pay again if I am lucky enough to have a DC3.

OP - please speak with your midwife and perinatal MH team about an amenity room. That way you will have privacy, peace (to the extent that is possible with monitoring and observations) and if it’s like my hospital your DH will be able to stay with you constantly and help take care of the baby. I had c sections and struggled to bf both times so the rooms were invaluable and meant I could stay and have the support I needed quite comfortably. Good luck

You absolutely can self-discharge. You can do that and have your baby on a Neonatal ward, with you caring for him while not being a patient. I will say though, if you self-discharged and then went home, leaving your newborn baby in hospital alone, we would risk assess for possible Social Services review and intervention.

Hi,

Have you talked to your midwife? I wonder if instead they could support you with a private room and letting your partner stay with you. You might find it really difficult to be physically separated from your baby if they remain to be monitored.

Private rooms for extra £ in NHS hospitals has been a thing for at least 10 years. More common these days than when I had DS1 but the concept was certainly around then.

Does your hospital have private rooms? Maybe you could explain the extent of your anxiety and get your own room just see it as being looked after for a few days.

Your partner will not be able to look after the baby overnight unless there is a priavate room. If you self discharge without your baby SS will be involved.

I’ve been through this myself.. I haven’t read the replies as I’m supposed to be studying but I’ll sum up my story:
I have bipolar disorder; my boy needed to stay in as wasn’t feeding correctly; frenzied and anxious I asked to discharge; they said If I discharged baby they would have to call SS (absolutely fair enough and I see that now) and after a couple of hours was given a private room; stayed a week and was fine, glad I didn’t leave him and glad we worked on feeding.

The only thing I look back on now is how on gods earth did I stay in hospital for a week and absolutely nobody picked up on how mentally ill I had gotten since the birth!

Midwife here.

Self-discharging (which you’re well within your rights to do) but leaving your baby behind would be a safeguarding issue for me, and I’d be making SS referrals.

If you self discharge, either:
a) you’re visiting them all the time, in which case you may as well stayed a patient and avoided all the tension with staff about self disacharge/SS
b) you rarely visit, in which case you’re hugely compromising your bonding

Someone this ill needs help and support, not lecturing and hectoring.

The thing about booking these private rooms is that often times the booking is cancelled if the staff deem someone else has a greater need of the rooms available.

Really hope you can speak to your mental health worker, OP. Please be honest about your feelings to them.

Have you got any useful advice from this thread OP?

It would be nice to know if you manage to sort something out. I suppose so much depends on the policy at your local hospital.

Yesterday 16:22 rinabean
OneStepSideways your entire post is ridiculous. A lot of women don't "just tolerate it". OP is obviously on some heavy and/or unusal medication for her baby to need monitoring for days after birth.
Comparing this to the completely normal anxiety almost every woman feels is stupid. If you are too mentally unwell to look after your baby, you are medically unwell

OP didn't state the medications she is on or the MH disorder(s) she suffers from. Even commonly prescribed SSRIs like Sertraline require monitoring after birth in case the baby has withdrawal.

Lots of women with clinical depression/anxiety disorders/bipolar/personality disorders etc remain in hospital for a few days after birth, despite high anxiety over a hospital stay. The clinical team do their best to support, help and guide.

Of course OP's mental health is important. But the baby's wellbeing is equally important. Some hospitals have specialist mother and baby units, staffed with mental health professionals, to help new mothers suffering with mental health conditions. The focus is on NOT separating mother and baby.