After birth, can you discharge yourself and leave before they discharge you?

[swampwomp]

Not sure I worded that brilliantly so I’ll explain!

I need to have a c section next month but I’ve only heard not great things about the hospital I’ll be going to for after-birth care on the ward. I know working for the NHS is very difficult right now so I’m not judging the staff, who I imagine are overworked and stressed enough. However, when I gave birth before (different hospital), after being told I can go I still had to wait about 7 hours to be discharged. When I’m fit to leave hospital, do I have to wait until they discharge me or can I leave once they say I’m physically okay to go? I don’t want to stay any longer than necessary.

Many hospitals have a 24 hour discharge option for uncomplicated c sections, so you could ask if you are eligible. My hospital does, but I wasn’t eligible because of my heart condition. So I was in for 48 hours for my 2 C sections (babies 2 and 3).

I’ve found pharmacy is often an even longer hold up than paperwork. With baby 1, which was a tricky vaginal birth requiring several lots of medication to take home, pharmacy took so ridiculously long that the ward agreed to let us go and my husband went back later to pick up the medication, once the baby and I had settled at home. Could something like that be an option for you?

You can discharge when you want, however if there are any concerns or issues over baby you shouldn’t

@EarlGreywithLemonthat would be an option, hospital is only 20 minutes away. Obviously I won’t leave without the injections! I’m honestly happy to stay 48 hours if all is well and longer if it isn’t for each of us but I just meant if you were fit to leave but it would end up being another night in, can you leave kind of thing.

as a PP said, you can leave any time you want, you dont have to sign anything, you can just walk out. Whether that is a good idea medically is another discussion. They can want you to sign any number of bits of paper and wait for this and wait for that, but you CAN just stand up and take the baby and go home.

I got early discharge after 24 hours because the ward was not supporting me. I could not sit up after the section and could not lift my baby to feed her.

I felt every bump in the road whilst being driven home by dh. I should ideally have stayed 48 hours.

Hospitals don’t want to keep people unnecessarily - they’re too busy with the people they need to have there to want more but they will want to make sure you and baby are okay before discharge. If you decide to discharge against medical advice, they’ll get you to speak to doctor /sign something (you’d be surprised how many people are incredibly rude to nurses and then become reasonable when doctor says no problem to leave as long as you take responsibility) - and if baby is obviously unwell and you insist on leaving, that is a red flag and will be followed up. If it’s a case of waiting on paperwork, be nice and see where that gets you. I brought gifts for nurses to say thanks etc and was generally a decent human being and when I explained I wanted to go, they facilitated it as quickly as they could (not immediately because I wasn’t urgent and they appropriately prioritised, but not long either)

You can ask about a side room too if that will help things. It's rare but you never know. My midwife requested it for me when she booked my induction. And I did get one. Still wanted to leave ASAP though hate the wards.

I had a planned section with ds which was really smooth thankfully. And I was nervous about the care I'd receive having heard so much negative about the pressure the nursing and midwifery staff are under etc but I have to say they were all absolutely lovely and very supportive. I had ds first thing in the morning and was discharged by the next morning. It was really late evening time before the spinal block wore off and i was very dizzy walking to and from the bathroom. They also don't discharge before checking you've passed a certain amount of urine and baby has had their checks. So I feel I was discharged really as early as I could have been. I found the ward noisy so was keen to get home to my own bed to actually sleep but definitely in my experience they want you out as soon as you are fit to be out and your meds have been delivered to the ward.

@Psychologymamthat makes sense, thank you. I’d never do it against medical advice, I meant after everything being given the okay if it would mean avoiding another night if the discharge takes a very long time, but as you and many other posters have said, they will want me to leave when I’m able to

Oh you’ll be fine!!!! I’ve had 3 c sections and they start the conversation about ‘do you feel ready to go home soon’ usually around 16 hours after your OP: they were very keen every single time that I could go home at 24 hours if I wanted to!!!

gosh they really won’t insist you stay 2-3 days against your wishes, they want the beds back!!!

All going well you should be allowed leave after a c section if no issues with you or the baby after 48 hours. As others have said even 24 hours could be possible. If you tell the staff you would like to leave as early as possible, that you feel well and have good support at home etc they should get the ball rolling on paperwork and newborn checks etc to allow you to leave. I had two baby’s via c section during Covid and couldn’t wait to get home. I was asking to leave nearly straight away and they said minimum 48 hours but I’m not in the UK. I kept mentioning that I wanted to leave to every nurse and midwife I saw and that I was feeling well, baby fine etc so they were happy to let me go after 48 hours and were happy to have the bed back I felt

I don’t think they would tbh, it may drag on during the day while waiting to see medic/get things signed off etc, but they will want you to get out of there too. Best of luck with it all!

Gosh, I walked out before being discharged from the Homerton in Hackney after my CS 13 years ago. It was hotter than Hades.

I had my first c-section 14 years ago and was in for 3 days - and my last 4 years ago and I was out in less than 24 hours.

I don't think staff have any desire to keep patients in hospital any longer than necessary anywhere these days. If anything, bed pressures mean that people are often sent home too soon in my opinion. It's a good few years since I had anything to do with maternity, but I believe that most women who have had uncomplicated sections only stay one night in our local hospital now and those who have had straightforward vaginal births mainly go home after 6 hours. I had a 6 hour discharge after I had my last child even though I'd had a retained placenta. There were no beds on the post natal ward so they sent me straight home from labour ward pretty much as soon as the spinal had worn off. I doubt things have improved significantly in the intervening years.
But it does take a finite amount of time to get the paperwork done, newborn checks and any take home medication dispensed and it's not generally because the people who need to do those things are twiddling their thumbs somewhere. Depending on how far away you live, there might be the option to go home and send someone back for medication if there's going to be a long wait. We did that recently for my mother in law when she was discharged after some surgery but her prescription wasn't ready. In my experience, if you let the staff know that you're keen to get away they'll usually do their best to facilitate it unless they think it's dangerous, as chances are there's someone alreasy waiting for your bed. However, they can't make pharmacy open earlier or magic up a paediatrician if they're all busy on SCBU or on labour ward etc so you do sometimes have to be a bit patient.

I tried to discharge myself. The midwife on the ward made a veiled threat about social services so I stayed. I put in a complaint against her as soon as I left which was upheld. I got an apology but not from her. Apparently she was off sick. It was an appalling and completely uncalled for thing to do to a new mum. I knew I would be better at home. I had support, proper food and was much comfier. Baby was absolutely fine.

I did when I had my DD,but this was 41 years ago! Back in the early 80s you were expected to stay in hospital for 10 days with your first born,which I thought was ridiculous if you'd had a straightforward, problem free birth. After 8 days,I'd had enough of the noise and not getting any sleep so I said I was discharging myself. The ward sister has a right go at me,saying I was endangering my baby's life blah blah blah and that if anything went wrong,I'd have absolutely no come back and I wouldn't be allowed to be readmitted to hospital. Which I now know is total bullshit. I discharged myself and a midwife visited me at home for the next 2 days, despite the hospital saying that they wouldn't be able to provide one. They just try to scare you into not discharging yourself.

They usually issue you with a load of injections to do at home when they discharge you after a CS so you'd likely need to wait for that. Plus the checks they do on the baby and issuing all the paperwork. It can be a pain when they take forever to get everything together but it will be much more hassle for you and them to sort it all later.

After a vaginal birth and zero sleep in hospital for two nights, I really wanted to go home. We asked the midwife and she said "if that's what you want to do".

We said to her "only if it's safe for the baby to go home. If not, I'll stay. What do you think?" She said it was safe for me to leave with the baby.

BUT, she wrote it up in the notes as "Mum insisted on going home" There was totally an implication that I'd railroaded the discharge even though we said that we'd trust her judgement and that we wouldn't leave if she thought it was in the best interests of the baby to stay (and we made that quite clear).

So, be careful as they write it up and see it as a red flag.

I was ready to be discharged 24 hours after my section. First baby as well. They eventually discharged me at about the 30 hour mark. It’s not a given you’ll be there for 2 nights, especially for a morning procedure.

You can discharge early but it will be against medical advice and you have to sign discharge papers as such will still take hours to get together

I discharged myself. 3rd child. The ward sister didn't like it but I had had no help from the staff for 48 hours and I shared a noisy 4 bed room.
We left at 9 am. They could have the paperwork ready at 4 pm. No, thank you - I asked them to put it in the post. They did. Never heard anything about it.

I think thags it’s probably in everyone’s best interests to be dined off by a doctor.

Well, this question is probably redundant then.
Last person I knew who had an ELCS at 2pm, was discharged the following afternoon.
So, if you are happy to stay 48 hours, and longer if medically necessary, I don't think this will be an issue.

Shocking really after major surgery, even if you didn't have a baby to look after, but that is where maternity service / NHS is currently

Yep, I gave birth at 5am and stayed that night. They wanted me to stay the next night too and I said no. They discharged me and did everything they needed to, I didn't just walk out