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.

There's usually a long wait between the midwives saying all is fine and discharge is happening, and actually being waved goodbye. I think this is what OP means? I'd just prepare myself for another long wait OP, you need the blood thinner injections and painkillers at the very least.

I did, I had two sleepless nights with my first (loud talking, beeping machines etc) and combined with the sleepless previous night giving birth I wasn't in a great place to start with newborn sleeps! So second time around, as soon as I'd had the baby and was told all was fine I just left. I had a very quiet peaceful night at home and my GP said she felt honoured to do the newborn check the next day.

I’ve done it twice after giving birth. I wish I’d just walked out tbh, I had to wait ages for paperwork.

I didn't get any injections after I left the operating theatre - but okay, my c-section was 11 years ago. The baby was examined at birth by a very kind paediatrician.
No doctor or midwife saw to her afterwards.
The nurses kept promising me painkillers but I never saw them in the 48 hours I spent on the ward.
Our GP saw us the same day (on the way home from the ward) as I left without any painkillers. She was happy to see the baby. It took 5 minutes.
She told me that it was common in the NHS for mothers and babies to be left to fend for themselves.

You do now get blood thinning injections after a section - 10 days minimum if I’m right? I got 6 weeks after all three births, including the vaginal, because it was complicated and I was in for 5 days. I also got Codydramol for all three, laxatives, and antibiotics for the vaginal (but not the section).

Yes you can. I did all 3 times. But they will be angry and they will try and get you to stay because it fucks up their paperwork essentially.
They will get you to sign a paper that says you left against medical advice. You should do this rather than just walking out because if you just walk out it's a big faff for them in terms of what they have to do after a patient does that.
But you do have to be very assertive. I had to threaten to walk out before they'd bring me the discharge against medical advice forms.
You have to expect some hostility.
I personally did the best thing for me and my baby. I'm sorry I caused bother to hospital staff but it's not a prison and I wasn't staying in there any longer than I felt was physically necessary.

Can't you change the hospital where you will have the c-section or is it too late? Since it's not a "good" one?
And yes, totally get your concern. In my case, we spent an extra week in the hospital as the baby was not feeding well. But eventually the doctor gave us the ok at 9 am. Midwife said paperwork will be ready in 2h tops. So spent the entire day awake, ready to leave "in a little while". Eventually threatened to walk out and left around 6pm... Still angry about how they ruined our first day home with baby as we were both (me and husband) shattered by the time we got home.

I discharged myself 4 days after my emcs, I'd been very poorly, 2 days in HDU with HELLP syndrome & then dumped in a single room & left with zero care. First time mum & not much experience of caring for a baby, once I had recovered from the drugged state they left me in & insisted I was formula feeding it was like a switch & all care stopped, I got paracetamol & BP meds given to me twice a day & that was it, I didn't get fed for most of my stay either. Once a doctor came & did the newborn checks I rang my parents to bring the car seat, got myself dressed & told them I wanted to go home, I was given my paperwork & meds to take home, ironically diclofenac & Co-codamol when they had only been giving me paracetamol & we got ready to leave, a midwife chasing me down the corridor because I hadn't had the birth control lecture, I just told her the only way I would ever be going back there was to be sterilised. The midwife came the next morning & every day for 2 weeks & then less often for a month as I had severe PND. My BP went sky high again when I got home but my lovely GP treated me at home as I refused to go back to hospital.

Totally agree with you @PoodlesRUs. This will have stressed the staff, and detracted from someone else’s care. Maybe someone who needed it more?

I didn't have a c section but I did discharge myself - they wanted to keep me around to see me feed my baby, which I had successfully done several times but every time I tried to call them over to see it, they were too busy. I had a fab community midwife who would come out every day if needed for a home visit so I was confident any issues would be picked up by her.

They called us when pharmacy/discharge paperwork was ready later that day and DH went back to pick it up.

I did this after my second night in after a “straightforward” vaginal birth. I was at breaking point after a long induction prior to the birth and all the checks had been completed and everything was fine, it was just a case of waiting for paperwork, which I was told could be up to 7 hours. I just said to them “I am leaving now, give me a ring when the paperwork is ready” and left.

As far as I’m aware nothing was flagged to social services, but to be frank I couldn’t have given a shiny shite if it was, I was perfectly ready to justify my decision of protecting my mental health and therefore my baby. Nobody is going to start raising flags for removing a well baby from a post natal ward!

Sorry if it was a pain for the midwives, however treatment in general on the post natal wards is appalling and I’m sorry but my priority is the wellbeing of me and my baby. It’s a shame if the way the system works is putting extra stress on staff but don’t try and guilt vulnerable new mums into putting up with more time on awful postnatal wards just to avoid causing extra work for someone else.

Mystified by all the ‘should’ be able to leave.. ‘might’ have to sign something.. comments . Hospital is not a prison. You aren’t there under a court order. No one can ‘make’ you do anything - including sign paperwork. As long as you can walk there is absolutely nothing to stop you leaving.
That said . If you do decide to do so it may be against you and baby’s best interests. Hospitals don’t want anyone there where it’s unnecessary. However as a PP has already mentioned - self discharge is a really dickhead move . Because the way the NHS bureaucracy works a doctor has to see the patient and try and talk them out of it or get them to sign a paper explaining why discharge at this point is unwise . Which means in practical terms you have put yourself to the top of the doctors priority list - and away from the person they SHOULD be treating. Because YOU consider YOUR needs and wants are more important than anyone else’s . This particular self absorbed behaviour as demonstrated by @strangerontheinternet (yesterday 21:45) is exactly why some NHS staff are sometimes burned out. In her case she states that after stamping her figurative feet a ‘paed miraculously arrived’ .. in her room ten minutes later .. No - not miraculous. I bet they weren’t sitting at their desk having a nice long chin wag about last nights episode of a soap opera! They were almost certainly attending to a child or baby that had a more urgent medical need - than her inability to be patient. !

@YaWeeFurryBastard I totally agree and I did the same thing.

I feel like hospitals don't help themselves with this stuff. My hospital to be fair was actually fine with calling us back to pick up the paperwork - why can't all hospitals just offer this as an option? They could even just email it!

The amount of NHS money that must be wasted on beds being occupied by people who don't need to be there

Not necessarily. I was in for under 24hrs.

Yes how dare a vulnerable new mum prioritise the health and wellbeing of her and her baby 🙄. If the system means this puts unreasonable pressure on doctors that’s the fault of management, not exhausted new mums.

I didn’t see a doctor when I self-discharged, perhaps because everyone was agreed that we were ready to leave it was simply a matter of waiting for paperwork? Frankly I wasn’t prepared to wait to speak to a doctor anyway when I had already been signed off by two, if they had said “no” I would have quite simply taken my baby and walked out of the hospital.

Discharge yourself when you’re ready 100% - I was kept in 3 days longer than I needed to be with DD1 because they were too busy to get the paperwork sorted. One of my biggest regrets not discharging myself, spent the first week of my daughter’s life in an awful ward and I was physically exhausted by the time I got home.

Yeah I didn't see a doctor at all when I self discharged either - I don't think I saw a doctor at all the whole time actually, gave birth on a midwife led unit.

Of course you can, it’s a hospital not a prison

If you mean they have said you’re medically fit for discharge, and the only thing you’re waiting for is any medication you’re discharged with to come up from pharmacy (which can take ages) then you could leave, as long as someone can come later to pick up your medication. At least that’s how it was when I was a ward nurse a few years ago.

I find it absolutely mad that new mums are discharged after only a few hours. With DD1, we had told we were going to be discharged about 20hrs after she was born (overnight basically) but inbetween them telling us this and sorting the paperwork, she developed Group B Strep sepsis, blood sugar tanked, temp tanked, massive rash appeared and she was rushed to NICU where she spent a fortnight. I dread to think what would have happened if we'd had been at home - we had no idea i was even GBS+ at that point. The postnatal wards are horrible but after my experience, I think 24hrs at least gives a certain period of monitoring for any issues.

If you have your baby at home you never go to hospital in the first place, so it’s not that mad really. There should be much more aftercare I think though

Often it’s a case of waiting on the pharmacy to dispense your meds! You need blood thinning injections after a c section, I’m not sure how it works if you discharge yourself before those are given?

Also, I was all ready to go, baby was bathed and dressed and just as a midwife came in to say I could go DS puked up some brown gunk and they then made me wait for a paediatrician to assess him! So that set us back a couple of hours.

FWIW I was moved to a private room for free after my c section and it was great, so I stayed 2 nights and was offered a 3rd if I wanted more help with breastfeeding but I declined as by that stage I just wanted my own bed.

Don't you get much more care at home with a homebirth though? Eg two midwives that stay with you throughout the birth and immediately postbirth? So more likely to pick up on issues given the close monitoring? It seems that some women have the worst of both worlds - a hospital birth and then shoved on a postnatal ward for 6hrs before discharge. Due to my experience with DD1, when I had DD2, she was very closely monitored after birth (we stayed for 48hrs) and the level of care was so different to DD1. Midwives constantly popping in and out to check on her. It shouldn't take a child nearly dying to receive that type of care. It should be available to everyone.

I was told I could go home about 4pm, but no paperwork was ready by 7.30, so the staff agreed I could collect it the next morning, when I was due back at the hospital for more routine baby checks (I can’t remember what they’re called!) I wasn’t waiting on any medication though, so that might change things for you.

My discharge after my DD's birth was horrendous! We were removed from the bed space after being given the ok possibly late morning and had to hang around till early evening waiting for medication. In the end my DH told them we were leaving and he would return to collect the medication. Amazingly the medication was sourced and given to us very quickly. We then left but it was not a good experience. Fortunately discharge after my DS's was swifter.....same hospital.