How long to spend in hospital (assuming all goes well)

[Nightfall1983]

I know that I might not get to decide this, but I'm 37 weeks now and assuming all goes well I could have baby and have an "early discharge". Our hospital offers them 6 hours after labour even for first timers (which I am) if everything is fine with mum and baby. I don't like hospital, have lots of support at home and just want to come home with my baby so I've written on my birth plan "would like to be considered for an early discharge is all is well".

However my midwife keeps saying she thinks I should stay for 24 hrs. I don't want to just dismiss her expertise, but nor do I want to stay overnight... Her reasons are good, mainly:

• She believes that a few hours after labour, if Dad can go home and have a good nights sleep safe in the knowledge that mum and baby are in good hands then even though mum might not get much/any sleep in hospital he'll be sufficiently recovered that once home he can care for baby downstairs whilst mum has a proper sleep upstairs - she believes that this can fight the initial exhaustion that is a contributor to PND. I think it's an interesting point, I do think that we could do that at home anyway, one sleeping upstairs and one with baby downstairs...

• She thinks that we need to stay in to get breastfeeding established. I desperately want to breastfeed and despite lots of research I'm aware that I don't know what I'm doing! Where I live (Derby) there is not that much support, just a breastfeeding group that only meets once a week and midwifes/hv's so I definately take her point on this one...

What did you do/what are you planning?

If you don't want to stay in hospital, have you considered a homebirth Night?

I've had two, had the first one at 5.40pm and came out the next morning, around lunchtime. Can honestly say it was probably the worst night's sleep of my life. Was totally overcome and had one woman freaking out because she couldn't bf, and one snoring her head off.

Had the next one around 3.45am, by the time I'd had skin-to-skin, a bath and got on the ward I only had an hour's sleep before they were waking us all up.

Was a bit naive with DC1 and didn't realise you could have a Homebirth with your first one and really, really wish I had.

With DC2 we lived much further from the hospital and I ended up having a hospital birth as DH was so worried about the transfer if I had needed one.

Your MW does have a point about DH getting some sleep and establishing bfing and the last one is a very good reason to stay in, but my advice would be read up on Homebirth and then decide on that one, then have the baby and see how you feel. I've got friends who were said they didn't want to stay and ended up staying 3 nights, while you are in there it is a lovely time for just you and your LO to get to know each other without the myriad of visitors you'll get once you are home.

I am a first timer too and will insist on early release. My response to your midwife would be:

• DH is a worrier and will not sleep well on his own at home after baby born. This will stress/freak him out. I will not sleep/relax well on ward with other new mums/new babies. We are BOTH more likely to relax/sleep at home as a family unit in own bed with own comforts.

• breastfeeding is most likely to establish if mum and baby relaxed which is most likely at home. I have all info of doctors/midwife/hv/nct/groups/peer supporters and will ask for help if needed.

I have been really insistent on this and discussed it with my consultant. Consultant has agreed (and put in my notes) that I should be given early release unless a medical issue requires otherwise.

So many people have tried to convince me it'll be relaxing spending a few days in hospital being taken care of. That it'll be a good idea. Sorry but I'd rather my own food, in my own bed, with my own bathroom and my own noise. DH is perfectly capable (and knows its his role) to feed me and look after me more attentively then the hospital would have time to do.... My hospital is a busy city one not a nice relaxing small town birthing unit.

Sorry rant over.

OP I totally agree with you.

"She thinks that we need to stay in to get breastfeeding established."

It isn't always that easy to establish breastfeeding, so I think this is a sensible point. DD wouldn't latch on for several days so if I had gone straight home she would have been on the bottle straight away. Why do you hate hospitals so much? I felt "safe" in hospital and could always get hold of a midwife every time I tried to get DD to latch on. That said, I had no extra support at home other than my husband so wasn't in any hurry to leave. The hospital were very happy for me to stay until I had managed to establish breastfeeding (it took 5 days in the end).

With both DCs I stayed in one night, and will do the same again this time. DS was born at 5.03pm and DD was born at 5.38pm so my DH got to spend a couple of hours with us after the birth then go home and get a good nights sleep before getting us the next day. With my first I liked the reassurance that if I needed help there would be a midwife around to help or advise me. With my second it was because I wanted that first night just me and the baby, to bond and enjoy the time before getting straight back into the routine of cooking, cleaning and looking after DS when I got home. This time I'm planning on the same again. That first night just full of snuggles and feeding, just me and baby is bliss. Then I get to take them home and share

JiltedJohnsJulie Agree with you that homebirth would be a good solution, but not brave enough to try it for the first one! Although I am planning on having a waterbirth/active birth with minimal intervention I've never given birth before and I want to know that the epidural is nearby if I need it and that doctors (love doctors despite hating hospital) are on hand if something goes wrong.

MrGeresHamster Interestingly DH said this himself when we talked about it, he said that he doesn't think he'll be able to sleep well with me still in the hospital and would rather wait till I get home. That said I imagine he'll be knackered and able sleep anywhere when the time comes...

Bunbaker Hospitals just make me uncomfortable, I've only been in a couple of times in the past - for appendisitis as a teenager and then for a tennis elbow operation 10 years ago - however have found that hospital makes me stop sleeping and eating, I've always had to lie about how much I'm eating just to get home...

MrsPaynie Can see what you mean about you and baby time for the 2nd and 3rd, however this is my first, I can (and intend) to spend the first few days in bed at home just snuggling my newborn and being brought food :-)

It may depend on what time you have baby. I think if you have baby in the morning then going home for the 1st night is totally reasonable. If you have baby from early evening onwards then it may make sense to stay. You can always see how you feel at the time- have a overnight stay bag just in case.

Breast feeding is easier to establish when you are at home, comfortable and have help.

Remember you are not asking permission to leave, you tell the NE's that us what you are doing.

I left after 6 hours (to the second) with DC2 - we were dressed and ready to go and waiting. With DC4 I left after 2 1/2 hours - the MWs couldn't really be bothered to do the transfer to the postnatal ward and so were happy for me to go. I did feel a bit shaky walking down to the car but as soon as I was at home I new I'd made the right choice.

Good luck

Well I had mine at home.

I think that it all depends on how you feel. Of course this being your first you can get plenty of rest at home and you will rest best where you feel the most comfortable. I think the main thing is the bf support and not knowing your hospital I don't know how good it is. Here when i attend antenatal bf workshops as a peer supporter the line from the MCAs (who do all the bf support rather than the MWs) is to stay in hospital until you are happy and confident latching the baby on yourself which seems very sensible. Establishing bf takes time and frequent feeding and personally I think this is probably best done at home when you can slob around in bed and on the sofa with your breasts out. However, you do need to be happy with your latch so that you are comfortable and the baby is feeding effectively so just try to relax after the birt, don't rush things thinking "when can I get home when can I get home?" and take things one feed at a time. If you are happy after feeding the baby that you know what a good latch looks and feels like then go home :)

As an aside if bf support is poor then before giving birth look up NCT or LLL in your area and see what groups they have and what support they can provide and have their numbers to hand. If bf support within the hospital as not good and you are struggling then discharge yourself and call a helpline, especially if they have people who can get to your home.

The worst bit of the whole thing for me was the PN ward. I nearly cried when I found out I'd have to stay in after having DD and DS.

Shit food, over stretched midwives, uncomfortable bed, lights on and noises all night and no BF support, or any food you like, the support of your partner, lights on and off as you choose, TV, time and space to BF in your own time?

"Breast feeding is easier to establish when you are at home, comfortable and have help.

The thing is I wouldn't have had help. I would have had to hire a maternity nurse for a few days to get that kind of help, and we just didn't have the funds. Besides, I didn't know such things existed either.

I think you've done the right thing by putting in your birth plan: "would like to be considered for an early discharge if all is well ".

It sounds as though you have strong instincts about how you feel about this. By putting this in your birth plan, you are wisely making sure that your preference is stated, and importantly, you are also also keeping your options open.

It is quite likely that if you feel this strongly at this stage about going home, that that is how you will feel on the day. But at the same time, there are so many factors to consider (time of birth, lenth of labour, condition of mum and baby (and dad!) post delivery, conditions on PN ward, etc) that you can't be 100% sure how you will feel on the day.

But when it comes to it, you will know what you want. If you're desperate to go home and all is well, you will know. And they won't be able to force you to stay.

Be prepared for all eventualities. It's very hard to predict how you will actually feel after the juggernaut crash that can be childbirth. Take all the support offered wherever it's from. Good luck.

I found my midwife really good at helping me establish bf after I got home. They're supposed to visit every day for ten days so was able to check latch go through different feeding positions etc. I'm not sure how you being exhausted helps, realistically DH won't be able to care for a newborn for any extended period of time for you to rest as baby will often want to feed.

bunbaker when I said help I mean general help, as in someone to fetch you a glass of water whilst you're glued to the sofa, someone to make dinner and hold the baby whilst you take a shower.

You may not need "specialist" help to establish breastfeeding if you do (and I did with each of my DC) you are far more likely to find it away from the post natal ward

I, like you, was desperate to get home quickly, then found bf difficult, panicked and rang up hospital and got then to readmit me! They were fine about this. I just needed a night in with help and support to get bf established. I think it's difficult to know in advance what will be best for you and dc - I'd plan for all eventualuties and see how you feel at the time. Good luck!

I had DS at 7am and was out by 2pm. There was no way I was staying in overnight. The ward was so hot and noisy and just awful. The MW ignored us all completely and there were other women helping with bf'ing rather than MW.

I would go to your local bf'ing group now and meet the ladies there - there might be a peer supporter who you could contact to come over when you are home too.

I really want to stay in (do you have to go home the same day if they say so or can you stay)
Reasons being:

• This is dc3 I want at least 1 night just me and him as I know how manic it will be once home!
• I would have a tendancy to want to start organising (cleaning, washing etc) as soon as I'm home and dont want to overdo it straight away
• It gives me time to get over whats happened, have people there to ask questions if I need to
• Believe me even with lights on, hearing others, crap food its a rest if you already have other children!!

miaboo I think you're right in that it depends what you are going home to. For me, this is my first and I know that home will be a calm place. When you have other children, who will be demanding of your time and attention, it makes perfect sense to stay in longer in the basis that that is the place you are most likely to be able to recover and bond. I don't think you will be released until you are happy to be. Good luck!

OP I felt exactly the same as you and was hoping to be out same day. :) However I also naively thought breastfeeding would come naturally.

In the end we were kept in for 5 days as DS had a rash. I hated being in hospital, but I would have been in a far far worse pickle at home as ds didn't latch and the whole feeding thing was such a nightmare (me clueless, ds not getting the hang of it). Without the day and night support from midwives helping me with that, I don't think we would have coped at all

As it was we managed to successfully bf for a long time in the end, but without that start I don't think we would.

So I would say that while our bf start was one of the worst of all my friends, don't leave until you have it sorted and keep an open mind how long that might be.

IME it is better to stay as long as you can in order to establish breastfeeeding (with help on hand) and also to rest.

I ended up staying for 5 days post birth after DC3 (due to him having an infection - mild). I felt rested and had bf sorted by the time I left. I loved it!

I had my first DC 5 weeks ago. We went home after 24 hours although I get tte impression that we could have been released sooner but baby required 24 hours of monitoring. I would have happily stayed another night as I had my own en suite room and lots of help and support from midwives but as we were both well and breastfeeding was going well then the bed was obviously required for someone in greater need.

"but I would have been in a far far worse pickle at home as ds didn't latch and the whole feeding thing was such a nightmare (me clueless, ds not getting the hang of it). Without the day and night support from midwives helping me with that, I don't think we would have coped at all"

That was exactly what happened with me. DD just wouldn't latch on at all. She was so uninterested in feeding that her blood sugar plummeted and she went very drowsy and couldn't be roused. She ended up being given formula in a cup. A midwife visit every day is all very well, but I needed one every time I tried to get DD latched on - feeding a baby once every 24 hours isn't recommended. I was very lucky that the maternity unit wasn't that busy and I received loads of bf support at the hospital.

Nightfall I would just try and keep an open mind and try to get your head around the idea that you might not be able to leave after 6 hours. That way you won't be too disappointed. After all, if you end up having a section you will need to stay in for 2 or 3 days anyway.

Personally, if I had not had bags of support from the MWs in hospital, I don't think I would have successfully got breastfeeding established. I didn't have a successful breastfeeder in the family to fall back on, so was going to have to learn from MWs alone. I chose to stay in hospital until my milk came in. That didn't happen until day 4, so I spent 5 nights in hospital then went home, with DH starting his paternity leave the next day. However, the idea of being in hospital never really bugged me TBH, so neither was I in a massive rush to get home either IYSWIM. I do really strongly feel that physically I got off extremely lightly after episiotomy/ ventouse/ stitches, and I do wonder if it was because all I did in hospital was rest and feed DS.