Should mothers go home ASAP after delivery?

[mears]

As promised I have started a new thread on this. I am involved in the planning of a new maternity hospital. Ours is going to move to be near a general hospital for emergencies.
The plans are that there will be rooms that you deliver in then go home after 24 hours - sooner if possible, all being well. Some midwives are horrified that women will be going home too soon - especially those who have other children and perhaps need the rest.
Does anybody feel that they would have liked to stay longer? Did anyone feel 'kicked out'.
Is there a need to be in hospital after an uncomplicated birth?

Sorry if my last post sounded critical of you, mears, it wasn't intended. I wasn't including you in the " powers that be"

I would have hated to have been booted out oif hospital after 24 hours. And I had normal pregnancies and easy births both times.

Would this make me a prime candidate for a 24hour room? who would suggest the 24 hour service, me or the staff? Would I have felt pressurised? and if I stayed, would I have felt guilty about taking up a bed and being a burden on the overworked nurses?

Would the question be asked just after the birth and check up? ie everything looks ok, you can go in the 24 hour room. If so, I don't believe I could have made a decision on my exit so soon after the birth. I wonder how many mothers, wanting to get out quickly, will then regret their choice?

I didn't feel 'kicked out' of hospital either time, and loved being in the ward. Luckily, I can sleep through anything, which helped. The happiest five days of my life were spent in a public ward in Greenwich hospital just after the birth of my first son. Just resting and getting to know the ropes. I had no idea how to care for a newborn, needed to be shown (not referred to a book) and I wanted the reassurance of 24 hour back up in the ward. Even the best home support network can't provide that.

I truly felt that left alone at home, even with a supportive dh, I could have easily succumbed to post natal depression. I cannot stress this stongly enough. The slightest thing could have toppled my confidence. I also did not want to face al the hoo ha, the cards and flowers and visitors. I just wanted time alone with him, lots of routine, set visiting hours, set meals, and no danger of unpredictable things happening.

After three days my dh was begging me to come home. He had cleaned the house from top to bottom, even running a nail file to root out dirt between the floorboards, but I resisted for another two days. When I came home I felt ready and had enough core knowledge to see me through.

Even when I had my second son, I felt the same. I knew my oldest son aged five would be all over us, and there would be little peace, and I wanted to bond with my youngest away from the bustle of home life.

Reading these messages I see that lots of mothers couldn't wait to leave hospital. I think this should be their choice, and agree that for lots of mothers, more support at home is the answer. However I hope that mothers like me, who had no medical reason for staying in hospital for longer will not be made to feel they are taking up precious beds and really 'should' be going home.

Emma, it was the Freemasons Hospital in East Melbourne. I think they lead the way in how a modern maternity hospital should be and since then I know there are many more units that are just as luxurious and nuturing with first class medical facilities scattered all over Melbourne.There are also some pretty average public ones that have also cut costs by sending mothers home very quickly.
Tigermoth said what I was attempting to say before I got sidetracked. Had I not as a first time mother been checked in for 5 days I would have been easily convinced to leave after a few hours. I had never felt so amazing. It would have been a complete disaster and I think I would certainly not have breastfed as I needed just so much help and constant advice to get the hang of it all. It was a nightmarish situation that I had never anticipated for a minute. Despite being an RN and having loads of experience with newborns I really felt overwhelmed and certainly didn't feel a "natural" and having no pressure to leave was the best thing.

No criticism noted Tissy - I have absolutely no doubt we will be downsizing. We may be doing that soon already because we have a 60% bed occupancy rate. At a more recently newly built unit, those women who choose not to leave after 24 hours are transferred to a 4 bedded area to stay as long as they want. We will obviously ned to cater for all needs.
SueW - it is vital that there is public consultation for new proposals in the delivery of care. There was a comprehensive consultation about the proposed move of the hospital. I attended quite a few of these but unfortunately - despite being well advertised - the women did not. In one specific area not one member of the public turned up. Thanks for your offer of assistance, but that part will be dealt with by the patient/public involvement folks.
I posted this query because I knew I would get lots of great opinions for my personal information. Thanks everyone.

And tell me again why, as a joint citizen, we dont move to Australia.

I had ds on Saturday afternoon and went home Sunday lunchtime, which was just right, I wanted to be at home. With dd I had her Thursday morning and didnt go home until Friday lunchtime but could have stayed in longer had I wanted. Again this was good for me, I needed the rest before going home and looking after two children. I didnt mind being in with other mums, I can sleep through other peoples babies crying. They also encouraged co sleeping which helped everybody sleep. I must say second time round was very different, not sure if it was because I had been there before of the midwife on duty made it a nicer experience, I believe the latter to be.

I had a lovely time with the birth of my Ds at Kings in London gave birth at 5.40 am and then had my own room (wow) until I went home on Sunday afternoon by which time I was ready to go. Currently 16 weeks with this baby and Kings policy appears to have changed dramatically ie. if you are OK to go home after 6 hours I think (may be even less) you can go and I am pretty alarmed by it. My reasons I suppose have something to do with my previous birth the time I had alone with ds was wonderful but no doubt I would not be lucky this time round but what worries mostly is that their info says that the a Doctor will check baby but if they dont get a chance (words to that effect) then your GP can do that the next day or alternatively you can come back to the hospital. If I feel fine I think I wont mind going home so much as long my baby has been thoroughly checked out. Also I think having one child at home it would be nice to spend some time with just the new arrival!

I also found the time I had in hospital (5 days as ds needed phototherapy for jaundice) very useful for adjusting to being a new mum and trying to get bf established (although that actually took about 8 weeks!). The support I got from the midwives (with one exception) was great - they would literally spend hours with me at all times of day or night trying to help with getting ds latched on.

I had thought that I wouldn't mind being in 4 bed ward, but I have to admit that once I was moved to a single room - so that ds could get his photherapy without disturbing the others - I was much happier. Yes, it could get a bit lonely - but was much better than being disturbed by people coming and going, and babies crying, all day and night. And that's from someone who can always (even with a newborn!) sleep well! I also found I had nothing in common with the other women on the ward. (Basically I'm a snob!)

Mears - what would happen if a baby needed phototherapy? Would there still be some single rooms available or would there only be 4 bed wards?

I was in for 5 days after first birth (section), hated every minute of it and wished I could go home.
I'm having an elective section this time and wish I could go home ASAP.

Mears - I think the powers that be have to look at when and where they are holding the meetings though. Anything held in the evening around 7pm is not necessarily going to be acceptable or accessible to women with young children.

By going out to see women in their iwn space, especially those who have had recent experience of maternity services in your area, they will find out what people really want.

Until their babies are around 4mos old, many women won't have returned to work. After this, it may be difficult to get a proper crss-section of the community as you will be starting to exclude working mums.

lulu, I seem to remember that a doctor (my gp) only checked ds the day after he was born, not on the day. The midwives were responsible for staying with me for 6 hours afterwards to make sure we were both ok and were happy for us to be on our own after that.

I would have love to be home with dd1 & dd2, with dd1 they spent 7 days trying to induce me and she still didn't move, after she was born i was in a further 3 days as she was jaundiced, i only just made it to the hospital for dd2 but she was rushed to SCBU less than 24 hours after being born, after 4 days in SCBU the head midwife of the maternity ward said I could go home even though it was a 40 minute walk there and back and dd2 was feeding every 2 hours, at the time she wanted to discharge me 3 of the 4 wards were shut and there were only 4 women altogether on the whole ward, after I refused saying that I couldn't as SCBU said that dd2 had to be monitered on the maternity ward for 48 hours, after that none of the ward midwives had anything to do with me and begrudged giving me painkillers, in the end the head of the community midwives had to come in a see me, she was disgusted at the way i was treat, it goes to show how different hospitals and commumity and ward based midwives are.

JoPat, if you feel ready to go, then go. Hospitals aren't prisons and they can't keep you there against your will whatever they say. You can leave whenever you like!

Janz, obviously cannot speak for Mear's hospital here, but when my DS1 was newborn he had phototherapy for jaundice and we were in a ward with four beds, they just wheeled the cot with the lights on it and plugged it in beside my bed.

When ds2 was born almost 2 years ago he was readmitted for jaundice and they put us in a single room for his phototherapy.

Babies at our unit do not go under lights any more so you would not necesarily go into a single room. We use bilibeds which are like babygoes that the babies are zipped into which lie on the lights. Babies then do not need to have their eyes covered and lie in an open incubator. Infact, there has been some talk of babies with uncomplicated jaundice receiving phototherpy with the bilibed at home. At the moment babies needing phototherapy after they have been discharged home are readmitted to the paediatric wards, depending where you live, that are separate from the maternity unit. Not an ideal situation IMO, because breastfeeders tend to give up through lack of support from paediatric nurses. It is a policy that is being relooked at.

When I had my booking-in appointment with my midwife last month, she informed me that policy at my hospital was to get new mums off home between 6-12 hrs after birth, all things being equal. I was horrified. While I'm not mad on the idea of hospital birth with the bad food, overwrought staff, noise etc, I know nothing about babies and doubt that 6 - 12 hrs is time enough to show me things like how to change a nappy, how to bath the baby, and to get breastfeeding established. Especially given the fact that I might well facy a bit of a kip after the event too, before I get turfed out, and of course a shower and a clean up, and just a bit of time to cuddle and stare. I know this sounds a bit feeble but the idea of leaving when I feel anything less than confident about how things should be done is terrifying, for someone with no previous experience of babies. I'd rather not be made to feel that I'm an inconvenience or somehow 'less able' for wanting to stay a while. Fair enough if I want to go and everything's fine in medical terms. But I think new mums need to be offered AT LEAST a day on the ward if they want it, I'd have been much happier if I'd been told that the hospital has a 24-48 hr chucking out policy, but that they're flexible either way. I think flexibility is the key; there's too many ifs and buts to generalise about whether a hospital stay is 'restful' for women and other concerns like that.

Both my births had complications (c-section, haemmorage) which meant that I had to stay in hospital. Both times I was desperate to go home as soon as possible (so I could get some rest and some decent food) and checked myself out days earlier than the hospital wanted me to. First time I was in a 4 bed room and second time I was in a single room. It was certainly nice having my own bathroom in the single room so that I didn't have to worry about leaving my baby to pee.

Well I was in hospital for a little over 2 days (and that was more than enough for me) but I didn't come out knowing anything really.

I do remember a midwife coming into the room and didn't declare what she was there for, she mumbled something about bathing (not dunk in the water bathing, just with cotton wool and water). I was desperate for the loo and dh hadn't come in yet so I asked if she'd look after ds while I went. I came back in and she left and I later found out she'd ticked the sheet which said that I'd been shown how to clean my baby!!

The actual bath was given just after I'd given birth and I was too out of it to watch so it was left to dh to try and remember what to do. I guess that was classed as "teaching me how to bath the baby" too.

Plus the fact that every night when dh was away I was pressured into giving ds a bottle (I refused point blank) because it was easier for them than spending the time helping ds to latch (it took me 2 days to see a breastfeeding consultant - and I had to fight for that) I wasn't totally impressed with my hospital experience.

They put ds2 in a bilibed mears, it seems a lot more sensible than having bright lights overhead and masking the eyes. We were readmitted to the maternity ward though, because the hospital had a policy of babies being there until 10 days old then transferring to the paediatric ward.

Most of the midwives there were quite nice, but one of them i really didn't like, she enjoyed telling me that ds could be at risk of brain damage , and implied it was my fault the jaundice had been left to get to that stage. His sbr level was quite high but I don't think it was at the stage she was inferring.

When I had ds, there was a girl who gave birth the day before me. She was intending to stay in the ward for a whole week because her benefit check did not come through until then, and she & her dp could not afford to buy the baby's bed until then!

My SIL is due in May, and she told me that she will stay as long as possible, for the rest! This will be her third child, so I personally don't blame her.

Going back to Mears original question (and sorry if I double up, as I haven't had time to read this thread), I think that mothers should be able to stay as long as they wish, within reason. I gave birth on Friday morning, and left Monday morning, by which time I was ready. I did not feel like I knew enough, but wanted to be at home. Having said that, my milk came in that night, and it was terrifying, because my boobs were too full for ds to latch on. I spent a horrible night, and think that I would have dealt with it better if I had been in hospital.

If I had another baby, I think I would want to come home immediately if there were no problems. I do think that the MW's in my maternity ward were eager to send mums home. I got the impression that they actively encouraged it, which is wrong IMO. However, if mums are happy to go home after 24 hours, why not.

I would have been quite happy to stay in hospital for quite a while if I kept on being fed there. I loved the mobile catering trolleys as we always had a few choices and a yummy pudding afterwards. I was usually first in the queue and always stayed till last to get seconds (oink oink), but then I did always loved school dinners too.

Private rooms weren't too bad but being on a ward was a bit grim because there was always someone's baby crying in the night or somebody snoring. I was in for 10 days with DS1, 2 days before and 2 weeks after with DS2 but most of the postnatal stays were in the single rooms in transitional care on the SCBU (I actually got the same room on both occaisions). DD was born Friday early morning, came home Sunday but back in to the children's ward with jaundice on the Tuesday for 3 long days. This was bad because parents didn't get fed but I had to stay there to feed her and when you're just a few days after the birth you don't really want to be stuck on a children's ward. Unfortunately SCBU won't take babies in who have previously been discharged due to the risk of infection.

Mears, that sounds much nicer. I thought DS1 looked quite pittyful under the lights with his goggles on, he was always trying to take the goggles off as well.

Did anyone else feel that before the birth the midwives were wonderful, very understanding and always there for you, but after the birth didn't really want to know. It seemed to me that they felt like 'the job was done'.

When I gave birth we had a mat. unit and a GP unit. The mat. unit was woefully understaffed and the GP unit was run by midwives. I had to give birth in the Mat. Unit but I had already booked for the GP unit so I could go downstairs to them and it was wonderful. The nurses/midwives took time to help you, give advice and were just fantastic. Unfortunately the hospital has now seen fit to close the GP unit down and so there isn't the choice. I stayed four days in the GP unit and it was great. If I had had to stay in the mat. unit I would have left the next day because it was overheated, understaffed and just plain awful. Because women were in labour they couldn't even escort me to the toilet the first time (it was in the guidelines that they had to). I felt so sorry for them. When we left there was a woman left downstairs in reception in labour because there was no-one to come down for her. When I was in labour for 3/4 of the time we didn't have a midwife with us and the doctor had to be called as a matter or emergency but she didn't turn up for 3/4 of an hour.

JoPat, both time I have felt that the midwives in the delivery suite were much nicer than the midwives on the post-natal ward (with a few exceptions, ie the midwife that sat with me for about an hour while a wept buckets and tried to b/feed) but maybe it's all the post-natal hormones!