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Postpartum Hospital Discharge Too Soon for Some

A collaborative decision-making process may help some women-infant dyads unready to leave hospital

MONDAY, Aug. 6 (HealthDay News) -- About 17 percent of mother-infant dyads may need more hospital time to deal with perceived medical and psychological issues after childbirth, according to a report published in the August issue of Pediatrics.

Henry Bernstein, D.O., of Dartmouth Medical School in Lebanon, N.H., and colleagues conducted a prospective study of 4,300 mother-infant dyads. Data were obtained from questionnaires provided to clinicians and mothers at discharge.

Overall, 11 percent of mothers felt they or their infant were either psychologically or medically unready for hospital discharge while 5 percent of pediatricians and 1 percent of obstetricians identified patients unready to be discharged. In less than 1 percent of cases did two or more of the informants agree that discharge was too soon. The main reason women felt unready to leave the hospital was concern about their own physical status. When it came to infants, feeding and baby care issues as well as health problems were the main reasons for concern.

"The LAND-study results suggest that the mother and the clinicians caring for her and her infant must make the postpartum discharge decision jointly, because perceptions of readiness or unreadiness at the time of discharge often differ," the authors write. "Clinical decision-making regarding maternal and infant discharge is a subjective and contextual process that must take into account the perspectives of each person involved in the mothers' and infants' health care experience."

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