The Newborns' and Mothers' Health Protection Act
In September of 1996, Congress signed into law The Newborns' and Mothers' Health Protection Act. This law states that health insurance policies and group health plans that already provide coverage for childbirth must also provide for a minimum inpatient stay following delivery. This stay amounts to 48 hours for a vaginal delivery or 96 hours following a cesarean section. However, your physician has the option of discharging you earlier, after a consultation with you and your newborn's pediatrician. Before this law was enacted, insurance company policy -- and not the requirements of the mother -- dictated the length of the stay.
Your health and that of your baby is for your doctors to evaluate, but
together you can discuss the other factors that will enter into your
decision of whether to stay or leave. These may include your previous
experience as a mother, your ability to get back to the hospital in case of
emergency, your physical ability to assume care of your infant, the amount
of nursing care provided by the hospital and whether
you have adequate help at home.
Early discharge may have implications for breastfeeding as well as for the diagnosis of jaundice, sepsis and other conditions that typically appear after a few days in newborns. In a 1995 policy statement, the American Academy of Pediatrics established that it generally takes 48 hours to meet the minimal criteria they deem necessary before discharging an infant from the hospital. A two-day postpartum stay can also allow for intensive education about parenting skills, breastfeeding, maternal after care, contraception and care of the newborn.
When Jeannette Cona-Larock gave birth to her children, she decided to stay
in the hospital the full two days. She says, "This way we had nurses there
24 hours a day to help us out if we needed it, and I was able to get a bit
of rest. With my second daughter this turned out to be a blessing since she
developed jaundice during the second night."
Admittedly, hospitals can also be unpleasant places. Some of the negatives of a long stay might include sharing a room with a person who has frequent guests or a crying baby. Sleep can be difficult in a busy environment. Some hospitals now have only minimal nurseries, and you may be expected to lift your baby and do most of the care yourself. Even after an easy birth, this can be difficult in a hospital environment. Privacy is non-existent, and you will be at the mercy of the hospital's schedule.
a good family support system, close proximity to the hospital, and
previous experience with babies, you might be best served to leave the
hospital early. Edna
Huelsenbeck's experience confirms this. "If it wasn't my baby crying,
someone else's down the hall, and every time I closed my eyes, someone
come in to ask me if the baby had pooped or to take his temperature or
something like that. I decided I would be much better off at home."
The freedom to choose
Weighing the pros and cons carefully and discussing them in advance with your physician will help you decide the appropriate course to take for you and your newborn. Staying in the hospital or leaving is a decision that you and your doctor will make together based on your immediate health and physical needs. Thanks to the Newborns' and Mothers' Health Protection Act, you now have the freedom to choose the way in which you want to begin life with your child.