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24 hour stay only after birth?


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#51 scarfie

Posted 17 May 2010 - 05:19 PM

As a midwife working in a caseload model, can I say that while I agree with some of what Soontobegran has to say, there is also some that I don't.

I begin my relationship with a pregnant woman and her family at around 8 weeks gestation.  We are able to build a relationship buiit on mutual trust and respect, an equal partnership in her pregnancy.  We begin our discussions about breastfeeding on the day she books in.  Throughout her pregnancy we have many discussions about breastfeeding, we attend an assessment, we demonstrate positions, attachment etc.

Women come into our unit well advanced in labour.  They birth and enjoy immediate skin to skin contact.  We adhere to baby led feeding as much as possible.  New families are discharged home between 4 and 24 hours after the birth.

I visit everyday for the first 4 days and then every second or third day for 3 - 4 weeks post birth.  I am willing to visit at anytime, and the women know that they can call me in the mddle of the night if they are having problems breastfeeding.  But, do you know what?  Most of them don't.  They have the confidence and they have the skills to do it themselves.  Most of all, they have an understanding that breastfeeding is a learned process, that if they have patience, if they persevre, and most of all, if they practice, that it will come.

Surely that is better off done in the comfort of your own home, instead of on a busy ward, where you share a room with another mum, her baby, and usually her visitors, and where you buzz for a midwife to come and help you, because she did say she would come and help you, and you wait and wait and wait and then baby is too frazzled to attach properly?

I have just completed our yearly stats at work.  We have a 97% rate of mothers still exclusively breastfeeding at 12 weeks post birth, can't be such a bad way of doing things then.

Ali

#52 nessed

Posted 17 May 2010 - 09:49 PM

I booked myself out of hospital with DS1 the next morning, no need to be there with 4 other mums in a ward in a public hospital. The midwife visited me a couple of times that first week and helped tremendously with the breastfeeding. I was having trouble at the hospital breastfeeding and wanted to be home to calm down.

I booked myself out the same day with DS2, i had a great labour and felt great. Gave birth at 10.30am and was in the car going home by 8.30pm that night. Again the midwife visited a few times and I went back a couple days later for some injection or something for bub (can't remember). Breastfeeding was great this time ( i knew what i was doing). This was a private hospital, my OB asked what was wrong with the hospital. I just said i prefer to be home in comfortable surrounds. My babies settle so much better.

When mums like me leave hospital early because we are coping fine then it frees up beds and midwives for mums who need a little extra time in hospital. I would never suggest that all mums go home as early as I did, the welfare of the mum and baby is paramount.

#53 Mulan

Posted 17 May 2010 - 10:09 PM

Don't let home be the hectic environment.

Plan the home as if you would be gone for a week. Prepared meals, other people making meals and dropping them off hot or reheatable.
Arrange someone to clean the house for a week or two
Arrange for someone else to pick up and drop off other children to various activities/school etc for a couple of weeks.

At home you can set your own visiting hours. Sleep when you want to sleep and won't have other babies crying and waking you up.

Midwife visiting daily may actually give you more time than a midwife in hospital interestingly enough. Think about an hour long visit at home compared to popping in and out over the course of a day. Let alone various midwives all of whom have different and sometimes contradictory advise.

#54 judy_

Posted 18 May 2010 - 10:27 PM

I am definately an advocate for going home as early as possible - I hate hospitals and the staff (yep, even the good ones get on my nerves quickly).  I am a very impatient person with a low tolerance for stupidity.  Some stupid pharmacist came round every morning asking if I wanted pain relief - WTF!  and then offered me birth control pills - I am intelligent woman and if I want bloody birth control pills I will sort it myself.

With DS1 he was born at 36 weeks and only 4 pd 5 oz.  He spent 2 nights in SCN being tube fed and then roomed in with me for 2 nights. After 4 nights I was going crazy and we went home almost against hospital wishes (Had some totally incompetent midwife on that day who I tricked into discharging us - I think she was about 15 years old).  We spent day 6 at the Breastfeeding clinic (about 5 hours) which was so much better than the stream of midwives with different ideas.  

I hate sitting in bed all day and I detest wearing pjs.  I hate people visitng me in hospital -  yuck.

With DS2 he was born on time and a reasonable size.  We went home at about 8 hours (he was born at 2 am and 10am is about the earliest logistically possible by the time paed does check and paperwork done).  

I must say it was magic going home so early.  

I succceeded with breastfeeding both my boys - including DS1 who I now know was very very hard to feed (DS2 was so so easy in comparison).  It had nothing to do with staying in hospital.  

I have 2 SILs who both spent 5 plus nights in hospital (private) and both failed at breastfeeding.  I don't think that staying i hospital has any bearing on breastfeeding.  It is the support you get from friends, family and professionals when necessary that matters.

#55 TheFirstNoel

Posted 19 May 2010 - 08:59 AM

I'm also a 'get home asap' girl!

I went public, birth centre, with my first two.  The midwives were asking me & encouraging me to stay longer.  I discharged myself early both times (against medical advice with DS) and went home and was much happier - but that's just me.  After DS I had some complications which is why they wanted me to stay longer, I spoke with the doctor myself so I'd know what exactly to look for and I was fine.  With my first I stayed about 15 hrs after DD was born, my second was about 30hrs.

If I had stayed until I got breastfeeding down-pat I'd have been there at least 2 weeks!  I have/had flat nipples, so attachment was a learning curve, but with persistance we got there.  I had home visits from the local MCHN (3 I think...)  DS had some jaundice which we dealt with at home (lots of BF & sunlight).

DH was a great support at home though, so I felt very confident going home.  He's planning to take a month off after bubs is born this time.  

Just my personal experience, but remember you are not a prisoner in hospital - assert your rights and negotiate if you want to stay longer!

#56 lexington

Posted 19 May 2010 - 09:26 AM

I would rather run out the door than be stuck there for days.
I'm not sure why people rave on about being able to stay in the hospital for a week.
I would die having to report how many wet nappies and dirty nappies. I DON'T REMEMBER OK!!

And having to deal with pushy midwives. Urgh.

#57 FeralProudSwahili

Posted 27 May 2010 - 10:40 PM

While pregnant with DS, my midwife repeatedly mentioned how I'd be able to return home within 24 hours if all went well with the labour etc. I was really not keen on the idea while pregnant but once I had him I was itching to get back home. I just don't sleep well in hospital and I wanted to be with DD and DH. I walked out exactly 24 hours after having had DS. I felt great and had far more rest back at home than I would have had in hospital.

#58 JinksNewton

Posted 27 May 2010 - 11:46 PM

The public hospital I gave birth in had a 3 night policy for natural births and 5 nights for c-sections. We were in for 4 nights as DS had jaundice and had to spend a little over a day under lights. I am VERY glad that I had that stay as despite all my reading I had non-existent hands on baby experience and it was great having someone there at any hour of day or night who could answer my questions.
After night 2 I had a meltdown as my milk hadn't properly come in and DS had only let me have about 1 hour's sleep. I broke down in tears when a midwife asked how my night had been and she gave me a hug and a talk, saying they would be happy to take DS for a few hours if I needed sleep  wub.gif  I have never forgotten that. I had my own very quiet room with its own bathroom. I had very strictly controlled visiting hours. My insurance provided boarding for my husband as well so he was with me for a couple of nights.
At home I had a mess and a MIL in residence who, although I love her, could talk the hind leg off a donkey. Being as hormonal as I was post-birth being in the hospital was best for me.
That being said, if and when we have number 2, I'd be happy to leave after a day or two. If i'd been in a public ward, I probably would have hobbled out as fast as I could.

#59 Soontobegran

Posted 27 May 2010 - 11:50 PM

QUOTE
Midwife visiting daily may actually give you more time than a midwife in hospital interestingly enough. Think about an hour long visit at home compared to popping in and out over the course of a day. Let alone various midwives all of whom have different and sometimes contradictory advise.


But popping in and out during the day is needed because babies feed right through the day --not just at the time of the visit from the visiting midwife huh.gif Personally I spend hours with some mums in hospital, popping in and out is just for those mums who do not need our help to get their babies to suck.
Once a day visits at home is fine for those mums who feel confident, have support and have babies attaching and feeding well but with early discharge there are mums going home with NO milk , jaundiced babies, tired babies, sore nipples, engorgement and a multitude of other problems that seemingly there are women here who have been lucky enough to avoid! What does the mother at home 24 hours post delivery do for the other 8 feeds that the visiting midwife ISN'T there for?
I have done Domicillary midwifery and there is no way the women at home are afforded the same amount of time to help sort out any issues as they would had they stayed in hospital a couple more days.
24 hour discharge is absolutely wonderful for those mums who want it BUT for those who need more time  (and there are many who fit into this category) there should be the option to have some more time in hospital without being made to feel they are taking up valuable space.


QUOTE
Just my personal experience, but remember you are not a prisoner in hospital - assert your rights and negotiate if you want to stay longer



If only that was possible :-( I have fought so hard to get an extra day for some women but it definitely is dependent on bed availability. Much easier to negotiate an extra day in the private system.

Edited by soontobegran, 30 May 2010 - 10:51 PM.


#60 Soontobegran

Posted 27 May 2010 - 11:55 PM

QUOTE
And having to deal with pushy midwives. Urgh.


Damn those pesky midwives  blink.gif
Tarring them all with the same brush don't you think?

#61 Alina0210

Posted 28 May 2010 - 12:05 AM

In King Edward Hospital in Perth... They offer early discharge 4hrs to 24hrs after the birth of the baby ohmy.gif

crazy...

#62 Tokra

Posted 28 May 2010 - 12:06 AM

With DS1 I stayed in for a few days. With DS2 I forced them to let me go home the following day. I would have left earlier that day but they wouldn't discharge me until late that afternoon.

They had wanted me to stay in for 48 hours.

I simply couldn't because DS1 was going through a really difficult time and he needed me just as much as DS2. Plus, I was confident in my abilities and knew I would feel much better at home!

The hospital making me wait those extra few hours was hell for me.

Oh and I chose not to breastfeed for more than a week (I had to go back to work 3 weeks after DS2 was born).

ETA: I didn't have a midwife come (or even offer) to my home.

Edited by Tokra, 28 May 2010 - 12:07 AM.


#63 kaboo

Posted 28 May 2010 - 12:17 AM

I remember breaking down in tears in (public) hospital when the home visit midwife was trying to get me to do an early discharge with #1. I was having an awful time breastfeeding, had no support and she kept hounding me until I cried. I ended up staying 5 days and was able to feed.

I was booked in to have #2 at a public hospital but as I came closer to the birth I just couldn't face being kicked out after 24 hours and changed to a private hospital where I knew I would get 4 days. I am glad that I did that because it meant less pressure. I also did that with my other 2 kids.

I always have terrible trouble feeding newborns due to my nipples. I would struggle to keep calm and sane without the knowledge that I have a midwife down the hall in the middle of the night. I also have had bad baby blues on about day 3 and I don't know how I would have coped with that had I been at home with the other kids.

QUOTE
Plan the home as if you would be gone for a week. Prepared meals, other people making meals and dropping them off hot or reheatable.
Arrange someone to clean the house for a week or two
Arrange for someone else to pick up and drop off other children to various activities/school etc for a couple of weeks.


Easy to say if you have support. It would be dh and myself, and the kids would be harassing me. The piles of washing etc would stress me out. I prefer to be in hospital where there is quiet time and a chance to sit and bond with my new baby.

#64 Guest_shauna+Molly+ Me_*

Posted 29 May 2010 - 01:49 PM

The hospital I am booked in at will kick you out 24 hours after birth if the the birth was uncomplicated
You have NO say, if they believe you are both in good health (physically).

The reason is they need the beds, its as simple as that we have had a massive baby boom in the area I live.
Its has DOUBLED the amount of babies being born in the last five years.

You might be able to ask to stay longer but if the bed is needed they will move you on home with DOM care.

I was having a conversation with a midwife the other day and she says its horrible but they have no control over it, simply not enough beds and no plans for any expansion.

The only other hospital is a hospital I really dont like.
Sure I might be able to stay longer but the staff are simply run of their feet and the experience I had there (with the birth of my first born) is not something I did not enjoy.
So I have two choices, give birth in a hospital were I will need to leave after 24 hours BUT have lovely midwifes and good OBS (who have good working relationships) and in a hospital that I had a great birth with my second child.

OR
give birth in a hospital were I will get to stay an extra night but with staff who dont have enough time and energy to say boo to me.
This other hospital is about a 35 minute drive from home compared to the 15 minute drive in the other hospital.

One thing I am certain of is my BF will suffer, this the main reason I want the extra is day so that I can get help with attachment and other issues (and with me and BF there is always alot wacko.gif ) but everyone knows that babe will often sleep mostly in the first 24 hours so what happens when I get home with a screaming hungry baby and boobs that often dont work for me!

I imagine the BF rates in my area are terrible, all due to no resources in the hospitals.
Even to get to maternal child care nurse you need to book ahead six weeks in advance so I doubt I will seen any lactation consultant any time soon.

I really wish I could go private and if I had the money I would.................

Oh the hospital I booked in to if anyone is interested to know is Bacchus Marsh hospital.

#65 Arthur or Martha

Posted 29 May 2010 - 08:10 PM

From my experience I see no reason to stay more than 24 hrs in hospital.  I only did with DD1 because they wouldn't let me go home.
Luckily my mother stayed with me after all my kids were born, with the first 3 she came before the baby was born but with the last she couldn't come until after she was born.  My mother had breast fed all of us, so had enough knowledge for anything I needed.  
Once you have had a baby your previous babies are at home and you miss them, so you don't really want to be stuck in hospital.  I found I didn't get any sleep in hospital so was less tired at home.

#66 mumandboys

Posted 29 May 2010 - 08:31 PM

QUOTE (plainjayne @ 13/05/2010, 04:17 PM) <{POST_SNAPBACK}>
I actually found the home midwife program FAR better than the support I was (not) getting in hospital.


Me too.

I found that the midwives in hospital were much busier, and often seemed cranky and impatient.  The home midwives were always friendly, calm, and not in a hurry.  I was also much calmer and more receptive to advice/tips when in the home environment.  In hospital I felt like a bother, taking up someone's time and resources.

Not to mention, I always had a shared room with 2-3 other women, which is fine, but then you add 3 other babies, 3 other sets of visitors.... it's soooo much more peaceful at home!!




#67 essy1

Posted 08 June 2010 - 03:23 PM

At the Royal in Randwick, their standard is 3 days in hospital after a vaginal birth or 5 days after a C-section. I think you can elect to go home earlier and they will send a midwife to check on you two days afterwards but you need to have left within a certain period of time to qualify for that.

This is my first and given that I had all my first trimester care in London (where, as a PP has said, you tend to be 'encouraged to leave' as quickly as possible), I am very glad to know that I have that 3 day window.

Maybe what you overheard is actually something similar?

#68 Carcosa

Posted 08 June 2010 - 04:16 PM

I had my son here at WCH in Adelaide & went through the shared care model with my GP simply because she was really supportive & I wanted to work right the way through so later appts etc etc - though all my care in labour, birth & post-natally was by midwives only.  I ended up leaving hospital after I had him (without any intervention or issues) on the 5th day.  The midwives had suggested that I'd be ok on the 3rd to go if I wanted but I was a bit worried about BF so they were happy for me to stay on and have a lactation consultant help me out (then the home visit midwives afterwards).  From the various posts here, I understand maternity care differs between states & every person is looking for something different from the care they receive - I was a first-timer, a bit anxious about going home & knew I could get support going thru shared care.  There are various models available here ie low risk birthing centres which are the 24-48 hour discharge & home visit midwives.  I can only imagine how frustrating, disappointing & worrying it can be to not have the ability to make those decisions for your own pregnancy & birth as the options just aren't there.

#69 Lia88

Posted 08 June 2010 - 07:05 PM

I don't really know if there are specific considerations for mothers to stay longer or shorter days in the hospital. But as for me, two to three days after giving birth is just fine. Though I can say that I am pretty much ok after 2 days - I still want to be sure that its ok for me and my baby to go home.

#70 livesarah

Posted 10 June 2010 - 12:27 AM

I had a great birth and would have loved to have been released from hospital within 6 hours as per birth centre policy,  but because of low-grade meconium staining in the waters was kept for 24 hours- which turned into 5 unnecessary days (long story- baby was kept in). I have a very supportive husband and had no problems breastfeeding (despite the hospital's efforts) and would have been far better off at home.

#71 Pearson

Posted 10 June 2010 - 04:42 AM

I went public 10 years ago, when the 24 hour stay started.  I WAS lucky, as I did not really share a room for the time I was in there, there was another bed, but was empty most of it, or short stayers.
I was booked in for an induction friday am, and ds was born 5am sunday morning, so before he was born, i was there for 2 nights, i was itching to leave by Wednesday, one reason being I could control who came to visit when, and all the babies crying at all times of the night kept me awake (and the parents who were visiting other mothers and letting their children run up and down the halls screaming).  
This time, I plan on being out, everything being all well and good, on the fourth day.  I am having a csect this time, and did last time too.

ETA - The public hospital i am attending has in its info section that csect patients are to expect on average a 5 night stay, and natural birth mums, 1-2.  again, it is all dependent on how you are going.

Edited by MSK, 10 June 2010 - 04:45 AM.


#72 Magenta Ambrosia

Posted 10 June 2010 - 05:54 AM

The first time I had to beg to stay 2 nights - I was having problems BF. I came to regret that decision due to constant interruptions and not being able to get solid sleep.
This time I'll be in a birth centre and after my "24" hours I will check myself into a hotel with room service so I can can sleep, eat, recover and bond with my bub. DH will be at home with the toddler (whom wouldn't let me get the rest I need). original.gif
A midwife I spoke to said it sounds like a great idea and doesn't involve the private health bill biggrin.gif

#73 km78

Posted 10 June 2010 - 09:55 AM

DS1 I stayed 4 day and then ask if I could go, that was public in Darwin. My care was fantastic.

DS2 had a homebirth and although not an option for everyone it rules out the stress of bf problems and incosistant advise as you only deal with 1 midwife that you know really well who come and supports you (with every aspect post birth) everyday if you need her for 6 weeks after the birth. You couldn't ask for better!!

Edited by km78, 10 June 2010 - 09:56 AM.


#74 Sarie

Posted 10 June 2010 - 10:18 PM

I stayed for 2 weeks after my c-section but I also had some complications and high blood pressure. Our hospital has a seperate wing for Mums who wish to stay longer, a few days or so.

#75 Guest_BBlessed_*

Posted 18 June 2010 - 09:49 PM

#1 - 5 days (he was in SCN)
#2 - 1 night (he was born right before Christmas)
#3 - 4 days (small country hospital where the maternity "unit" was a one bed room!)
#4 - 3 days
#5 - 2 1/2 days (before being kicked out - they tried to make me leave after 24 hours but wrangled me one more day when I protested)


I LIKE staying in hospital after giving birth. I don't have any scientific, peer-group reviewed, medically sound reasons - I just LIKE it. I feel safe and supported, able to recover from the birth and relax and focus totally on bonding with my new baby and not being distracted by all the other things going on at home. I believe my baby and I work hard during delivery, and we need a few days rest to recover and for us, that's best done in hospital away from all the on-going work at home.

After my last horrendous experience with the local public hospital - which was topped off with the midwife arriving the morning after delivery and informing me happily it was "home time" when I had been told previously it was a standard 3 day stay  - I'm prepared to pay the damn OB's incredible fees and endure his care (although I don't want OB care, I want midwife care!) just so I can get into the private hospital and avoid the local public system.




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