More than 10 years after an outcry against “drive-thru deliveries” led to a law lengthening most postpartum hospital stays to 48 hours, some mothers still feel they’re being pushed out the door. Nearly 12 percent of 4,300 mothers surveyed nationwide said they were discharged before they or their babies were ready. Pediatrics professor Dr. Henry Hank Bernstein led the study at Dartmouth Medical School in New Hampshire and published it last July in the journal Pediatrics. Surprisingly, Bernstein discovered that only 5 percent of the infants’ pediatricians felt mother or child were not ready for discharge. Among the mothers’ obstetricians, just 1 percent felt the same.
“Obviously, there’s some difference between what physicians perceive and what patients perceive,” said Dr. Edward Packer, chairman of the pediatrics department at Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Fla..
A closer look at Bernstein’s data hints at the reason for the disparity.
Most of the women who believed they were discharged too soon said they were physically unready. Yet the obstetricians caring for them overwhelmingly felt they were. Slightly more pediatricians concurred with the mothers. Bernstein, by the way, limited his study to women without severe chronic disease, who gave birth to healthy, term infants.
The doctors’ conflicting opinions likely stemmed from their different points of view. The obstetrician’s interest is in the mother’s physical recovery from childbirth. The pediatrician, on the other hand, considers the mother’s ability to care for a newborn.
The most telling data in Bernstein’s study reveals that mothers’ readiness for discharge is tied to their income, ethnicity and age. Women who said they were discharged too soon were disproportionately young, uninsured or on Medicaid. They were less likely to have help at home from the baby’s father or relatives than women who felt ready for discharge.
“In the majority of cases, it’s probably a lack of confidence or a network of support,” said Dr. Lourdes Forster, assistant professor of pediatrics at Florida’s University of Miami Miller School of Medicine.
Pediatric gastroenterologist Dr. Lawrence Adams of West Palm Beach, Fla., suspects that many impoverished young mothers “could stay a week and still have anxiety.”
Relief comes only from having friends or family to lend a hand.
“Women are trying so hard to be strong,” said Kristen Jayd, a La Leche League leader and mother of two in South Florida. “They don’t have a good sense of support. What mothers need is for other people to take care of them”
Jayd built her support network from friends, neighbors and family members. When one of them would ask what she needed for the baby, she eschewed all the unnecessary gadgets and instead asked for homemade casseroles to freeze, promises to watch the baby for 30 minutes while she took a shower, or offers to pick up and deliver groceries to her home.
“Seek out support ahead of time and tell people what they can do,” Jayd said. “That’s much more helpful than tons of baby lotion.”
Even newcomers to the area can form connections through more formal channels. Jayd naturally recommends La Leche League, a support group for women interested in breastfeeding. Women should attend a meeting or two before giving birth, Jayd said. Then they’ll know someone they can turn to with breastfeeding concerns after giving birth. La Leche League and similar groups often become more than a breastfeeding class for members who attend regularly. They typically come to rely on each other for tips on everything from diet to diapers.
Enrollees in WIC, the federal government’s Women Infant and Children’s nutrition program, can learn about breastfeeding and meet other new mothers through that program’s breastfeeding support groups.
A key member of any mother’s support group is her child’s doctor. Pediatricians implore parents to visit before giving birth. That eliminates the burden of a hurried search for a pediatrician after delivery. It also gives new mothers an expert to turn to soon as they come home with their baby. Mothers in Bernstein’s study who felt ready for discharge were more likely to have met with a pediatrician than those who did not.
“Interview pediatricians in advance,” Adams said. “Choose one you feel comfortable with. That takes one piece of anxiety away.”
Adams also urges parents to lessen the stress of life with a newborn by stocking up on necessities before the due date. That includes diapers, wipes, bottles and formula if needed, baby clothes and sanitary napkins.
“It takes a village to support the mama,” Jayd quipped. “And you have to create that for yourself.”
Cynthia Washam is a mother of a teen, and a full-time freelance writer. Her work has appeared in many newspapers and magazines including Nashville Parent, The Palm Beach Post, South Florida Parenting and the book A Cup of Comfort for Mothers to Be and many others. She also writes the It Figures column of amusing statistics, which runs regularly in Parents & Kids.
