Grand Rounds

Early Postpartum Discharge Versus Traditional Length of Stay Patient Preferences

Authors: MARGHANI M. REEVER MSW, ACSW, DEBORAH S. LYON MD, PATRICIA L. MOKHTARIAN PhD, FEROZ AHMED PhD

Abstract

ABSTRACTBackgroundDespite a vast body of literature on postpartum safety issues, little has been written about patients' preferences for hospitalized versus home-based support and reasons for those choices.MethodsA questionnaire was offered to obstetric patients at a prenatal class. Data were analyzed using chi-square analysis and logit modeling, searching for factors accounting for the patient's choice of discharge plan.ResultsNeither demographic nor style-of-care variables affected patient choice significantly. Personal issues like comfort with child care were highly correlated, both individually and as a group, with choice of length of stay. Less than 25% of the group studied expressed a desire for early discharge.ConclusionsWomen with a high internal locus of control and/or distrust of the medical system expressed a desire for early postpartum discharge. Few women in our study exhibited those qualities; over 75% of those who had a preference wanted a longer period of hospitalization. Although our sample has both negative and positive skews in terms of other available social supports, it is a well-educated and economically well-supported group. We conclude that many women do not believe they would be ready to leave the hospital at less than 24 hours postpartum.

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