Shepparton mother Lauren Whelan told me she was discharged from hospital so swiftly after the birth of her son in 2019 that she wasn’t wearing shoes.
She was experiencing urinary and bowel incontinence and had to use a public bathroom in the hospital’s hallway. Her son had been transferred to the hospital’s special care nursery 36 hours earlier following a traumatic birth.
“I didn’t have a choice. I was told to leave. I remember standing in the hallway sobbing,alone,humiliated and separated from my baby boy,” Whelan recalled. “It was one of the worst experiences of my life.”
Whelan was barely able to walk but found herself driving to and from the hospital every three hours for the next week to breastfeed her baby.
Another mother who emailed me recounted how she was discharged from a major public hospital in Melbourne 11 hours after the birth of her son earlier this year. It had been a gruelling birth,involving forceps,and the mother-of-three pleaded with midwives to let her stay longer.
“I was in a lot of pain and my milk hadn’t come in,” she said. “I said,‘I would feel a lot better if I could stay an extra night’ and they just said ‘no’. I told them I’m not going to be comfortable if I have a two and a four-year-old on top of me at home while I’m holding a newborn and bleeding on the floor.”
She ended up back in hospital a few months later to have surgery to repair an internal tear that had been overlooked. “They didn’t realise or sew me up after the birth because they were in such a rush to kick me out,” she said. “Disgraceful.”
Another reader said she was sent home less than 36 hours after an emergency caesarean.“I was furious,” she wrote,noting that she also had to care for two other young children at home. “Something needs to change.”
I agree. Women should be given more of a say about when they leave hospital following childbirth. At the very least,hospitals should be considering the World Health Organisation’s recommendation that women and newborns spend at least 24 hours receiving high-quality care in a health facility following an uncomplicated vaginal birth.
Many mothers want to spend more time in hospital to recover from the birth,detect potential health issues impacting the mother and baby,finetune breastfeeding and learn other vital parenting skills.
They also want to rest:something that is often hard to achieve when you are going home to care for another child.
A quick discharge would be less of an issue if women and babies received good at-home support,such as regular visits from a midwife and follow-ups from maternal child health nurses. But many experts and mothers say these services are patchy in Australia. While one family might receive two visits from a hospital midwife in the week after birth,another might miss out on these services entirely. It can often feel like the focus of these hurried visits is on the baby,rather than the mother. It’s not a substitute for the comprehensive,around-the-clock support available in hospital.
Another option might be expanding what is routinely offered to women who birth in private hospitals. After being discharged,some private patients move into a hotel for a five-day stay with 24-hour postnatal support from midwives.
This arrangement eases the transition between hospital and home and,most importantly,ensures that women can access immediate support during one of the most vulnerable moments of their life. It also frees up beds in hospital,which are much more expensive to operate and in intense demand.
UK research published in 2020 foundthere was no evidence to support early discharges less than 24 hours after birth,despite this practice being increasingly common across hospitals.
It also found that babies who are discharged less than 48 hours after a vaginal birth and less than 96 hours after caesarean birthare more likely to be readmitted to hospital within 28 days. Surely this is a cost that health systems should be considering when setting postnatal discharge policies.
When I was born at the Royal Women’s Hospital – 32 years before I gave birth to my eldest son there in 2019 – it was common for women to have a lengthy postnatal stay. A five to seven-day stay was standard in Australian hospitalsuntil the mid‐1990s.
My mum,a single parent who had no family in Melbourne,was able to rest and recover during her five-night stint in hospital. A midwife would bundle me up in a swaddle every night and take me to the nursery so that mum could sleep.
When she was discharged,she slipped into her new role as a mother with ease.
“I felt well looked-after and was taught how to feed and care for my baby,” mum recalled.
“When the midwives decided it was time for me to leave,I was ready to go home.”
Henrietta Cook is a senior reporter covering health forThe Age.
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