New approach to postpartum care

Early postpartum hospital discharge, combined with prenatal and postpartum nursing care, has yielded no apparent health disadvantages for Canadian mothers and their infants in a trial program.l The program, in which 78 women were enrolled, consisted of a postpartum hospital stay of 6-36 hours, nursing contacts by telephone within 48 hours after delivery and 10 days after the birth, and home visits by a nurse at 34-38 weeks' gestation and three and five days after delivery. Participants were compared with 97 women who received usual care: a 48-72-hour postpartum stay and follow-up as determined by the woman's and infant's physicians. One month after delivery, the two groups did not differ significantly in perceptions of their own competence as mothers, infants' weight gain, satisfaction with care, prevalence of breastfeeding and use of infant health services. The proportion of infants with excessive levels of bilirubin in the blood did not differ among those tested, but program participants were significantly less likely than those receiving usual care to have had their infant's bilirubin level tested. The investigators stress that because the nurse visits were an "integral part of the program," these findings apply only to programs that include a similar component.

1. A. J. Gagnon et al., "A Randomized Trial of a Program of Early Postpartum Discharge with Nurse Visitation," American Journal of Obstetrics and Gynecology, 176:205-211, 1997

Copyright The Alan Guttmacher Institute May/Jun 1997
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