EARLY OBSTETRIC DISCHARGE - DOES IT MAKE A DIFFERENCE TO HEALTH OUTCOMES

Clinicians in several countries have expressed concerns about possible adverse effects of shortening obstetric length of stay. A population- based survey of 1366 mothers who gave birth in Victoria, Australia, in 1993 was used to investigate social and obstetric characteristics of mothers discharged home 'early', and to assess whether shorter stays w ere associated with adverse health outcomes, or a lesser degree of sat isfaction, or both. Women's views and experiences of length of hospita l stay were gathered via a statewide postal survey of women who gave b irth in a 2-week period; 62.5% (n = 1336) responded. Assessment of the relationship between length of stay (1-2 days vs. greater than or equ al to 5 days, and 3-4 days vs. greater than or equal to 5 days) and fo ur main outcome measures (infant feeding at 6 weeks, period prevalence of feeding problems, maternal confidence and depression) showed no as sociation between these variables and length of stay after adjusting f or other obstetric and social factors in separate regression analyses. For stays of 3-4 days, the adjusted odds ratio (OR) for formula feedi ng at 6 weeks was 1.35 [95% confidence interval (CI) 0.9-1.9]; for fee ding problems OR = 0.87 [0.7-1.2]; for lacking confidence OR = 0.81 [0 .6-1.2]; and for depression OR = 0.96 [0.7-1.4]. Large randomised tria ls of early obstetric discharge are required to resolve continuing unc ertainties about the safety, and possible benefits of shorter hospital stays.