Can you discharge yourself after delivery

Coralcoras

Summary: horrible stay in postnatal ward. If I had another baby can I leave without staying overnight. Or just one night if I give birth in the early hours?

Hi all,

Not pregnant, but had my first DS last September.

Every now and again I ruminate over our stay in hospital.

Staff were lovely, no qualms there, but Jesus Mary and Joseph the three nights spent in the 6-bed post natal ward almost killed me...no joke.

It brought me so low I dropped my baby (10cm only the mattress) on the fourth morning. Everything just went blank.

I had a blood sample taken to check iron at 6.30 am on the morning of my discharge, three days after giving birth. Don’t ask why this wasn’t done earlier...I didn’t ask myself. I was a 7 (5 is dangerous apparently). I was offered a blood transfusion but refused because I had to get out of the ward. I was close to tears at the prospect of another night.

My own baby slept perfectly fine thankfully, but I got at most 3 broken hours per night and maybe 1 during the day.

I had no sunlight or fresh air for those 80 hours of postnatal hell on earth.

A smell of musty blood hung in the warm air (sorry to be graphic), and I only really smelled my baby properly once I got home.

It was noisy. Collectively from all of us. Staff in and out. But also one inconsiderate woman who was on the phone during the night and moaning and calling the bell every hour begging for pain relief above the allowed amount.

I had a med-free birth and jumped off the table after having my baby. Three days later I was a shivering, delirious weeping wreck when leaving the wards. It broke me - sleep deprivation (13 hr Labour + 80 hours on postnatal ward) probably compounded by low iron levels.

I don’t think I could go through the postnatal ward experience again. If I have the money to, I’ll try secure a private room.

I felt so great immediately after birth (Baby also perfect), why can’t I just go home at that point? Can I? Surely I can self-report mother and baby milestones?

bee06

I spent 3 nights as well on my first (had a post partum haemorrhage and low iron). Hated every minute as well.

For my 2nd I did the domino scheme and was there for 24 hours. On the domino scheme they will discharge from 6 hours after birth. I had to stay a bit longer because I had group b strep and they needed to make sure she hadn’t picked up an infection.

Something else to look into would be a home birth. Depends on where you are in the country but maybe an option.

Cash_Q

As bee06 says the Domino scheme will discharge you early, look into it and see if you're eligible. Regarding a private room, as far as I know there is no guarantee that you will get one, but maybe look into health insurance now as many plans require you to be under cover for a certain period of time before maternity care is covered.

I get where you're coming from, I was there 4 nights post section, it was difficult. I saw ladies arrive in the ward and leave the same day, so many ladies came through while I was stuck waiting. I was regularly woken at night for meds and checks, other patients on the phone is just plain rude but it's very hard to manage that. The staff are amazing but the other patients make it difficult. I know that me, my baby and my visitors contributed to the noise in general but overnight I wouldn't dream of being on the phone. You possibly got very unlucky with that roommate.


I'd be very wary of discharging yourself without approval as you never know what could be missed. My friend's sister in law died shortly after being discharged after giving birth because she had an infection that was missed, they gave her a crutch when she returned to the maternity hospital in pain and said to report to her local A&E if things got worse. She died there in her local hospital leaving her newborn and toddler behind. Ok, that is a tragic case and absolutely the worst case scenario, but realistically you need to know it's safe to leave and I wouldn't risk discharging myself.

And even if its possible to discharge yourself, they might not discharge the baby or allow you to do so. Also bear in mind that Day 2 and Day 3 post delivery your hormones are all over the place so while you may have hopped off the bed after giving birth, you might have hit a wall of exhaustion anyway even if you'd been at home, I know you'd have been more rested, but maybe you wouldn't have either..maybe anxiety would have kept you up, maybe the baby would have screamed all night, theres no way to know. It's a pity that your iron levels weren't checked until they were, but maybe there was no indication that it was needed until then, and if you'd been at home they would have missed whatever indication they saw that prompted that check.

I'm due in September and having another section even though it means several nights in. I was speculating that they might let me out sooner owing to all the Covid measures and my husband's immediate response was "is it safe though" and he's right.

The Coombe offer a service called 'Reflections' which allows you to discuss your labour, birth and postnatal care with a midwife so you have a better understanding of what happened and why. If you attended a different hospital then maybe contact them and ask if there is anyone available to discuss your experience. Birth is a massive life changing experience and it's important to understand what was the reason for the length of your stay so you can reconcile that with the exhausting experience of the postnatal ward.

Blingy

You should definitely look into a home birth.

ladystardust

I would not discharge against medical advice but it is also worth noting that you are not a prisoner in the maternity system. Vulnerable and tired, but no one can hold you against your will. If there is a medical reason for you to stay, they should discuss that with you. Otherwise, after a non complicated birth and all going well you would be heading home after a day anyway. There is no reason to stay if its all normal. If you live in catchment area for domino care or early transfer home, this may also be an option.
But once again, no one can stop you leaving if you wish.

screamer

I’d also not be discharging early, and you need to make sure you’re ok to go too. If covid19 is still circulating they may well have an accelerated discharge policy, who knows. I had a private room on my kids but I also had awful experience with no help on the 2nd night after section with twins to care for. The heat in the room was unbearable and I was wretched, so wretched that after three days I begged my consultant to let me home so I could have help and fresh air.

pwurple

I discharged myself next day on my second baby. Similar to you , an awful post natal stay... Even though it was in a semi-private. No sleep or food after giving birth is torture, and it felt unsafe for both me and the baby.

Second baby was during some hospital ban, swine flu maybe? No visitors, and I had a 3rd degree tear repair. I was looked after much better at home.

Love2love

Hi,

When I had my daughter (10 years ago / NMH) I was allowed to leave after 6 hours. Like you I didn't have pain relief and jumped up after giving birth. I think you have to remain there for 6 hours as a doctor assessed the baby and gave us the all clear to go. Midwives then came to visit me in my home daily for 5 days

GalwayGrrrrrl

Depending on the hospital you need to find out when the doctor checks the baby. In GUH the baby was checked by the paediatrician on the day of planned discharge. They did the heel prick test etc so you wouldn’t want to miss that.

jlm29

You can always discharge yourself AMA. As above, you aren’t a prisoner. If you were a public patient it’s unusual you were kept so long unless there was a medical need. Usually they like to keep you for 24 hrs to keep an eye on baby but after that they’d ship you out no questions. I stayed three nights on all mine, would have stayed a week only my health insurance wouldn’t cover it so was out the door.

ladystardust

GalwayGrrrrrl wrote: »

Depending on the hospital you need to find out when the doctor checks the baby. In GUH the baby was checked by the paediatrician on the day of planned discharge. They did the heel prick test etc so you wouldn’t want to miss that.

Heel prick has to be done after 72 hours minimum. Most are done by the public health nurses these days. Not a reason to stay. The hospital will ensure the heel prick is organized before anyone is discharged

jlm29

ladystardust wrote: »

Heel prick has to be done after 72 hours minimum. Most are done by the public health nurses these days. Not a reason to stay. The hospital will ensure the heel prick is organized before anyone is discharged

If it needs to be done on a sat or sun people go back in for it to the hospital

ladystardust

jlm29 wrote: »

If it needs to be done on a sat or sun people go back in for it to the hospital

That is true, but often not a good enough reason to stay alone. Individual cases I guess.

jlm29

ladystardust wrote: »

That is true, but often not a good enough reason to stay alone. Individual cases I guess.

People don’t stay though. They normally go back in for the midwives to do the heel prick as outpatients

ladystardust

jlm29 wrote: »

People don’t stay though. They normally go back in for the midwives to do the heel prick as outpatients

Absolutely! I agree. But one of the posters stated that you wouldn't want to leave and miss the heel prick. I was just pointing out that leaving after birth wont cause you to miss heel prick.

jlm29

ladystardust wrote: »

Absolutely! I agree. But one of the posters stated that you wouldn't want to leave and miss the heel prick. I was just pointing out that leaving after birth wont cause you to miss heel prick.

Sorry, I was trying to strengthen your point and it seemed like I was contradicting you

Victor

Get a private room?

ladystardust

Victor wrote: »

Get a private room?

It is for sure an option to go private if you are in a position to afford it however it is also worth noting that in busier maternity hospitals, that is still no guarantee that you will actually get one.

Digs

Yep. Of course you can! It’s not a matter of discharging yourself but requesting to be discharged “early”. My first I stayed a night and hated every single second of it, it was noisy, busy and I couldn’t sleep.

My second I asked to go home ASAP after birth and they let me go home as soon as there was a Paed available to do the baby check and discharge her. That was about 6hrs after birth. It was amazing. Getting home to my own bed, fresh sheets, food etc pure bliss.

Planned the same for my 3rd which they were totally fine with but baby had other ideas during the paed check and we ended up with a 4 day stay which again was torture for me, I knew though we had to stay for baby so just got on with it.

This was all as a normal public patient in Holles Street by the way, not domino scheme or anything. All of my births have been fast, intervention and epidural free etc so it was an easy decision for me.

ETA: for an overnight birth. Third baby was born at 2:07am and the Paed was on the ward by 9am for checks.

sallysue2

Honestly it's part of the reason I'm going private is that I could not handle a 6 person ward.. I am very high risk anyway and have spent a good few weeks in the hospital while pregnant and I have had my own room for all of it, with the exception of 2 nights in semi private room.

I would weigh it up financially and see if you could afford to go private, you might not get a private room for all your stay but you might end up in a semi private. AFAIK you need to be a private patient with a consultant to get a private room. If you are public patient you don't have much hope, even with health insurance.

ShaShaBear

Three nights seems like a long time to be kept with no medical complications to be honest. I had my first 6 years ago in Cavan, had tearing which required stitches and I only stayed for two nights. My second was also in Cavan 2 years later through the Midwifery-Led unit and there were no complications or stitches, they told me I could go home that evening if I wanted. I requested to stay the night simply because in getting to the hospital we got caught in a flood and we lost our car so had no way home until my husband got things sorted. Glad I did, because a second paed exam turned up my daughter's hip dysplacia which ended up with weekly visits to Temple Street from Monaghan and two braces for the first year of her life.

I will just say that while I understand the noise, lack of sleep, heat etc - you really can't control how other women feel after giving birth to their babies. They won't all "jump" off the table and they won't all sit happily in their beds pain-free. Some women could have been stitched from here to there and back, some might have terrible anxiety, could have gotten bad news about their baby's health after the birth or could just be incredibly lonely and unsure of themselves. You do need to have a certain amount of compassion and empathy when on a 6-bed ward - you don't know what these women went through, but since every labour is different it is safe to assume it wasn't the same experience as you!

shesty

Jaundice might be the other reason to have to stay.If the baby has a reading above a certain level you would have to come back in on day 3 to get the baby checked, as PHNs do not have the instruments to check them.

You can certainly ask to be discharged - did you just not ask OP?I had 5 days in after my first, healthy birth but baby needed antibiotics, and I went home for 3 days, haemorraged, and went back in for 4 days.The 5 days was absolute hell, and I was in a semi private ward.But I will say the baby blues hit on day 3/4 and it was like being run over by a freight train.I remember having a total meltdown 3 days after she was born, and the senior midwife sitting on the bed and crying with me because she remembered herself how hard it is on the first.

Second and third times round were far easier because I knew what to expect, I knew not to get so worked up.I got out quicker on baby 2 and baby 3 decided he wanted a 3 night stay too, but I bssically just chilled for 3 days, embraced the sleep deprivqtion, brought the baby into the bed with me, and slept when I could.Totally different experience.It was a huge fear for me on the second, firstly that I would go home and miss something being wrong with the baby (Strep B was the complication) and secondly, that I would bleed again (it was very minor so the infection symptoms were ascribed to new mother exhaustion, it was only when I actually haemorraged that it became clear there was a problem). I requested my notes from all 3 there last year and surprisingly, reading the notes from my first really upset me for several days, but oddly it did give me some closure on things.

Definitely consider going private or semi-p if you think that would help, but equally don't be afraid to ask when you can go home.They will tell you alright, you can say you would like to go home when they do their rounds, and they will make it happen if it is possible.You aren't a prisoner, but the other side is that you need to ask them to find out if they are happy or if there is something they are monitoring.You might be happy to stay in on your second for a night or two tbh,for a rest.But there are certainly things you can do to move it along if possible.

Millem

Op I feel your pain re ward. On my first I did domino and stayed less than 24 hours. In hindsight I should of stayed longer.

Second child went private, got my own room straight away. Fantastic experience.

Third child going private again and have packed my own bag for a full three nights. If I get my own room I wouldn’t consider leaving earlier

Neyite

The 5 days on the ward were the worst parts of my birth experience as well. And I had a EMCS with a baby in distress. I could not wait to go home.
I think that you can discharge when you want, but it would be prudent to get signed off by a doctor just to ensure no complications. And the baby needs to be signed off for discharge by a paediatrician as well - that was the delay on my last day. I'd been signed off the evening before but it was about 2pm before the paediatrician came around to do their checks and I was so fed up waiting for them.
It's worth asking your midwife on your next checkup. I always found that they listened and did their best to advise me. They might be able to write something into your notes or make arrangements for a quicker discharge. The nurses on the post-natal ward were nice too but far too thin on the ground.