Mothers are often not staying in the hospital long enough after giving birth. Research on hospital stays in 92 countries around the world reveals that there is immense variability in time mothers stay in hospitals – from an average of a half-day in Egypt to 6.2 days in the Ukraine following vaginal births. It matters most in middle and low-income countries where efforts are focused on getting women to give birth in hospitals rather than at home.
“Ultimately, length of stay is an approximation of what we are really after, which is high-quality care for women and babies,” said lead author Oona Campbell, professor of epidemiology and reproductive health at the London School of Hygiene & Tropical Medicine.
The 24-hour period following birth is critical for the health of both the mother and child, because it is the period in which many complication are likely to arise. Having close medical attention can help prevent problems and allow for a swift response if anything does go wrong. The World Health Organization says that staying less than a day is too short a period for anyone in the world.
Data from the Demographic and Health Surveys used in the study showed that more than 20 percent of women living in 15 of the 30 low and middle-income countries analyzed stayed in the hospital for less than 24 hours. That leaves mothers and children at greater health risk, and it also denies healthcare providers the opportunity to educate families about child care. Mothers might learn about the importance of exclusive breastfeeding or that withholding water from an infant with diarrhea can cause more harm than good.
“It is crucial we make sure not only that childbirth facilities have skilled care attendants and effective monitoring and treatment, but also that women stay in hospital long enough so that they and their newborn babies can benefit from these,” said Campbell. “The challenge is to commit to achieving adequate lengths of stay for women in low- and middle-income countries, while ensuring any additional time is used to provide high-quality and respectful postnatal care.”
On the flip side, staying too long can expose women to infections and harm their overall health. The answer is a Goldilocks-like solution – stays after birth should not be too long nor too short. The research also raises the factors that contribute to the length of time some women stay in the hospital after giving birth. It is not as simple as hospital protocol. Surprisingly, wealthier women tend to have shorter stays than poorer women.
Some women leave early because they have to return home to take care of their other children. In other cases, hospitals will force women to stay if they cannot pay their fees – which might inflate overall averages. Or high-demand hospitals could move women along to free up beds for other patients. Finally, the authors suggest that it is possible wealthier women prefer being back at their own homes as opposed to staying in the hospital room.
But the key takeaway is that encouraging women to give birth in hospitals is not enough. Despite limitations to the data available, the research shows that women in all parts of the world are not staying in hospitals the optimal length of time after giving birth. For women living in countries where there are already greater risks, the time at the hospital matters.