The American College of Obstetricians and Gynecologists called for a moratorium on shortening hospital stays for new mothers and their babies until science proves it's safe.
In a statement issued last week, the ACOG cited anecdotal reports of serious problems in newborns, such as dehydration and undetected jaundice, following early discharge. It said early discharge "could be equivalent to a large, uncontrolled, uninformed experiment" on women and their babies.
A spokeswoman for the Group Health Association of America, which represents HMOs, countered that early discharge can be safe with proper precautions.
The ACOG and the American Academy of Pediatrics recommend stays of 48 hours for vaginal delivery and 96 hours for Caesarean births-exclusive of the day of delivery-in uncomplicated cases.
Yet, it has become common for insurers to limit stays to 24 hours following a vaginal birth and 72 hours after a Caesarean delivery, the ACOG said. It cited reports of some insurers considering stays as short as six hours for routine deliveries. However, some complications take more than 24 hours to develop, and early discharge means less time to educate new mothers, the ACOG said.
The ACOG did not point to HMOs specifically, but most HMOs offer a coordinated approach that includes education during pregnancy, said Kathryn Wilber, associate general counsel for the GHAA.
"The other piece is follow-up. Having the family come back in a day or so, a home visit, or even phone calls have been very effective," said Wilber.
Wilber said she's unaware of any plan requiring discharges after six hours, although patients seeking less clinical environments can go to birth centers where they can be released that early.