A recent study published in ACOG’s Journal of Ob-Gyn has me scratching my head. The Malaysian study purports that it’s safe for women who have had a cesarean section to go home the next day.
Physicians who practiced in the mid-nineties remember the days of the drive-by-deliveries and the aftermath that occurred. We remember hospitals booting post op patients out 48-hours after a c-section only to have them return less than 24 hours later with a myriad of complications including jaundiced babies. The Department of Labor had to jump in and issue the Newborns’ and Mothers’ Health Protection Act of 1996 that forced health plans to pay for maternity coverage of at least a 48-hour hospital stay following a vaginal delivery and a 96-hour stay for a c-section.
In the Malaysian study, 360 women were selected randomly to go home either on the first or second day after a cesarean section and declares it is safe to do so. However, here are a few points from the study that you need to know:
- The Malaysian healthcare system is free. Women do not pay for care
- Out of 360 women selected, only 142 women actually participated in the study
- 14 women could not go home on post operative day 1 (the day after c-section) between they had blood loss greater than 800 cc which is almost the same as a liter of soda
- Six women couldn’t go home because of complications ranging from a placenta stuck to the uterus, bowel injuries, too much gas in the abdomen (aka distended bowel)
- Five babies were not eligible to be sent home
- Eleven babies couldn’t go home because they had yellow jaundice
- Nine women refused to go home the next day for reasons unknown but went home on post op day #2
- 24 women were not even ready to go home on the second day after the c-section (aka post op day #2)
- 20 to 24% of the mothers had a positive test on the Anxiety test but did not have depression
It is also important to note that according to the study, over 90-percent of Malaysian women went home to an extended family that provided 24-hour care for them.
Would you want to go home the next day after having a c-section? Please tell me what you think.