Lewis Margolis is an associate professor of maternal and child health in the School of Public Health of the University of North Carolina at Chapel Hill. He has worked with state health departments in the design and evaluation of perinatal programs.
Midwives, Physicians, and the Timing of Maternal Postpartum Discharge
Article first published online: 6 JAN 2011
1996 American College of Nurse Midwives
Journal of Nurse-Midwifery
Volume 41, Issue 1, pages 29–35, January-February 1996
How to Cite
Margolis, L. H. and Kotelchuck, M. (1996), Midwives, Physicians, and the Timing of Maternal Postpartum Discharge. Journal of Nurse-Midwifery, 41: 29–35. doi: 10.1016/0091-2182(95)00070-4
- Issue published online: 6 JAN 2011
- Article first published online: 6 JAN 2011
Hospitalization for childbirth has traditionally provided the opportunity to assure that infants and mothers have adjusted to the birth and that ongoing care has been arranged, but economic and social pressures have resulted in a dramatic decrease in the duration of hospitalization. Using a sample of mothers who delivered well infants from the 1988 nationally representative National Maternal and Infant Health Survey, this study examines how midwives and physicians used an extra day of hospitalization in response to demographic, economic, behavioral, health status, and health care risk factors. Although midwives were much more likely to discharge mothers early (OR = 2.29) there were marked differences between risk factors and discharge timing for midwives and physicians. For the patients of midwives, the only factor associated with early discharge timing was attendance at childbirth classes. For the patients of physicians, less than a high school education, inadequate prenatal care, receipt of Medicaid or lack of insurance, and no childbirth classes were associated with early discharge. In spite of the intense pressures to discharge patients early, midwives appear to have been more attentive to potential risk factors in making discharge decisions in 1988. Because brief hospitalization is now prevalent, attention to maternal and newborn adjustment after birth, as apparently practiced by midwives, is crucial.