From Hospital to Home
by Kate Kahn - 21st August 2007
There's an interesting article on the U.S. Department of Health and Human Services' website that highlights some dramatic problems in our healthcare system. It cites a new study published in the August issue of Pediatrics which clearly shows more education is needed to help new mothers transition from hospital to home.
The researchers culled information from 4300 mother-infant pairs and what they found was that, at the time of discharge, almost one in six was deemed unready. And, more often than not, it was the mother, rather than her doctors, who felt she and/or her infant was not yet prepared to go home. Anyway you look at it, that statistic is unacceptable in a country as advanced as ours. So it's important to analyze the reasons behind the numbers.
The study found that the lack of readiness to start life at home with a newborn had nothing to do with length of hospital stay (not sure I agree but the study shows what it shows). Rather, the team identified eight contributing factors: a maternal history of chronic disease, first-time parenthood, inadequate prenatal care, delivering during non-routine hours, neonatal problems in the hospital, a limited number of in-hospital education classes, plans to breast-feed, and the mother's race -- black women were almost 40 percent more likely to feel unready to be discharged than whites. .
"To increase readiness, it's critical to emphasize personalized discharge plans for that infant and his or her family," says the study's lead author, Dr. Henry Bernstein. Dr. Bernstein is chief of general academic pediatrics at Children's Hospital at Dartmouth, in Lebanon, N.H. .
Commenting on the study Dr. Robert Welch, chairman and program director of obstetrics and gynecology at St. John Health's Providence Hospital in Southfield, Michigan, says it really highlights the need for increased educaiton.
Welch brings up an interesting thought. He points out that societal changes play a part in the results. It used to be that when a new mother came home from the hospital, newborn in tow, often there was someone like a grandmother there to help teach how to care for the baby. "A lot of times now, moms are going home, and they're alone with the baby, and she may not have an appropriate support system in place, or day care if she's planning on going back to work," says Welch. "From the time that they have the first inkling that they want to have a baby, women should start building a support system," he suggests.
I think Dr. Welch has hit on something. My mother had passed away by the time I had children. I was fortunate enough to have a stepmother who jumped right in. Without her I'm quite positive I wouldn't have eaten anything for days (and thus not been able to pump), I wouldn't have gotten any sleep, or been able to stay on top of sterilizing bottles etc. But not everyone is as lucky as I am.
And Dr. Welch brings up another important factor that I think is at the core of the problem. He believes that hospitals should provide more standardized postpartum education. Right now what's included in postpartum education programs can vary greatly from hospital to hospital.
Dr. Bernstein and his team might have part of a solution. "We're hoping to come up with a score to be used at discharge, similar to the Apgar score just after birth, that can help clinicians predict who is ready and who is not ready, so appropriate postpartum supports or services can be put in place."
That's a good start.
Comments
Past Entries
This Week's
Question
Sign the Petition
Do moms know best? We believe they do, but the government may not..
Your freedom to choose between breast and bottle-feeding could be in jeopardy.
