IV

104TH CONGRESS

1ST SESSION H. CON. RES. 79

Expressing the sense of Congress regarding an appropriate minimum length

of stay for routine deliveries.

IN THE HOUSE OF REPRESENTATIVES

JUNE 27, 1995

Mr. SANDERS (for himself, Mr. DEFAZIO, and Mr. MILLER of California) submitted the following concurrent resolution; which was referred to the

Committee on Commerce

CONCURRENT RESOLUTION

Expressing the sense of Congress regarding an appropriate

minimum length of stay for routine deliveries.

Whereas the Guidelines for Perinatal Care of the American

Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend, when no complications are present, a postpartum hospital stay of 48

hours for vaginal delivery and 96 hours for caesarean

birth, excluding the day of delivery;

Whereas the American College of Obstetricians and Gynecologists reports that it has become common for insurers

to limit length of stay to up to 24 hours following vaginal

delivery and up to 72 hours following caesarean delivery,

and the American College of Obstetricians and Gynecologists has received reports of insurers proposing limits
2

•HCON 79 IH

of 12 hours, and in some cases 6 hours, for routine deliveries;

Whereas the American Medical Association recently expressed

concern about the trend toward increasingly brief

perinatal hospital stays as routine practice in the absence

of adequate data to demonstrate the practice is safe;

Whereas the American College of Obstetricians and Gynecologists has stated that the trend toward earlier discharge is ‘‘equivalent to a large, uncontrolled, uninformed

experiment that may potentially affect the health of

American women and their babies’’;

Whereas a recent study by Dartmouth-Hitchcock Medical

Center found that within an infant’s first two weeks of

life there is a 50 percent increased risk of readmission

and 70 percent increased risk of emergency room visits

if the infant is discharged at less than two days of age;

Whereas studies have shown that early release of infants can

result in jaundice, feeding problems, respiratory difficulties, and infections of the cord, ears, and eyes;

Whereas the American Medical Association has urged hospitals and insurance companies, in the absence of empirical data, to allow the perinatal discharge of mothers and

infants to be determined by the clinical judgment of attending physicians not by economic considerations; and

Whereas the American Medical Association recommends that

the decision regarding perinatal discharge should be

made based on the criteria of medical stability, delivery

of adequate predischarge education, need for neonatal

screening, and determination that adequate feeding is occurring and with consideration of the mother’s social and

emotional needs and preferences: Now, therefore, be it
3

•HCON 79 IH

1 Resolved by the House of Representatives (the Senate

2 concurring), That it is the sense of Congress that—

3 (1) the Maternal and Child Health Bureau

4 should promptly collaborate with other concerned

5 national organizations to encourage well-designed

6 studies, separating economic concerns from concerns

7 about the health and well-being of mothers and chil8 dren, to identify safe neonatal practices with regard

9 to the hospital discharge of mothers and infants and

10 establish appropriate medical care procedures during

11 the perinatal period;

12 (2) decisions on how long mothers and

13 newborns should stay in the hospital after delivery

14 and before discharge should be made by doctors and

15 patients together based on the medical and health

16 care needs of the mother and newborn and not by

17 hospitals, health insurers, health service organiza18 tions, and health benefit plans based primarily on

19 economic considerations; and

20 (3) until further empirical data are collected so

21 as to indicate a need for change in current Guide22 lines, hospitals, health insurers, health services orga23 nizations, and health benefit plans should abide by

24 the current Guidelines for Perinatal Care of the

25 American Academy of Pediatrics and the American
4

•HCON 79 IH

1 College of Obstetricians and Gynecologists, that

2 state that the general time for discharge for mother

3 and baby should be at least 48 hours following un4 complicated vaginal delivery and at least 96 hours

5 following uncomplicated caesarian birth and that

6 permit early discharge if specified criteria are met.

Æ