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) sub-
mitted 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 Ob-
stetricians and Gynecologists recommend, when no com-
plications 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 Gyne-
cologists 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 Gyne-
cologists has received reports of insurers proposing limits
•HCON 79 IH
of 12 hours, and in some cases 6 hours, for routine deliv-
eries;
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 Gyne-
cologists has stated that the trend toward earlier dis-
charge 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 difficul-
ties, and infections of the cord, ears, and eyes;
Whereas the American Medical Association has urged hos-
pitals and insurance companies, in the absence of empiri-
cal data, to allow the perinatal discharge of mothers and
infants to be determined by the clinical judgment of at-
tending 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 oc-
curring and with consideration of the mother’s social and
emotional needs and preferences: Now, therefore, be it
•HCON 79 IH
Resolved by the House of Representatives (the Senate
concurring), That it is the sense of Congress that—
(1) the Maternal and Child Health Bureau
should promptly collaborate with other concerned
national organizations to encourage well-designed
studies, separating economic concerns from concerns
about the health and well-being of mothers and chil-
dren, to identify safe neonatal practices with regard
to the hospital discharge of mothers and infants and
establish appropriate medical care procedures during
the perinatal period;
(2) decisions on how long mothers and
newborns should stay in the hospital after delivery
and before discharge should be made by doctors and
patients together based on the medical and health
care needs of the mother and newborn and not by
hospitals, health insurers, health service organiza-
tions, and health benefit plans based primarily on
economic considerations; and
(3) until further empirical data are collected so
as to indicate a need for change in current Guide-
lines, hospitals, health insurers, health services orga-
nizations, and health benefit plans should abide by
the current Guidelines for Perinatal Care of the
American Academy of Pediatrics and the American
•HCON 79 IH
College of Obstetricians and Gynecologists, that
state that the general time for discharge for mother
and baby should be at least 48 hours following un-
complicated vaginal delivery and at least 96 hours
following uncomplicated caesarian birth and that
permit early discharge if specified criteria are met.
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