Subject:         Discharge of Mother and Infant from The Birth Center.

POLICY:         Mother and Infant will be carefully assessed for safety and eligibility prior to discharge from The Birth Center.  Parents will be prepared for independent care at home.

GUIDELINES:

1.   Mothers will be considered eligible for discharge from The Birth Center to their home two hours after delivery provided there is evidence of all the following:

a.   Afebrile with pulse and respiration of good quality and rate

b.   Blood pressure within normal range

c.   Appropriate color and amount of lochia

d.   Firm fundus

e.   Adequate urinary output

f.    Ambulation without difficulty

g.   Edema within normal limits, both in extremities and at site of repair if applicable

h.   No other questionable finding

i.     A desire for early discharge

2.   Infants will be considered eligible for discharge from The Birth Center to their home two hours after delivery provided there is evidence of all of the following:

a.   Stabilization of temperature above 97o F.       

b.   No evidence of hypoglycemia

c.   Adequate sucking reflex and toleration of first feeding at breast or bottle

d.   No episodes of bleeding from the cord

e.   Normal respiratory patterns

f.    Normal reflex patterns

g.   No other questionable finding

If any of the above criteria are unmet by 12 hours post delivery, the mother and/or infant will be transferred to the hospital according to transfer procedures.

PROCEDURE:

1.   Birth Assistant will assess and assure the eligibility of mother and infant to be discharged.

2.   Birth Assistant will assess and assure readiness of parents to care for mother and infant at home during discharge teaching and discussion with family.

3.   Birth Assistant will see that all procedures, paperwork, assessments, and teaching have been completed prior to discharge:

a.   Blood testing for Rh negative mother/baby

b.   Maternal/infant void

c.   Pediatric exam

d.   Consent forms for refusal of vitamin K and/or erythromycin ointment

e.   PKU forms completed

f.    Discharge teaching completed and packet given to mother

g.   Discharge medications

h.   Appointments for follow-up exam

i.     Copies of medical records for pediatric care providers

j.    Birth certificate information complete

k.   Birth log book complete

4.   Mother will have all appropriate paperwork and supplies

a.   Appointment card

b.   Bulb syringe

c.   Discharge packet

d.   Password card for pictures

e.   Extra chux

f.    All personal belongings

5.   Transportation home:

a.   Arrangements for transportation of mothers and infants to their homes are the responsibility of family members.

b.   Staff will assist families in leaving the building and entering the transport vehicle.

c.   Infant car seat will be properly installed in vehicle.

d.   Mother and infant will be properly secured in vehicle.

6.   If patient or parents of infant decide to leave before they are evaluated to be appropriate for discharge then the AMA form needs to be completed and signed and the care provider notified.

7.   Ongoing communication with The Birth Center:

a.   Families are encouraged to call their care provider if there are any questions or any problems arise.

b.   A follow-up clinic appointment will be made for the mother and infant 2 days post partum.