early discharge possible at Sibley?

[Anonymous]

Hello there,

I am just entering my second trimester and am starting to think about the birthing process. Because I want the safety of a hospital setting for labor and delivery, I am opting for a hospital setting with a goal of a natural childbirth with only those interventions that my doctor believes are truly necessary. Obviously, many things may change before, during, and after my labor experience, but as of right now I truly believe I will want an early discharge to bond and care for my newborn at home.

The reasons for this are fairly straightforward: First, I have a strongly developed sense of privacy and don't believe a few days in the hospital will mesh well with my personality and privacy needs. Second, my husband is very much an equal partner and, while he cannot do the breastfeeding, I believe he will be an enormous help. My sister is going to be coming to stay with us, so both my husband and I will have help around the house. Finally, and fortunately, we are in a position to hire any help we need, whether it is a lactation consultant or other medical or domestic personnel. We would also be willing and able to take baby for check ups if his or her situation merited follow-up.

While I am certainly open to hearing opinions from people who believe i will change my mind or that I'm making a mistake, or that I can't truly plan a birth, or know what lies ahead, but please keep in mind that I am aware of all this and will be flexible -- but I do want to know beforehand what my options are. I'm simply looking for a straight answer as to whether or not I will be able to gain early discharge from Sibley if, after having the baby, that is still my desire. (Obviously, this would only apply to a no-complications, full term birth, vaginal birth, with healthy mom and baby).

[Anonymous]

If all you're looking for is a yes or no answer that is definitive, you would be better off to ask your doctor or call Sibley directly. I've heard of friends - all on the 2nd or 3rd child - requesting early discharge but I don't know about Sibley specifically.

Although you say you're aware of all the dimensions of childbirth etc so aren't specifically looking for feedback from those who've gone through this before, I'd just point out that 2 nights is a pretty short period of time - in many cases less than 48 hours - and may not feel all that excessive particularly if you do have a healthy natural birth. I went to Sibley at 6am with my first; gave birth vaginally after 10pm; went into a room just around midnight - so that counted as my first night - and then was discharged on the second AM, about 36 hours after giving birth. Given that I'd been up the entire night before the birth with contractions - and given that I spent the first night home awake all night with a screaming newborn since my milk didn't come in quickly enough to satisfy a 9lbplus kiddo - I wound up pretty exhausted and strung out. And I too had a willing husband, family at home, etc as well as an intense sense of privacy. My advice to all my friends who have given birth subsequently is to take full advantage of your time at the hospital to recover, adjust, bond, and learn to handle a newborn. You, your husband, your sister and your hired help will have plenty of time to handle things solo after day 2! good luck!

[Anonymous]

Doctors, not hospitals, set the parameters for how you are treated in a hospital setting. If your ob is okay with your being discharged, you can be discharged.

[Anonymous]

I delivered my first at Sibley and was not discharged early. I delivered my second in London (at a private hospital) and went home within 24 hours of being submitted (after one night). As long as you and the baby are fine, you should be able to leave the hospital early - no problem. Make sure you let your doctor know your intentions early though as there are certain tests (hearing, genetic screening) that a baby is required to have done at birth and some docs may wait until the second day to do the tests (especially if it was a long labor). But I suspect you can also go back later and get these done, so not a huge deal.

Even though you didn't ask, I would encourage you to keep an open mind about staying at the hospital the whole time. Labor is tough. And you will be very emotional. Also, the baby may not be feeding well, etc. If nothing else, remaining at the hospital longer can give you a much needed break. You mention that you can see lactation consultants, etc. That is great, but not at all the same thing as having nurses around at 2 am.

Now, if you plan on hiring a baby nurse who will be home with you for the first few weeks, then by all means go home early. But if not, I would stay. Take advantage of it.

[Anonymous]

OP, many freestanding birth centers allow (nay, encourage) their moms and babies to go home as soon as they want to. As long as you're feeling up to it, I don't see any reason why you shouldn't get the heck out of Dodge -- provided that EVERYONE at home can and will function without you having to play cruise director. Your job will be to stay in bed, in your jammies and nurse the baby. Their job will be to take the initiative to handle everything else. If this is the case, you'll definitely get more rest and relaxation at home than you will in the hospital.

Make sure to also run your plans by your pediatrician, once you find one. S/he will likely want to see the baby on days 1 and 2. In most cases, this happens at the hospital -- but babies born at home are routinely seen at the office, so yours can too. If you get pushback about your plans, take the time to decide whether your pede's concerns have merit or if this is a signal that your family may be more comfortable with another practice.

[Anonymous]

OP here, thanks for the insights. I do plan to ask my doctor the next time I'm in, but I forgot to ask him last week and this is not something I think is worth ringing him up about in between visits so i was hoping someone might share their personal experience or knowlege of early discharge at Sibley.

As I mentioned, I'm completely aware of the fact that I may really appreciate that time in the hospital once I've gone through labor, which is why I'm not planning to make an iron-clad decision to leave early right now. Nonetheless, my understanding is that the postpartum care is always a woman's chief complaint in a hospital. Also, I've read numerous reports suggesting that women who go home early have less postpartum depression, BETTER nursing results (I can send you links, or you can just google and find them), better mom / baby bonding, fewer disruptions (many moms have actually reported BETTER sleep because you're not having your vitals checked during the few moments of shut eye you get between feedings) and fewer postnatal infections for both mom and baby.

I personally don't like hospitals -- they make me uncomfortable and unhappy. Given these feelings, I would VERY much lean towards a home birth, but I don't want to cut myself off from medical advantages and the added safety of a hospital birth should complications arise during the birth. For the same reasons, I would also naturally agree to any check-ups and assurances needed by the doctors and nurses to ensure healthy mom and baby and that we would not need to turn right back around and readmit ourselves.

While you're right that many women will fare better by taking full advantage of any hospital stay allowed, I am pretty sure that I will prefer to go home as soon as possible, provided I enjoy a low complication birth. I know better than to say I'm sure right now of how I'll feel in 5-6 months, but at the same time, but I don't expect my fundamental personality to change just because I've given birth. For me, there really is no place like home.

Thanks for the replies.

[Anonymous]

I have a friend who was discharged after only one night at Sibley--but in her case, her baby was at GT Hospital in the NICU so the doctor wanted her to be able to visit the baby. I agree with the PPs who said it is likely up to your doctor, and your condition postpartum. By all means get a private room (it;'s worth the extra money--300 bucks) and have your baby room-in.

FWIW, I too planned a natural birth at Sibley, but in my experience, it is not a supportive environment for it. Hopefully you have a doula, if this is your first. I found that once the nurses learn you want a natural birth, they pretty much leave you on your own--except for intermittedly checking monitors, which they force on you. Sorry if this bursts your bubble, but it's somewhat of a battle to have a natural childbirth at Sibley.
Good luck

[Anonymous]

To PP 13:35, thank you so much for that helpful info and for validating how I feel about getting the heck out of dodge, as you put it! I couldn't agree more.

Most recent PP, thanks for the heads up on Sibley. To be honest, I've heard various things but most have said the most important factor is how supportive your doctor is of your plan to have a natural birth. I will not allow internal or continuous fetal monitoring unless the situation medically warrants, and I have the full support of my doctor on this. I do not intend to have a doula (fewer people in the room the better, honest to god, I wouldn't want another person fussing over me -- makes me uncomfortable).

I also won't plan to rely on nurses for pain management support. I'm going to take a Bradley course, husband will accompany. We are both pretty forceful people, which is good, since my doctor told my husband and I that if we want natural childbirth, we should be prepared to repeatedly refuse continuous monitoring and other interventions. He said that nurses sometimes push these on you without respect to the birth plan and despite not being told to push this by the doctor, but he said they can't force you to have treatment or monitoring that you don't agree to. Would you disagree based on your experience? Curious if your OB was as supportive of your natural decision as mine, and if that had anything to do with the way the nurses forced treatments on you.

[Anonymous]

I just had my second child at Sibley 2 1/2 month ago and was discharged early. The delivery went really well and baby and I were doing great so I immediately informed the doctors/nurses at Sibley that I would like to be discharged as soon as possible. I gave birth Thursday morning at 7:07 am and was out of the hospital at 3:30 pm Friday after my OB and the Sibley pediatrician agreed that we were good to go home. They did say that the general rule at Sibley is to keep new moms and babies for a minimum of 36 hours, but I did not have beg anyone to go home early.

Best of luck with the final stages of your pregnancy and labor.

[Anonymous]

Hi,
I had two c-sections at Sibley, so my medical situations were very different from yours. However, I just wanted to let you know that my dr. suggested I go home a day early the first pregnancy because I felt so good and was in such good shape. The second time, I went home a day early even though I didn't feel all that great.

The staff was very supportive, and all went well.

Best of luck.

[Anonymous]

Early discharge is possible at Sibley if you and your baby are doing fine. It's your ob/gyn that will allow you to go home early.

[Anonymous]

For the amount of money we have to shell out for a private room, I've always wondered whether moms would be better off checking out of the hospital and into the Ritz Carlton for a night or two with a post-partum doula. Comfier beds, better TV options and no one coming in at 3 a.m. just because the manual says they should.

[Anonymous]

I had two C's at Sibley (FYI, planned for a natural birth the first time around, so prepare for EVERYTHING, including a C) and got myself checked out a day early from hosp. but it is all about the dr.

[Anonymous]

Anonymous wrote:Doctors, not hospitals, set the parameters for how you are treated in a hospital setting. If your ob is okay with your being discharged, you can be discharged.

That's true, but at a hospital I was considering (not Sibley), once the baby was born, it was up to the pedatrics dept as to when they would discharge the baby. And if you didn't go along with them, it would be AMA, and then your insurance might not cover it (!!). So it's not just about the OB -- you need to know about any pediatrics/pediatrician policies the hospital may have. No good them giving you an early discharge if your (healthy/normal) baby's stuck there.

[Anonymous]

I really don't think you can pre-plan out your delivery before it happens because there are so many variables. You will ultimately be more happy if you don't get one particular birth plan in your mind and then it doesn't go your way. My advice is it is okay to have a general idea of what you want, but just go with the flow once you are there. If you want to go home early and everything is okay, then let them know at that time...but you might really appreciate your time there.