Early Versus Late Discharge in Postpartum Care: Outcomes after Normal Delivery

Introduction: The optimal timing for postpartum discharge remains a subject of debate, with varying recommendations and practices globally. This study aims to compare the outcomes of early versus late discharge in postpartum care following normal delivery. Methods: This randomized controlled trial was conducted at the Department of Gynaecology and Obstetrics, Institute of Child and Maternal Health, Matuail, Dhaka, Bangladesh, from March 2011 to August 2011. 200 patients who underwent normal vaginal delivery were randomized into early (<24 hours) and late (>24 hours) discharge groups. Baseline characteristics, regularity of antenatal care visits, clinical examination findings at discharge and 7-day follow-up, and postpartum complaints were recorded and analyzed. Result: In our study of 200 participants, the early discharge group (n=100) and late discharge group (n=100) showed comparable baseline characteristics. Age, residence, socioeconomic status, educational status, and gestational age were similar across groups. Antenatal care regularity showed no significant difference with a p-value of 0.75. Clinical examination findings at discharge and the 7-day follow-up revealed no statistically significant differences in maternal and newborn health indicators: anemia (early: 26, late: 28), edema (early: 15, late: 12), minor breast problems (early: 8, late: 6), jaundice (early: 15, late: 12), dehydration (early: 12, late: 9), excessive crying (early: 26, late: 21), and complications of the umbilical stump (early: 7, late: 11). Postpartum complaints such as excessive vaginal bleeding (early: 5, late: 4), fever (early: 8, late: 6), foul-smelling lochia (early: 6, late: 8), feelings of depression (early: 16, late: 14), breast engorgement (early: 26, late: 22), and feeding difficulty (early: 32, late: 28) also showed no significant differences. A substantial number of mothers in both groups preferred the same or a shorter duration of hospital stay for their next delivery (shorter duration preference: early: 46, late: 39). Conclusion: The study concludes that both early and late discharge protocols can be viable options in postpartum care after normal delivery, without significant differences in maternal and newborn health outcomes. The findings support the implementation of flexible discharge policies, tailored to individual needs and preferences, in postpartum care.