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A Return to Drive-Thru Deliveries?

I'll never forget when I told a friend about my c-section and she nearly exploded with envy. It was 1994 and what she coveted wasn't surgery -- it was my three days in the hospital. She'd delivered her son just before midnight and been booted out the next morning on orders from her insurance company.

I thought of her recently when a study by Harvard researchers concluded that short maternity stays were not necessarily harmful to infants. This was huge news because in 1996, urged on by women and medical groups, Congress essentially banned these "drive-through deliveries" by requiring insurers to cover 48 hours of hospital care after vaginal deliveries and 96 hours after cesareans.

But let's get one thing straight: The study doesn't endorse putting unwilling moms onto the street. What it suggests, says principal author Jeanne M. Madden, Ph.D., is that women should feel comfortable going home before the 48 hour deadline if they so choose -- and if they have a health-care program that provides adequate home support. As required by law, women in the study who went home early received a visit from a nurse within a few days of discharge.

In the heyday of drive-through deliveries, moms and babies were sent home 6 to 24 hours after delivery. This was particularly dangerous for babies with health problems such as heart defects or infections contracted during delivery.

Fortunately, none of the experts I spoke to felt Congress would dare reconsider such popular legislation. If you choose to go home early, take some steps to get the benefits the law guarantees. "Learn in advance what your insurance covers," says Terre McFillen-Hall, executive director of The Center for Patient Advocacy, a nonprofit that lobbies for quality health care. The American Academy of Pediatrics recommends that infants be evaluated within 48 hours of an early discharge. Talk to your pediatrician before delivery to discuss how to recognize infant health problems. And consider your location: If a medical issue arises, you'll want to be close to a hospital. And may the only drive-through you experience be well-stocked with hamburgers!

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