Early Discharge of Maternity Patients.

For many years the consultant obstetric staff of St. Mary's Hospital had sought to arrange for a selected number of their patients to be discharged early in the puerperium. The reasons for this were twofold. Firstly, the belief that there are some patients who should be delivered in hospital for medical reasons who yet neither merit nor, in many cases, wish for full hospital stay. Secondly, such a scheme would make more efficient use of the limited number of obstetric beds then available. Efforts to initiate such a scheme had failed because of the natural reluctance of district midwives to accept more than the occasional hospital patient for puerperal care at home. However, in 1960 a temporary reduction occurred in the number of maternity beds during the rebuilding of our maternity department. This was at a time when, in the London area, there was a serious increase in the number of unbooked obstetric cases, admission for which could be obtained only through the Emergency Bed Service. This combination of factors provided the opportunity to ask for and obtain the co-operation of the London County Council authorities to operate an early discharge scheme from St. Mary's Hospital for an experimental period. This was initially for one year, but the results were encouraging enough to all concerned for the scheme to be continued. The results of the first three years form the basis of this paper (see Table I).