Early postpartum discharge during the COVID-19 pandemic

J Perinat Med. 2020 Nov 26;48(9):1008-1012. doi: 10.1515/jpm-2020-0337.


Objectives To report our experience with early postpartum discharge to decrease hospital length of stay among low-risk puerperium patients in a large obstetrical service during the COVID-19 pandemic in New York. Methods Retrospective analysis of all uncomplicated postpartum women in seven obstetrical units within a large health system between December 8th, 2019 and June 20th, 2020. Women were stratified into two groups based on date of delivery in relation to the start of the COVID-19 pandemic in New York (Mid-March 2020); those delivering before or during the COVID-19 pandemic. We compared hospital length of stay, defined as time interval from delivery to discharge in hours, between the two groups and correlated it with the number of COVID-19 admissions to our hospitals. Statistical analysis included use of Wilcoxon rank sum test and Chi-squared test with significance defined as p-value<0.05. Results Of the 11,770 patients included, 5,893 (50.1%) delivered prior to and 5,877 (49.9%) delivered during the COVID-19 pandemic. We detected substantial shortening in postpartum hospital length of stay after vaginal delivery (34 vs. 48 h, p≤0.0001) and cesarean delivery (51 vs. 74 h, p≤0.0001) during the COVID-19 pandemic. Conclusions We report successful implementation of early postpartum discharge for low-risk patients resulting in a significantly shorter hospital stay during the COVID-19 pandemic in New York. The impact of this strategy on resource utilization, patient satisfaction and adverse outcomes requires further study.

Keywords: SARS-CoV-2; early discharge; length of stay; postpartum; pregnancy; puerperium.

MeSH terms

  • Adult
  • Betacoronavirus*
  • COVID-19
  • Cohort Studies
  • Coronavirus Infections / epidemiology*
  • Cross-Sectional Studies
  • Delivery, Obstetric / methods
  • Delivery, Obstetric / statistics & numerical data
  • Female
  • Humans
  • Length of Stay / statistics & numerical data*
  • New York / epidemiology
  • Pandemics*
  • Patient Discharge / statistics & numerical data*
  • Pneumonia, Viral / epidemiology*
  • Pregnancy
  • Retrospective Studies
  • SARS-CoV-2
  • Surge Capacity