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Comparative Study
. 2020 Mar 23;20(1):181.
doi: 10.1186/s12884-020-2839-9.

Length of stay after childbirth in India: a comparative study of public and private health institutions

Pradeep Kumar  1 , Preeti Dhillon  2
Affiliations
Comparative Study

Length of stay after childbirth in India: a comparative study of public and private health institutions

Pradeep Kumar et al. BMC Pregnancy Childbirth. .

Abstract

Background: This paper discusses length of stay (LOS) following childbirth as an indicator of quality of postnatal care in health institutions. This research aims to describe LOS according to both vaginal and cesarean deliveries in public and private health care institutions in India, and to identify any association of LOS with postnatal care and post-delivery complications.

Methods: We use recently released nationally-representative data from the National Family Health Survey-4 (2015-16) and apply the Cox proportional hazard model to determine the factors associated with LOS at the health facility after childbirth during a five-year period preceding the survey.

Results: Overall, the average LOS after childbirth is 3.4 days; 2.1 days for vaginal deliveries and 8.6 days for cesarean section (CS) deliveries. Strikingly, half of the women are discharged within 48 h. Women who give birth in private hospitals have a more prolonged stay than those who give birth in public health facilities. For vaginal birth in public hospitals, one-fourth of the women are discharged with insufficient LOS as against only 19.2% women in private hospitals. LOS is significantly related to the cost of delivery only in the case of private facilities. Uneducated women belonging to lower wealth quintile households and those living in rural areas stay for a shorter duration for vaginal deliveries but for a longer duration in case of cesarean deliveries. Women who get four or more antenatal check-ups (ANC) done have a longer stay, while those who receive benefits under the Janani Suraksha Yojna (JSY) have a shorter stay. Another key finding is that women who are discharged on the same day report lower levels of postnatal care and a higher proportion of post-delivery complications.

Conclusion: The study concludes that early discharge has a negative association with maternal health outcomes, which has important program implications. Therefore, it is essential to maintain an adequate LOS at a facility after childbirth. We recommend that government programs should strengthen the JSY scheme not only to improve delivery care, but also to provide effective postnatal care by promoting sufficient LOS at facilities.

Keywords: Cesarean delivery; Discharge from the hospital; Length of stay; Postnatal care; Private; Public; Vaginal.

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Conflict of interest statement

PK carried out this work as a part of the research for his PhD thesis. Authors declare that they do not have any competing interest.

Figures

Fig. 1
Fig. 1
Cumulative percentage of women by their length of stay at the institution after delivery
Fig. 2
Fig. 2
Average cost of delivery by length of stay
Fig. 3
Fig. 3
Women received postnatal care (PNC) at public and private health facilities
See this image and copyright information in PMC

References

    1. Watt S, Sword W, Krueger P. Longer postpartum hospitalization options–who stays, who leaves, what changes? BMC Pregnancy Childbirth. 2005;5(1):13. doi: 10.1186/1471-2393-5-13. - DOI - PMC - PubMed
    1. Blumenfeld YJ, El-Sayed YY, Lyell DJ, Nelson LM, Butwick AJ. Risk factors for prolonged postpartum length of stay following cesarean delivery. Am J Perinatol. 2015;32(9):825–832. doi: 10.1055/s-0034-1543953. - DOI - PMC - PubMed
    1. Mitchinson W. Giving birth in Canada, 1900–1950. Toronto: University of Toronto Press; 2002.
    1. Registrar General of India . Sample Registration System (SRS) New Delhi: Office of The Registrar General and Census Commissioner, Ministry of Home Affairs; 2018.
    1. Graham WJ, Bell JS, Bullough CHW. Can skilled attendance at delivery reduce maternal mortality in developing countries? Safe Mother Strateg a Rev Evid. 2001.

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