[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H. Con. Res. 79 Introduced in House (IH)]







104th CONGRESS
  1st Session
H. CON. RES. 79

   Expressing the sense of Congress regarding an appropriate minimum 
                 length of stay for routine deliveries.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 27, 1995

 Mr. Sanders (for himself, Mr. DeFazio, and Mr. Miller of California) 
 submitted the following concurrent resolution; which was referred to 
                       the Committee on Commerce

_______________________________________________________________________

                         CONCURRENT RESOLUTION


 
   Expressing the sense of Congress regarding an appropriate minimum 
                 length of stay for routine deliveries.
Whereas the Guidelines for Perinatal Care of the American Academy of Pediatrics 
        and the American College of Obstetricians and Gynecologists recommend, 
        when no complications are present, a postpartum hospital stay of 48 
        hours for vaginal delivery and 96 hours for caesarean birth, excluding 
        the day of delivery;
Whereas the American College of Obstetricians and Gynecologists reports that it 
        has become common for insurers to limit length of stay to up to 24 hours 
        following vaginal delivery and up to 72 hours following caesarean 
        delivery, and the American College of Obstetricians and Gynecologists 
        has received reports of insurers proposing limits of 12 hours, and in 
        some cases 6 hours, for routine deliveries;
Whereas the American Medical Association recently expressed concern about the 
        trend toward increasingly brief perinatal hospital stays as routine 
        practice in the absence of adequate data to demonstrate the practice is 
        safe;
Whereas the American College of Obstetricians and Gynecologists has stated that 
        the trend toward earlier discharge is ``equivalent to a large, 
        uncontrolled, uninformed experiment that may potentially affect the 
        health of American women and their babies'';
Whereas a recent study by Dartmouth-Hitchcock Medical Center found that within 
        an infant's first two weeks of life there is a 50 percent increased risk 
        of readmission and 70 percent increased risk of emergency room visits if 
        the infant is discharged at less than two days of age;
Whereas studies have shown that early release of infants can result in jaundice, 
        feeding problems, respiratory difficulties, and infections of the cord, 
        ears, and eyes;
Whereas the American Medical Association has urged hospitals and insurance 
        companies, in the absence of empirical data, to allow the perinatal 
        discharge of mothers and infants to be determined by the clinical 
        judgment of attending physicians not by economic considerations; and
Whereas the American Medical Association recommends that the decision regarding 
        perinatal discharge should be made based on the criteria of medical 
        stability, delivery of adequate predischarge education, need for 
        neonatal screening, and determination that adequate feeding is occurring 
        and with consideration of the mother's social and emotional needs and 
        preferences: Now, therefore, be it
    Resolved by the House of Representatives (the Senate concurring), 
That it is the sense of Congress that--
            (1) the Maternal and Child Health Bureau should promptly 
        collaborate with other concerned national organizations to 
        encourage well-designed studies, separating economic concerns 
        from concerns about the health and well-being of mothers and 
        children, to identify safe neonatal practices with regard to 
        the hospital discharge of mothers and infants and establish 
        appropriate medical care procedures during the perinatal 
        period;
            (2) decisions on how long mothers and newborns should stay 
        in the hospital after delivery and before discharge should be 
        made by doctors and patients together based on the medical and 
        health care needs of the mother and newborn and not by 
        hospitals, health insurers, health service organizations, and 
        health benefit plans based primarily on economic 
        considerations; and
            (3) until further empirical data are collected so as to 
        indicate a need for change in current Guidelines, hospitals, 
        health insurers, health services organizations, and health 
        benefit plans should abide by the current Guidelines for 
        Perinatal Care of the American Academy of Pediatrics and the 
        American College of Obstetricians and Gynecologists, that state 
        that the general time for discharge for mother and baby should 
        be at least 48 hours following uncomplicated vaginal delivery 
        and at least 96 hours following uncomplicated caesarian birth 
        and that permit early discharge if specified criteria are met.
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