[Congressional Record Volume 142, Number 35 (Thursday, March 14, 1996)]
[Extensions of Remarks]
[Pages E359-E360]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              THE MOTHER AND CHILD PROTECTION ACT OF 1996

                                 ______


                          HON. EDOLPHUS TOWNS

                              of new york

                    in the house of representatives

                        Thursday, March 14, 1996

  Mr. TOWNS. Mr. Speaker, I rise today to introduce legislation which 
ensures that newborn babies and their mothers receive appropriate 
health care in the critical first few days following birth.
  The legislation requires insurance companies, HMO's, and hospitals to 
offer mothers and newborns at least 48 hours of inpatient care 
following normal births and 120 hours after caesarean sections. Mothers 
may choose to go home earlier but insurers and HMO's must then offer 
them a home care visit within 24 hours of discharge.

[[Page E360]]

  The typical length of stay over a decade ago for a woman and her 
infant after delivery was 3 to 5 days for a vaginal delivery and 1 to 2 
weeks for a caesarean delivery. Over the past few years the typical 
length of stay decreased to 24 hours or less for an uncomplicated 
vaginal delivery and 2 to 3 days for a caesarean. In some regions 
around the country, hospitals are now discharging women 6 to 12 hours 
following a vaginal birth.
  Health care organizations such as the American Medical Association 
[AMA] have stated that early discharge of women and infants after 
delivery cannot be considered medically prudent. The AMA's policy on 
early discharge is that it is a decision which should be based on the 
clinical judgement of attending physicians and not on economic factors. 
Furthermore, national medical health care organizations such as the AMA 
and the American Academy of Pediatrics and the American College of 
Obstetricians and Gynecologists, all agree that shorter hospital stays 
are placing the health of many newborns and mothers at risk.

  There is reason for concern for the trend toward shorter hospital 
stays. Health care officials agree that the shorter stay increases the 
incidence in newborns of jaundice, dehydration, phenylketonuria [PKU], 
and other neonatal complications. For an example, adequate PKU test 
requires a newborn to have had 24 hours of milk feeding and most babies 
are not fed until 4 hour after birth. If a newborn is discharged prior 
to the 24 hours of milk feeding, then the hospital readmissions for 
undetected jaundice, a common condition in newborns and the easiest to 
treat. PKU and severe jaundice are conditions that can cause mental 
retardation if not detected early. Clearly if newborns spend more time 
in the hospital, then these and other conditions can be easily detected 
and treated, saving lives and money.
  A recent study by the Dartmouth-Hitchcock Medical Center found that 
within an infant's first 2 weeks of life, there is a 50-percent 
increased risk of readmission and a 70-percent increased risk of 
emergency room visits if the infant is discharged at less than 2 days 
of age. Other studies indicate that early release is just as harmful to 
mothers as to infants.
  Mothers can develop serious health problems such as hemorrhaging, 
pelvic infections, and breast infections. There is also the concern 
that opportunities for educating new mothers in the care of their 
newborns are lost when inappropriate early discharge occurs. This, 
coupled with the fact that many mothers are simply too exhausted to 
care for their children 24 hours after delivery, often leads to 
newborns receiving inadequate care and nourishment during their crucial 
first few days of life.
  A 48-hour minimum stay is consistent with steps being considered by 
some States. For example, my bill is very similar to one which recently 
passed the New York Assembly, and which is being considered in the 
Senate. New Jersey, Maryland, and North Carolina have also enacted laws 
on maternity hospital stays.
  Prevention has always been a way to cut health care costs. However, 
discharging mothers and newborns early creates its own costs. When a 
child suffers brain damage or other permanent disabilities because they 
did not receive adequate early care, insurers are then forced to pay 
for treating patients for conditions which could have been prevented or 
lessened if caught earlier.
  Mr. Speaker, this bill allows new mothers to focus on learning to 
care for their newborns and themselves instead of being concerned with 
when their insurance coverage will run out.

                          ____________________