Discussion of the Day
Modern medicine. Extreme cost saving?
Elizabeth H 16587919-Aug-24
Women who have Caesarean births in Scotland go home on the second day of the birth. This is a financial decision, not a medical one. Surely, the care of the mother and child should be paramount. I was concerned when I heard this. Do you think this is going too far in the cost-cutting exercise, potentially putting patients at risk?
Comments
  • my daughter had a tumor removed from her brain she was home 2 days later, and my wife had heart surgery and was home 2 days later as well, at this stage we were public, I was hit by a car fractured vertebrae lots of cuts, etc I spent 6 months in hospital I was private at the time, I think a lot of health decisions are financial if you hurt yourself at work why does it cost double to see a doctor for the same advice no wonder work cover cost are up
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    • I wonder if this would hold the same if a MAN had a Caesarean!
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      • Cost cutting going too far. There is no way mum would be well enough for baby's needs.
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        • a tough life in the Highlands
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          • I'd prefer to be at home than in the hospital myself. Too many bugs in the hospital I found. A bad place for both mum and baby, and at home there is usually more caring help.
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            • Definitely
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              • I am sure they would have daily home visits, but still a think a few more days is needed.
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                • Definitely. That is why we have private cover.It is a scheme by the govt; they are trying to reduce none private cover patients into private scheme
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                  • Definitely putting mother and baby at risk, so glad I had my children 19 and 16 years ago as a private patient, my first I stayed 10 days with Emergency Caesar and baby had a severe jaundice and second was an Elective Caesar stayed 6 nights.
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                    • Absolutely disgraceful. Higher risk of post natal depression and undiagnosed versions of it ... Why put so much pressure on new mums ? Day 3 is the worst day after birth for the baby blues to set in and milk production to come in properly ,then complications can arise ... that is all just after a natural childbirth!
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                      • reminds me of the song Rawhide,, movem on... hedem up... hedem up... movem on....i feel sorry for people in hospital now and it's not the staff its the gov
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                    • Well unsure if cost cutting is the only motivation. In Australia I had a placental abruptness,emergency surgery to save me and my son,eas put in an induced coma and was discharged 4 days after the birth,1 day after I woke. Lack of beds was the excuse I was given.
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                      • 2nd day seems too soon to me. I think from memory I was discharged day 3 or 4 when I had my youngest via emergency c section. Given it's MAJOR surgery & you need to start recovery & start to identify & sort out feeding issues etc. For experienced mums If there is good follow up at home it might be ok, but I would not be a fan. Pregnancy & birth are frikking exhausting & quite frankly there is no rest once you go home, especially if you have older kids. It comes down to cost savings not maternal or baby healthcare.
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                        • sometimes due to the risk of infection in hospitals....it is safer to go home. at times the mother also is eager to go home to recover, hopefully she will have support when she gets home to rest and recover,
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                          • I think this is too soon. I never had a caesarean done but I did have a total hysterectomy and was cut just the same and I can tell you that pain is horrible.
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                            • A lot would depend on the age and health of the mother and /or child.
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                              • Certainly very risky! Don’t understand this final decision - it’s a hospital or a factory?!
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                                • Recovery times are quicker. It's not all cost cutting it's also the pace if modern society. Technology advances and the possibilities of all sorts of miracle medicine of the future. Cancer cures limb and joint replacement and si forth. If we don't destroy the earth thru greed putin Xi the fat guy in North Korea and their Iranian mate we might get to that future
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                                  • I don't know about all that
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                                    • Hospitals in United States send you home quickly too. My daughter donated one of her kidneys last month and said the pain was way worse than her 2 C-sections and she was sent home 2 days after her kidney was removed even though she has 5 incisions.
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                                      • When I gave birth in England I went to a maternity home and every day an ambulance would turn up with women who had undergone a ceaser in hospital 2 or 3 days previously. You didn't get to stay very long at the maternity home I can tell you as you were sent home with the district nurse to make home visits. It isn't as though you are own your own.
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                                        • Yes that is stupid
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                                          • I do coming from experience
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                                            • Seems too quick to me. Maybe a few extra days would help and not break the bank ,
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                                              • I agree , a few more days would not hurt and that would make sure mom and baby are ok to leave
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                                            • Yes that is stupid
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                                              • That’s ridiculous Especially if they have no one to support them Greedy, uncaring, cost cutting governments I’m in Australia had a caesarean in the 90s and in hospital for a week My mistake was not having any family support nearby and my husband had to go back to work Extreme bad post natal depression and husband didn’t realise he was asking too much of me eg using cloth nappies, we were both environmentally aware , probably to my detriment……lifting was the very painful, dumb thing to do. Yet he mistakenly thought I was up for it. I always agreed with first baby’s an experiment, second brings itself up lol Was definitely my case as I stopped trying to be the perfect mother
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                                                • I think medically you need to stay for a few days to make sure both mum and bub are ok. My daughter had a ceasarean 4 months ago and if she had went home early they would not have picked up the clot in her blood stream
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                                                  • Wow How fortunate Scotlands not a small place , so I thought that for a week or fortnight they could afford to have nurses do some home checks I feel so sorry for this lady’s daughter
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                                                • My daughter was born at 1 min to midnight they wanted to send me home the next day (just a few hours after birth) but on paper it looked like it was a different day. I ended up getting an infection so they had to keep me there. But utterly ridiculous!
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                                                  • Omg Outrageous
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                                                • It is everything that your have stated ... it is not enough to be just sound of mind but must also be sound of body before showing the patients the way out. It is a very dangerous way to be treating the sick, yes a mum is sick as in unwell after giving birth and should be allowed to fully recover before being discharged.
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                                                  • Very much It’s a Huge change
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                                                • Yes I think it is to far. It should be based on how the mother is feeling.
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                                                  • Patient care before cost cutting
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                                                    • way too far
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                                                      • I think it is going too far. I don't agree with it.
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                                                        • This is saving the patient a lot of money. And it's far easer ( I'm told ) on the new mother. Less complications.
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                                                          • Perhaps ok in some cases - but I think a big risk.
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                                                        • There's a lot of post op risk involved with a Caesar. She should be in hospital for at least 3 nights. It's outrageous how new mothers are treated these days.
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                                                          • Absolutely..mother and child need more care and support prior to leaving hospital
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                                                            • When I had my first daughter, which was back in the 1960's, I was in hospital for 10 days & then only allowed home if everything was going okay. With my 2nd daughter, born in 1968, I had heron the Saturday & as the following day was Mothers' Day, I was sent home. I had no help apart from the first day, as my parents lived about 20 kms away from where I lived. It was too early with the 2nd daughter, but I can understand that it is always going to be "beds, we need more beds".
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                                                              • Very well said. I agree with you.
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                                                            • A couple of days isn't long enough to accurately assess the overall health of the mother and new baby. Trying to save money very often costs far more in the long run, but there has to be a will to provide great care and of course it has to fit in the budget. We can't upset the "bean counters," can we?
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                                                              • The care factor does not seem to be there anymore and it is disgraceful.
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                                                              • It is called FREE ENTERPRISE and dedicated by the Private Health System where they turn the Hospital System into a Sausage Machine churning people through the system as fast as possible. The entire thing is made possible by Private Health Insurance which now owns the Hospitals, the staff who work in those hospitals and the Doctors who do as they are told by Accountants who run the Private Health Insurance Companies and are always only interested in the Bottom Line. The welfare of the patient is of no concern to them just how much money that they can rake in per procedure.
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                                                                • yes, if it were me i would expect hospital level care for at least a month
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                                                                • Doctors are corrupt
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                                                                  • Certainly this is a time & cost decision I would not do this unless there was a medical issue that called for a caesarean section
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                                                                    • They will do what is their protocol.
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                                                                      • I don’t like the idea, although if you have help and care at home, maybe a friend or family member who has medical training, that is possible. But mothers do need lots of rest and care. Our first child came home with my wife after 3 days, and I helped care for her and my sister and mother came by to help.
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                                                                        • yes i believe a woman needs at least 2 weeks rest in hospital after giving birth
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                                                                          • View all 4 replies
                                                                          • I dont think anywhere keeps new mothers that long. I'm due with my first in January 2025 and they said regular birth you stay for 24-48hrs then sent home. If have c section it's 3 days then sent home. My sister has gone home the same day as giving birth a few times too. Would be great for 2 weeks option if the parents wish but unfortunately they want the beds for the next patient so they send you home because there isn't enough staff or beds to stay so long
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                                                                          • Paul B 522937Annette G 805380
                                                                            I still think thr old way is the best
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                                                                          • AnnelieseAnnette G 805380
                                                                            I had an emergency c section and they literally wanted to send me home less than 9 hours after birth. It was only because I complained and got an infection that I was allowed to stay. So no, not 3 days at all.
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                                                                          • probably depends on the hospital, I'm in regional Victoria
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                                                                        • yaaaaaaas
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                                                                          • Absolutely recently a woman lost her premature baby because the hospital didn't have a bed for her. This is utterly pathetic and we are apparently getting a new hospital and God help us if they put the same administration in because they aren't doing a good enough job now. Absolutely shameful, any one we think we are living in a third world country the way some patients are treated. Just because they are in a fancy new hospital isn't going to change their work load or their work ethics. Just more empty beds people are dying to get in. I must admit I was in hospital for 2 nights after my second baby was born. I wanted out and as soon as I was allowed. I have been like that with all my operations too. Better off being in your own bed, with some one that loves you looking after you and with your own things around you.
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                                                                            • Yes, way too far. of course it was all to be expected wasn't it?Not that i believe in the existence of such a being but the old god we were brought up with - it doesn't matter what it's name is for we are told that under Mosaic Law (That covers Judaism, Christianity and Islam) Yahweh, God Allah are one and the same being. All of whom gleefully run around breaking one of the Most Important of the 10 Commandments "Thou Shalt Not Kill". That old deity has no been entirely replaced with a Brand New God and it's name is GREED. The only food it requires is Money and more Money - a bit like the old religions whose mantra became "Give me More Money and More and More, we never have enough Wealth"
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                                                                              • Yes and it’s scary to think that Australia will probably follow it soon.
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                                                                                • What do you mean, it's worse in Australia. I got asked to leave after less than 9 hours after birth! That was at the best hospital in Australia.
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                                                                                • The ghostAnneliese
                                                                                  I didn’t realise we had stooped so low in the medical system.
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                                                                              • Yes way to far
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                                                                                • Yes, sometimes this is true,
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                                                                                  • Yes. Cesarean sections, of which both my boys were born emergently-running around, paging any ob physician til reg one arrived (and by the way I'm tired of every woman I've heard say she had a c-section due to emergency bc they all certainly aren't), my baby boys born 8 yrs apart were in need of very specialized care, necessitating helicopter rides to trauma 1 hospital ICU's to assist them. I was in American hospitals a week each time. It's definitely cutting dangerous corners to send women home p.o.day 1 or 2. It might be their Healthcare systems protocol for cesareans. Idk about that. But this is my area of experience and education was/is, having spent my working years in newborn nurserys, post partum floors, and labor and delivery suites-depending on staffing. No amount of money can replace a sick or dead mother or child and quite often, health issues that are serious don't reveal immediately, sometimes days. Im still haunted at the passing of one of our mom's when the doctors failed to diagnose her properly. She was 24. She died ofca ruptured aortic anyuerism from pushing so long and a predispisition to a weakened abdominal aorta. It's a beautiful but difficult process to give birth any way. Women deserve better. That poor family losing a young woman having her first baby. I often think of her child and how old he is now and how life's been for him. Life first, $ second. Unfortunately, the mother that passed was in the hospital for weeks before they diagnosed her severe, writhing pain and sent her out by ambulance 10 miles to a level 1 trauma center, but she didn't survive the ambulance ride. I know she will be with her son again and they will know whom each other is and God will make it right. That's the note I'll leave my extensive comment on.🙏
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                                                                                    • Scotland has the NHS as the funding arm of publicly accessible healthcare. There are 3 main privately run hospitals in Scotland but taxation funds the NHS.and most Scots avail themselves of the NHS for treatment and hospitalisation. In Scotland most babies are delivered by midwives as here in Australia. If a woman has had a C Section and returned home the following day then you can bet your last dollar on the fact that a midwife will have daily contact with her and the patient will have a phone number to get straight through to the midwives on duty for any reason. If the midwife isn't happy then she'll either do an urgent visit or send the mother to her nearest hospital for review. In the US it is different which is why their maternal morbidity and mortality rates are so high. Women ARE sent home too quickly and many die of preventable issues such as infection which could be found sooner if the patient is still in the hospital and having regular checks which I myself have done. Women can decline really quickly so these checks are vital! Having said that, due to the number of C Sections in the US, the post op checks are NOT done frequently enough and I have read of cases where women have been found deceased in their hospital bed because nobody checked on them as they SHOULD have done. A C Section is a serious operation and I don't believe that most people see how horribly things can go wrong. The WHO recommended in the 1990's that the rate of C S should be 10-15%. Now it's at 25-28% globally and will be at 28.5% by 2030. In private maternity hospitals in India the rate is 65% which is completely unnecessary, but as the Doctor's, who often have a vested financial interest in these facilities, get paid vastly more for a C S than a vaginal birth these women and their families are being sold a lie that C S are safer than vaginal births and the neonatal and maternal morbidity and mortality rates are excessively high in these institutions. All women everywhere deserve a safe delivery whatever the means and that includes post birth care for both mother and baby! Thanks for reading.
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                                                                                      • Normal births here can go home the same day as giving birth, as for caesarean section I think it goes on how the mother and baby are doing and if they have help at home, also we can get a nurse/midwife to come to our homes to see how things are going. this is in NZ.
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                                                                                        • Extremely too early to send a mother home after 2 days after having a C-Section birth Without just the fact of bending, moving positions and keeping herself nourished , whether she's Breast's feeding or not... The child needs the mother to be in good form to be taken care of.. Also, even though it wasn't mentioned on here, .... What if the woman is a single mother? It shouldn't matter the situation.. Giving birth in any situation is the most spiritual and amazing thing a woman can do.. But, why is it so hush hush .. About the pain after birth and how long that may last. We are taught that no 2 people are alike Listen to those words.. Protect the mothers health, so she can protect the health of our future generation
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                                                                                          • I feel that it should be based on the recovery process of both the mother and the child. After 2 days when the final check-up before dismissal they should know if they do their job's correctly wether or not further medical attention is needed!
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                                                                                            • It depends on the condition of the mother post-op, how well she is feeding and bonding with the baby and whether post partum depression has surfaced. The human factor needs to override the cost cutting initiative of the hospital.
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                                                                                              • Whose financial decision? Why are people not insured when they live in countries with extra high medical costs? The hospital is not cost-cutting, they get no money if patient go home early
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                                                                                                • Yes they should be staying longer at no extra cost and they have no care for there people and the human life only the money it is so wrong
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                                                                                                  • who? the mothers? the hospital is not cost cutting, they get no money if no patients
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                                                                                                  • It's a revolving door. They are making plenty of money. It ALL about money. It's a business just like any other.
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                                                                                                  • JANN RJania S
                                                                                                    unless you have been through this you have no idea of what its like
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                                                                                                • They care more about money these days than human life. So why are we even surprised.
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                                                                                                  • did read no said the hospital is at fault. maybe she had no insurance. Question was not worded clearly
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                                                                                                • it depends on how mother and baby are doing. C section is not as risky as it once was.
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                                                                                                  • View all 3 replies
                                                                                                  • Lyn, I'm afraid that I am going to have to disagree with you. There are many more women these days dying due to having a C Section than previously. There are many reasons why this is so and here are some. The age of the mother at birth, the proficiency of the OBGYN doing the operation and the haste at which the procedure has to be done as per an emergency C Section. Then both peri and postoperatively there is an amniotic embolism which can easily cause death as the mother as the mother is having an allergic reaction to the amniotic fluid which gets into her bloodstream. The increase of maternal age and multiple births has caused this rare condition to become more common. Then there's post partum haemorrhage which can also be caused due to a placenta praevia and the mother can still bleed to death even after recieveing a blood transfusion in a 1st world hospital. There's blood clots, infection and many more dangers which are rarely listed but I have personally known 2 women who had their bladder walls stitched to their uterus by a surgeon whose mind was clearly on other things causing huge levels of pain and inflammation issues and urinary issues as well that persisted until a follow-up C Section. In the 1990's the WHO stated that a reasonable level of C S births globally was 10-15%. Now it's at 25% and by decades end will be around 28.5% of all births. In India in private maternity hospitals the rate is 65% of births for no other reason than convenience for the Doctor and money. The global rates of fetal and maternal morbidity and mortality are no better now than they were when the rate of C S was between 10-15%. Thanks for reading.
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                                                                                                  • Lyn A.Michelle S 553303
                                                                                                    All those things happened previously also. As to WHO I have no confidence in them not any other arms of the UN. I agree the increase in the age of mother's especially first timer's is a worrying factor. Also there are more 'pre planned' Caesars now. Used to be they were only done as 'emergency'. All part of the 'new world' I guess. As always we all have had different experiences so have different opinions and ideals.
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                                                                                                  • Exactly! I also have NO trust in the WHO but only used them for demographic purposes. Take care now Lyn!
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                                                                                                • Probably due to lack of beds. The hospital systems in many countries are stretched. Keeping someone in a bed means another patient who may have serious illness has to wait. Its not ideal but thats what it is. Yes its financial but they have to cater for too many patients for the amount of funding they get. There's many day surgeries performed where it would be best to recover overnight rather than go home but that doesn't happen. So a family member or friend has to have that responsibility to care for that person overnight.
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                                                                                                  • It's certainly a risky decision to have such short timeframes after any operations, etc. ... but as well as cost savings*, it is also done to free up beds. Hospitals these days have massive numbers of people to treat with a limited amount of space and staff. * The cost savings are next to nothing since another person will quickly take the place of the person sent home.
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                                                                                                    • It does seem unwise!
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                                                                                                      • My mother had a caesarean with my sister in 2001 in which it takes her a while to recover after she give birth to my sister at that time.
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                                                                                                        • seems not enough time in most cases but why not get back to normal as soon as possible
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                                                                                                          • Medical care of the human race is always about money, we stopped caring for our people a long time ago, and it is NOT safe ever
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                                                                                                            • It’s understandable that you’d be concerned. Releasing mothers just two days after a Caesarean sounds more like a decision driven by financial pressures than medical considerations. A C-section is major surgery, and rushing recovery could lead to complications for both the mother and baby. Ideally, care should be centered around their well-being, ensuring they’re fully stable before going home. Cost-cutting is a reality in healthcare, but when it starts compromising patient safety and recovery, it definitely seems like a step too far. Balancing budgets is important, but it shouldn’t come at the expense of proper care.
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                                                                                                              • When plumbers make more than doctors this problem will never get fixed.
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                                                                                                                • Totally unsafe. Why is insurance companies deciding the care instead of the doctor????
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                                                                                                                  • Way too far. Putting both mother and child at risk. If it’s a first time mother it is even worse, and a great risk for developing post natal depression. No one should be forced to go home till after day 3 at a bare minimum.
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                                                                                                                    • definitely!
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                                                                                                                      • insane.
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                                                                                                                        • I have had all 3 of my children by caesarean. I live in the USA btw. I think I was only in the hospital for like 2 days
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                                                                                                                          • In the United States we are allowed 4 to 5 days.
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                                                                                                                            • Thats disgusting you should have been allowed to stay in hospital until you are pretty well healed.
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                                                                                                                              • Yes! I'm in Canada and had my son Cesarean in 2005.. I was in hospital two weeks after that! I saw many other women come and go however, probably natural births..The condition of the maternity ward was gross! They cleaned the bathroom for the ward once the whole two weeks I was there, and it was very unsanitary in there .. there later was a C defficile out break there which is from germs basically
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                                                                                                                                • I think it goes too far. After giving birth or after any major medical event a person should be allowed to recovery in a medical facility for at least 2 or 3 days or until they feel that they can reasonably care for themselves.
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                                                                                                                                  • It's going to far.because the mother need to be monitored. To make sure that she is physically and mentally ready to go home.The baby needs to be observed for a couple of days.Because the baby and mother need to make at least one bioul movement before going home.And I have had 6 children.Am 47 years old.My doctor would never let me go home like that.
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                                                                                                                                    • WOW, GOES TOO FAR HOW I SEE IT...CRAZY THINKING,MY DAD WAS A HOSP ADMIN AND NEVER WOULD THIS HAPPEN..
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                                                                                                                                      • This happens in Canada as well 😞
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                                                                                                                                        • Should stay in hospital.
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                                                                                                                                          • what do you EXPECT - when the bottom line is PROFITS over PEOPLE...hm
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                                                                                                                                            • Very risky. They do many proceedures as outpatient too.
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                                                                                                                                              • Not just for Cesarean births. Most mothers get sent home within a day. I had my gallbladder out and was sent home less than 20 hours after the op. I ended up with a serious infection. Same thing happened when I had a total hysterectomy with everything removed i.e. cervix, uterus, tubes, etc. and sent home 2 days after this and again ended up with a massive infection which took weeks to get over. Both times I was home alone afterwards. Care is limited due to costs and I feel what we receive now is way below standards or expectations. We need better education of our young so they will take up the fields in medicine and the monies from taxes better spent and waste eliminated as much as possible. The funds should go to the care of patients. Look at the Aged Care industry. It is in crisis and disgrace at how they look after these vulnerable people. The food is poor quality and a high percentage of the residents are malnourished or border line. So many investigations into these areas have bought about little or no change.
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                                                                                                                                                • Big pharma, enuf said.
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                                                                                                                                                  • Hospital care is poor everywhere...you just have to hope you never need it
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                                                                                                                                                    • Yes, the medical staff focus on what insurance covers and will discharge people regardless of their condition. It's not patient centered anymore. Now on the other hand, I'm the type who would want to get out the hospital as soon as possible, but that's me personally :)
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                                                                                                                                                      • Yes they should keep the patient longer
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                                                                                                                                                        • Personally in Australia 🇦🇺 I think there have been similar incidents not only in maternity. Not all circumstances are the same for example a patient with several chronic health conditions should be monitored longer….but I guess it depends on the hospitals bottom line and thier policies
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                                                                                                                                                          • When I had my first caesarean in 2006, I was useless in the first 24 hours but when I had my second caesarean in 2012, I was able to get down from bed the next morning, albeit gingerly. So I guess advancement in medicine means the recovery is going to be quicker so it is very possible to be discharged after 48 hours.
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