Nearly 4 million women give birth in the United States each year, the vast majority of them in hospitals, making childbirth the most frequent reason for hospital admission.1 According to generally accepted standards of maternity care, the health care needs of the newborn and mother in the immediate postnatal/postpartum period should be met at the delivery site. These needs include monitoring and support to ensure the infant's stabilization during the initial physiologic transition from intrauterine to extrauterine environments, performance of recommended immunizations, mandatory screening for genetic disorders, and initiation of feeding and assessment of major medical risk factors. Standard inpatient care for mothers in the immediate postpartum period has also included instruction on infant and self-care, and training in breastfeeding and lactation support.

Hospital length of stay after childbirth has decreased progressively during the past 25 years, initially in response to public pressure to demedicalize childbirth but then in...

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