The first victim of the managed care backlash was rapid postpartum discharge, more commonly known as a “drive-through delivery.” The issue was framed as a morality play, with corporate greed on one side and the health and safety of mothers and infants on the other. When a few horrific anecdotes were added to this mix, legislators understandably concluded that drive-through deliveries were an abusive practice that needed to be halted. Between 1995 and 1997, 40-odd states and Congress enacted legislation requiring insurers to defer to physician preferences as to an appropriate postpartum length of stay, or to cover a minimum of 48 hours (vaginal delivery) or 96 hours (cesarean section) of postpartum hospitalization.1

Physician groups and individual physicians played a major role in the enactment of these laws, through testimony, lobbying, and critical commentary in news articles and medical journals. In testimony before Congress, the American Academy of Pediatrics,...

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