Summary:
SB 301 would require Delaware hospitals to create a formal discharge plan for pregnant patients who present with signs or symptoms of labor, but who are discharged before delivery. The bill establishes specific information hospitals must review and document before the patient leaves the facility.
Analysis:
Under the bill, a discharge plan would be required when a pregnant mother arrives at a hospital experiencing possible labor symptoms — including contractions — and a physician or treating health-care professional determines the patient will be discharged rather than admitted for delivery.
The legislation requires hospitals to discuss the discharge plan with the patient, the patient’s agent, or a designated lay caregiver before discharge. Hospitals must also place the plan into the patient’s medical record.
The discharge plan itself must contain several specific elements:
- Clinical justification for discharge,
- Aftercare instructions and confirmation that those instructions were explained,
- Assessment of the travel distance and time between the patient’s residence and the hospital,
- Verification that the patient has reliable transportation,
- Identification of a backup hospital or facility where labor and delivery services are available.
SB 301’s requirements aim to create additional safeguards for mothers and unborn children during a medically sensitive period, as they are in a time close to labor. The legislation may particularly benefit mothers living far from hospitals or those with limited transportation access, where delayed return to care could create serious complications. Proponents also argue that the bill improves accountability by requiring hospitals to clearly document discharge reasoning and communicate expectations to mothers and their families.
Critics, however, may argue this bill can result in keeping some individuals in the hospital longer than needed, thus costing the patient and their insurance provider more money. This small adjustment could further play into the larger issue of unbearable insurance premiums and high child labor expenses that hospitals currently have, as this would be yet another service hospitals offer and insurance companies pay for. Discharge plans are also already the standard by which hospitals operate by for any case, this bill would simply expand on the circumstance for pregnant mothers. Some may view the bill as encouraging defensive medical practices or unnecessary admissions in order to reduce liability exposure. Others may question whether discharge planning standards are better handled through hospital policy and physician judgment rather than statutory mandates.
SB 301 is to be watched, as it does show that Delaware lawmakers are making efforts to alleviate both hospitals and others from the current malpractices concerning child labor. This bill was inspired by the story of Mercedes Wells, a woman who was forced to give birth on the side of the road minutes after being discharged from a hospital while in active labor. The goal is that mothers such as Wells, would have been properly evaluated and not allowed to be discharged into the street to give birth.