Discharge Standard Operating Procedure

My baby and I went home Sunday, my third day after the operation instead of Monday so my husband need not take another day off work. The usual length of stay is 2 days for vaginal delivery and 4 days for a cesarean section. My obstetrician saw me in the morning and gave me permission to go home. The day before I asked her if I could go home a day earlier and she said it depends on my progress until the next day. She gave me a belly band and show me how to use it. She told me it would help me move little better and she was right! She gave me prescriptions and told me it was also written down on my discharge paper work. Aside from being seen by my doctor everyday, the nurses were taking my blood pressure and temperature every two hours so I thought I could rest more at home since there would be no constant monitoring. Even so I signed a Discharge Notice that states "Your doctor and the hospital have determined that you no longer require care in the hospital and will be ready for discharge on Sunday"

My baby's pediatrician who saw me every morning to report how my baby is doing also said he examined my baby and gave me a written discharge instructions for my baby.

Since my husband was not feeling well the previous day, we had a Rendezvous Lunch instead of the complimentary Rendezvous Dinner that the hospital offers on the evening before being discharge.

The registered nurse quickly discussed the Postpartum Teaching and Discharge Plan with me prior to my discharge. She put the day's date under the column beside each topic as she went over them with me then we both signed them. She also asked me to sign a lot of forms. One of the forms given to me was a pink slip that says "ADULT INFLUENZA/PNEUMOCOCCAL STANDING ORDER PROTOCOL". There are two column on the form, on the left column, under the Contraindications to immunize, the RN crossed out the box beside the phrase - Less than 65 years old and does not have : Heart disease; lung disease; sickle; diabetes; alcoholism; cirrhosis; CSF leaks; HIV/AIDS; splenectomy; dialysis or kidney failure; cancer; Hodgkins doisease; lympoma; leukemia; long term steroids; multiple myeloma; organ transplant. On the right side of the form was the influenza vaccine Contraindication to Immunize and Indication to Immunize checklist, which the RN left blank maybe thinking that I had it already during my prenatal check-ups because one of the requirements under Indications to Immunize was Pregnant women regardless of trimester. Why would government and health institutions want to inject toxins to an expectant mother when she is carrying a baby is beyond me! Is not sustaning a new life that is gradually forming its organs and what have you taking a toll on the mother's body already? Why gave an expectant mother's immune system the stress of trying to fight off outside toxins no matter how mild they are? Toxins are toxins for me aside from that didn't they say that the mother's immune system is weakened during pregnancy why taxed it more with this vaccines?

Among the forms that I signed was the Patient Discharge Instruction Sheet on Post Partum depression and C-Section. On this paper, under the Physician's Instruction, shower and walking indoor and outdoor were allowed as tolerated. I also signed a paper that said I acknowledge receipt of the New York State Medicaid/Child Health Plus mandatory letter. This letter stated that if I were on Medicaid when my baby was born, then my baby has Medicaid until her first birthday. I don't really need to read this letter since both my husband and I have insurance and my baby will be added to his since I am going to have child care leave for a year, which means I would be off the payroll after my maternity leave and would not be covered then so it is better for my baby to be added on her father's insurance so she will be have insurance continously.


The RN and the nursery nurses gave me written instructions to take home. They remove my baby's foot band and my husbands and my wristbands.

I also received the small slip of paper that says : I Have A Hearing Test Today which means that my baby had a Newborn Hearing Sreening. The nurses, the RN and the nursery nurses told me I had to give this to my baby's pediatrician.

When my baby was already in the car seat, the assistant nurse took me out to the front entrance in a wheelchair with my mother-in-law and my husband who's carrying our baby in the car seat, walking by my side.

Coping with the Side-effects of the anesthesia

My baby was delivered through c-section at 5:57. But I was wheeled out of the operating room after 7 PM. I stayed in the recovery room for at least 2 hours. Then the nurse wheeled my bed to a semi-private room in the maternity ward. She helped me rolled myself from the bed I used in the recovery room to the bed in the room. I asked for my baby again and the nurse from the nursery wheeled her in a bassinet enclosed with something like clear plastic or glass.

I took a few pictures of my husband and baby while he was holding her.

I didn't sleep soundly even though I'm really tired! There are mechanical wraps from my ankle to knee that keeps going on and off every few minutes, tightening as it make a whirling sound. I asked the nurse to take it off so I can sleep better but she told me she can't do that as I needed that to prevent blood clot.

As if the whirring sound and the constant tightening of the wraps were not enough, my face, my arms and legs were also itchy. I'm sure that if my belly was not numbed because of the anesthesia, I would feel that it is itchy too! The nurse told me that it was the result of the anesthesia and that I had an allergic reaction to it. She told me she has medication for me when she saw my discomfort as she and the assistant nurse checked on me every two hours, taking my temperature and blood pressure. I told her no thinking that I had lot of medications already! By morning she looked at my face and said that my allergic reactions shows in my face and repeated the offer of the medication to help me feel better she said. Since my parents-in-law were coming that morning I said yes and took the medication.

My mother-in-law commented that I gained weight (she hadn't seen me for a while since she and my father-in-law live in another state). I just smiled then but I understood what she meant at night time when I looked in the mirror after using the bathroom. I didn't need to go to the bathroom until night time since I had a catheter for 24 hours after my c-section.

Before they arrived, the nurse helped me to get up from the bed and sat on a chair. I was always lying down before then so I didn't discover how excruciatingly painful moving was! Even when I breastfeed my baby I didn't need to move that much! The nursery nurse positioned her in my arms then came back for her when I pressed the button afterwards.

Before being admitted to the hospital during my pregnancy I always thought that my baby will always be with me but best laid plans don't always worked out well. I was mostly alone during the day because my husband went to work and during night time he could not stayed because I was in a semi-private room so he was not allowed to sleep over in the hospital. Only the women who gave birth naturally were given the suite because they also delivered their baby there. Since I had cesarean delivery I can only have a semiprivate room, and even though there was no other patient in the room, they didn't allow my husband to stay with me during night time. I thought that because I had a surgery shouldn't I be more entitled to a private room?! I definitely need more help!!! Being alone when you're aching is a little bit depressing even for a happy person like me!























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In the Recovery Room

Once I was in the recovery room I repeatedly asked for ice chips (the only thing that I had for 24 hours, my last meal was dinner of a liquid meal the night before). After ignoring my request for a few times while she was busy hooking me up. monitoring my heart beat, checking my blood pressure and all, the nurse told me that I she was told I can't have anything through the mouth so she needed to ask the doctor if I can have ice chips. I found out that the nurse was also from my country and was nice after all.

My husband called the number that CBR gave us for the collection of my daughter's cord blood. After an hour or so someone called him telling him the collector is downstairs already.When the man came up, my husband completed the form and gave the cord blood to him.

A nurse from the nursery also came. She introduced herself to my husband and I telling us that she was assigned to care for our baby. She had a consent form for Hepatitis B vaccine. We signed a waiver instead telling her that we will wait and that our baby's pediatrician would gave it to her.

The Birth of my Baby

When I heard my baby's first cry, I was swamped with overwhelming feelings, I started to cry silently with tears rolling incessantly from my eyes. My husband asked me if I was OK. I just nodded. I couldn't speak then, so overcome with my emotion at the time.

We asked them if they saved the cord blood, and they told us that it was done already, we just need to give it to the delivery man later.

It just took them less than 30 minutes to deliver my baby but it took them 2 hours more to finished everything. I heard them say, we'll irrigate her when they were almost finished. They told my husband he could watch our baby outside the nursery but he told them he will stay with his wife.

I didn't even have skin to skin contact with my baby because I couldn't move. She is tightly swaddled too. My husband talked to her while they finishing up.

But they made him leave and go ahead to the recovery room when they were about to remove the barrier that covered my lower body from our eyes.

C-Section Delivery

30 hours of labor but I didn't have a baby to show yet! My OBGYN noticed that my baby's heart beat is dipping, so they temporarily took out the medication (oxytocin). My baby's heartbeat returned to normal. They unplugged the Doppler external fetal monitor or the two transducers that is held in place by elastic belts around my belly and put an internal baby monitor inside me instead. I got scared when I've seen what they're going to put inside me ( a small tube with thin wires - connected to a tiny spiral wire that they attached to the part of my baby closest to the cervix to pick up my baby's heart beat). I'm so afraid that they might burst an internal organ or something after all whenever they gave me a pelvic exam their hand come out bloody. I noticed that they have long fingernails and even though they wore gloves i wonder if that is the reason their gloved hands came out bloody. Who knows what is happening inside me? What I can't see petrified me! I appeared calm though I just tried to look in my husband eyes whenever my doctor or midwife do something that scares me. After a certain time they give me the medication again and my baby got distressed again as shown by her heart beat. Because I had good contractions all though the night (2-3 minutes interval) without my baby being distressed they concluded that my baby couldn't tolerate the medication and yet they told me without the medication my contraction would not be strong enough to open my cervix sufficiently. I was only 5cm dilated then so they decided a c-section delivery was needed.

They gave my husband a gown, cap, mask and even something for his feet and told him to put them on while they get me ready. They wheeled me to the operating room . I wanted to arrange my legs becuse they are in the awkward position and I felt so exposed but I couldn't anymore because they felt so numbed I coldn't moved them no matter how hard I tried. They rolled from the bed that I've been using for almost two days to the operating table.

They asked me questions like do you know what is going to happen? asked me what process I'm about to have or something to that effect and they made me signed after each question by rolling my fingertips on the appropriate space in the document they held.

They put my arms perpendicular to my body that it made me think I'm almost lying in a cross. My left hand's middle finger was hooked up to a heartbeat monitor (I found this out when I'm already in the recovery room, I asked the nurse what is the purpose of the clamplike plastic attached to my middle finger). My right arm was not connected to anything but they still spread it out shoulder level. They also put an inflated plastic blanket on top of my shoulders and arms. This emitted heat and the anesthesiologist told me that he could adjust the heat higher if I want to. I was trembling so badly. I found out later that I had a reaction to the anesthesia. When I was still in the labor/delivery room I thought that I feel cold after I was given a pain killer but there is a niggle of suspicion already that I had a reaction to pai n killers but I just ignored it.

Although there is a blanket of barrier so my husband and I couldn't see the process we knew what is happening because we watched a video of cesarean delivery during the birth classes that we attended. Aside from this. I can still feel their fingers even though I don't feel any pain.