Early Discharge After Childbirth in France: NICE-Birth Pilot Study, Digi Mart USA News: Most European countries limit hospital stays after childbirth to less than two days on average, while France often extends them beyond that, with an average stay of 4.6 days in 2023.
Early discharge from maternity wards remains exceptional in France. Reducing hospital stays after delivery, even without particular concerns for the mother or newborn, requires guaranteeing safety and continuity of care in a French health system that is little accustomed to outpatient care in the postnatal period.
Some women strongly want to go home less than 24 hours after delivery. Caregivers at the University Hospital of Nice (CHU de Nice) heard this request and designed the NICE-Birth experiment.
The pilot study aimed to assess the safety and feasibility of an early discharge protocol supported by a digital platform and follow-up provided by independent midwives.
The study was a prospective cohort study involving 100 volunteer mother-child dyads without neonatal or maternal contraindications. The protocol relied on strict inclusion criteria, antenatal preparation, discharge within 24 hours (between 2 and 24 hours), and daily home follow-up by independent midwives, coordinated through the mobile application “Link4Life.”
After discharge, an independent midwife visited the home on day 1, day 2 and day 3, and once more before day 7. Between day 4 and day 10, the newborn was examined at the maternity ward by a pediatrician.
Until day 7, mothers completed a personalized questionnaire each day, while the maternity team checked twice a day, through the application, for any abnormalities.
The results were positive and fully consistent with national recommendations. Pain was effectively managed with first-level analgesics (paracetamol, nonsteroidal anti-inflammatory drugs).
No mothers needed rehospitalization during the first month. Three emergency department consultations were recorded, along with four complications: one cystitis case treated at home and three cases of delayed resumption of bowel function.
Among newborns, four rehospitalizations (4%) occurred, unrelated to early discharge: three for bronchiolitis and one for unexplained hyperthermia that resolved spontaneously. Three emergency department consultations were also recorded, without severity or complications (fever, regurgitation, parental concern).
In addition, at one month, 98.6% of mothers who had started breastfeeding were continuing it. Satisfaction scores reached 9.7/10 among both mothers and midwives.
According to the study authors, “our results indicate a favorable preliminary safety profile and a very high rate of breastfeeding maintenance, provided the transition between hospital and home is secured by digital innovation and dedicated professional support. Early discharge constitutes a feasible and highly satisfactory alternative to conventional care.” In other words, digital tools allow the hospital to redeploy part of its resources toward tailored follow-up of mothers and newborns at home.
On X, Professor Pierre-Alexis Gauci, a gynecologist at the CHU de Nice and first author of the study, welcomed the NICE-Birth results, which he said successfully demonstrated “the feasibility of a paradigm shift: moving away from a hospital-centered vision toward an approach centered on the mother-newborn pathway. With this successful first stage, the next step is already underway with the preparation of a multicenter evaluation on a national scale.” He stressed that this was achieved without any compromise on medical safety.
The program is intended for women who wish to return home quickly, without seeking to impose this express return on all women.
