From the Research
Prolonged hospital stay after delivery is typically defined as a postpartum hospitalization that extends beyond 4 days for cesarean delivery, as evidenced by the 90th centile for postpartum length of stay in a study of 57,067 patients undergoing cesarean delivery 1.
Definition and Causes
Prolonged hospital stay after delivery refers to a postpartum hospitalization that extends beyond the standard length of time. This extended stay is usually necessitated by maternal complications such as postpartum hemorrhage, infections (like endometritis), severe preeclampsia, surgical complications, or difficulty controlling pain. It may also occur due to infant-related issues requiring maternal presence, such as neonatal intensive care admission or breastfeeding difficulties.
Risk Factors
Several factors can contribute to a prolonged hospital stay after delivery. According to a study published in the American Journal of Perinatology, perioperative complications such as ileus, endometritis, and wound complications are significant risk factors for prolonged postpartum length of stay 1. Another study found that emergency cesarean delivery, maternal complications, and neonatal complications are also associated with longer hospital stays 2.
Management
Medical management during a prolonged stay depends on the specific complication and might include:
- Antibiotics for infection (such as ampicillin/gentamicin for endometritis)
- Antihypertensives like labetalol for blood pressure control
- Additional pain management
- Interventions to address wound complications The healthcare team typically monitors vital signs, laboratory values, and symptom resolution while providing appropriate treatments.
Recent Findings
A recent study published in 2025 found that high-dose postpartum oxytocin is associated with lower rates of postpartum hemorrhage than lower oxytocin doses 3. Another study published in 2025 found that prolonged hospital stay after birth is associated with infant gut dysbiosis, highlighting the importance of minimizing hospital stay when possible 4.
Guidelines
The American College of Obstetricians and Gynecologists (ACOG) recommends that obstetrician-gynecologists and other obstetric care providers play key roles in implementing standardized bundles of care for the management of postpartum hemorrhage, which is a leading cause of maternal mortality worldwide 5. Therefore, it is essential to prioritize evidence-based management strategies to minimize the risk of complications and prolonged hospital stays after delivery.