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Early discharge after delivery, followed by home care, has been offered to maternity patients at Motala General Hospital since 1983. The results have been analysed retrospectively with regard to home care quality, morbidity, mortality, and cost-effectiveness. During the period, 1983-95, about 10,000 children were born at Motala General Hospital. Morbidity and mortality data have been elicited from the patients' records and from Statistics Sweden, the national bureau of statistics. The frequency of early discharge increased from about 20 per cent in 1984 to 66 per cent (79% of normal deliveries) in 1995. Hyperbilirubinaemia and nutritional problems were the predominant forms of morbidity among newborns in the early discharge subgroup, and mortality was zero. The numbers of nurses, assistant nurses and midwives were reduced by 50 per cent during the period, partly due to the early discharge programme, but also due to economies in Swedish health care expenditure. Provided a stable and well organised system is established, with home visits by a midwife and examination by a paediatrician 5-7 days after delivery, and alertness to the possibility of jaundice and nutritional problems is maintained, early discharge is a safe procedure.

Early discharge after hospital delivery is common in other countries. In Sweden it was not introduced until recent years. Previous investigations have mainly focused on medical risk factors. However, few investigations have been done regarding psychological factors. This study, comprising 44 families (7 primaparae and 37 multiparae) in an early discharge group (discharge 0-2 days after hospital birth) and a late discharge group (discharge 5-6 days), indicates that parents in the early discharge group had more negative experiences of their earlier postpartum stay. The mothers in the early discharge group experienced less sibling revalry compared to the mothers in the control group. There were no other differences between the groups. The parents were equally satisfied with their choices in both groups. Early discharge, as a voluntary alternative, presents an increased service for parents, since the parents may choose the most suitable postpartum care.