Implementation of early postnatal discharge within 24 h in France: Safety, satisfaction, and feasibility trial supported by a connected home monitoring application (NICE-BIRTH study).

PROBLEM: France maintains one of the longest mean postpartum lengths of stay in Europe.

BACKGROUND

Shortening hospitalization requires ensuring safety and continuity of care in a healthcare system traditionally unaccustomed to ambulatory postpartum management.

AIM: To evaluate the safety and feasibility of an early postnatal discharge within 24 h (EPD) protocol supported by a digital platform and community-based midwifery.

METHODS

A prospective cohort study was conducted on 100 low-risk mother-infant dyads. The protocol involved strict inclusion criteria, antenatal preparation, discharge within 24 h, and daily home monitoring by community-based midwives coordinated via the "Link4Life" mobile application. Primary outcomes included maternal and neonatal readmissions, breastfeeding rates, and satisfaction.

FINDINGS: Full compliance with national recommendations was achieved. No maternal readmissions occurred within the first month. Four neonates (4%) were readmitted for late-onset infections unrelated to early discharge. Pain was effectively managed with Level 1 analgesics. At one month, 98.6% of initiating mothers were still breastfeeding. Satisfaction scores reached 9.7/10 for both mothers and midwives.

DISCUSSION: Our findings indicate a favorable preliminary safety profile and very high breastfeeding maintenance when the hospital-community transition is secured via digital innovation and dedicated professional support.

CONCLUSION

EPD is a feasible and highly satisfactory alternative to standard care in settings where such practices are currently non-standard. This illustrates how digital health can facilitate a strategic reallocation of hospital resources toward high-value, personalized community-based support.