Research Mentor Name
Dr. Monique Swain
Research Mentor Email Address
Institution / Department
Obgyn/ Henry Ford Health Center
Level of Research
Objective: To understand reasons and events surrounding postpartum discharges against medical advice (AMA) in an urban population in Detroit, Michigan.
Methods: A retrospective chart review was conducted looking at women who left AMA in the postpartum period from Henry Ford Hospital in Detroit, Michigan between 2013 and 2021.
Results: 111 women (0.18%) left AMA in the postpartum period between 2013 and 2021. 35.1% of women were Black, 53% were White, 11.7% were of other races. 4.5% of women had home births and were brought in by EMS shortly after delivery. 44.1% of women had preterm births. 35.1% delivered via cesarean section. 19.8% left AMA before 24 hours, and 36.9% left AMA on postpartum day 2. 41.4% had pregnancies complicated by preeclampsia or gestational hypertension. 17.1% had subsequent admission after their AMA discharge for labor complications. 26.1% of women had a history of substance use and 33.3% had a history of psychiatric diagnosis. 17.1% of women stated substance use factors as reasoning for leaving AMA. 10.8% left due to childcare issues relating to their other children.
Conclusion: At a time when maternal support is critical to help mothers recover and support their newborns, social determinants of health were noted to play a significant role in postpartum AMA discharges in an urban hospital in Detroit, Michigan. Our results raise attention to better understand this vulnerable population and factors influencing proper care, support, and providing adequate resources to allow them to have safe outcomes and optimal care for mothers and infants.
Community Health and Preventive Medicine | Maternal and Child Health | Medicine and Health Sciences | Obstetrics and Gynecology | Patient Safety | Psychiatric and Mental Health | Public Health Education and Promotion | Women's Health
Bedi, Gurbani BS; Ayyash, Mariam MD, MSCR; and Swain, Monique MD, "Discharged Against Medical Advice in the Postpartum Period: Why Should We Care?" (2022). Medical Student Research Symposium. 150.
Community Health and Preventive Medicine Commons, Maternal and Child Health Commons, Obstetrics and Gynecology Commons, Patient Safety Commons, Psychiatric and Mental Health Commons, Public Health Education and Promotion Commons, Women's Health Commons