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.