Making U.S. Maternal and Child Health policy: from "early discharge" to "drive through deliveries" to a national law.
OBJECTIVE
To examine the national policy-making process in maternal and child health through a case study of the passage of a national law aimed at extending postpartum hospital stays.


METHODS
The study is based on a review of official and unofficial documents associated with the bill's legislative progress as well as an examination of scholarly research on early discharge and media coverage of the issue. Interviews were also conducted with legislative and interest group staff.


RESULTS
The passage of early discharge legislation occurred in an unusually short time frame and was aided by its minimal public costs, the willingness of its supporters to compromise on key elements, and its perceived appeal to female voters in an election year. Clinical and public health research had little influence on the process.


CONCLUSIONS
Maternal and child health advocates, while facing a problem with a politically weak constituency base, can benefit from their important symbolic role in policymakers' minds. They must respect the importance of compromise to legislative institutions and be alert to opportunities to frame their issues in a politically popular way.
Declercq
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Maternal and Child Health Department, Boston University School of Public Health, Massachusetts 02118, USA. declercq@bu.edu
D002669:Child Welfare / Q000331:legislation & jurisprudence*; D036861:Delivery, Obstetric; D005260:Female; D006291:Health Policy; D006801:Humans; D007231:Infant, Newborn; D008429:Maternal Welfare / Q000331:legislation & jurisprudence*; D010344:Patient Advocacy; D010351:Patient Discharge / Q000331:legislation & jurisprudence*; D011050:Policy Making; D011057:Politics; D011247:Pregnancy; D014481:United States