Research questions

The research questions included: ‘What evidence exists about factors that influence first-time parents' decision or readiness to be discharged within 24 hours?’ and ‘What evidence exists about outcomes and factors that influence the outcomes of discharge within 24 hours after birth for healthy first-time parents and healthy newborns?’.

Inclusion criteria

The authors conducted a comprehensive systematic literature search to identify relevant articles. The inclusion criteria were first-time parents and healthy mothers with an uncomplicated vaginal birth, healthy infants defined by the primary studies’ authors, and infants born at a gestation age between 37 to 42 weeks. We included first-time parents discharged within 24 hours after birth or described as discharged within one day after birth, compared to discharge later than 24 hours after birth. If a study included both first-time and multiparous parents, a clear distinction between the results for first-time and multiparous parents was required for inclusion. Also, a clear distinction between the results for discharge before or after 24 hours after birth, and a distinction between the results for vaginal birth and caesarean section were required for inclusion. Quantitative, qualitative, and mixed methods types of studies were also included. Study designs as metaanalysis, reviews, experimental and observational study were included. Conference abstracts, dissertations, books, essays, editorials, commentaries, and audio accounts were excluded. Articles written in English, Danish, Norwegian, and Swedish were included.

Pubmed, Cinahl (with full text), EMBASE (Ovid), and Scopus were systematically searched from the inception date of each database to 8 October 2019. Keywords in the search included: first-time parents (e.g. primipara, parents, or mother), first child (e.g. infant, or neonatal) and length of stay after birth (e.g. early discharge, labor, ambulatory care, or outpatient). The search included synonyms and variations of the keywords combined with Boolean operators. A combination of search techniques was used, including controlled vocabulary thesaurus terms (e.g. medical subject headings – MeSH, and Cinahl headings) and a free-text search of all the synonyms and variations of the keywords were used. Furthermore, to identify any grey literature, a search in Google Scholar was performed. Finally, the searches were supplemented with forward and backward chain search in citations and reference lists from the identified literature and relevant guidelines. The search strategies from all databases are shown in the Supplementary file.

Study selection

The authors independently screened the records in Covidence^® according to the inclusion criteria²³. Disagreements were discussed and resolved by consensus of the authors. An updated search was performed on 22 February 2021, based on the search strategy described above.

Data reporting

The data were charted in stage four, according to Levac et al., and a descriptive numeric summary and a thematic analysis guided by the research question was provided. Each study was narratively described. Authors VL and DM collaborated thoroughly in extracting the data from the identified studies.

Search results

Based on the search strategy, 3750 citations were identified. After removing duplicates, 2030 studies were screened independently, by authors VL and PSG, based on title and abstract, and 1892 studies were irrelevant. Authors VL and DM screened independently a total of 138 studies based on full text. A total of 126 studies were excluded. The updated search identified a total of 366 studies, and one new study was included. Thus, a total of 13 studies were included, and one article was added through chain search in reference lists, as shown in the PRISMA flow diagram (Figure 1).

Figure 1

Prisma 2009 Flow Diagram

As illustrated in Table 1, 14 studies fulfilled the inclusion criteria in this scoping review. The studies were published from 1987 to 2020. Six of the studies used a qualitative approach, and seven studies used a quantitative approach. One study used a mixed-methods design. Among the quantitative studies, three of the seven quantitative studies used questionnaires, two used surveys, one was a retrospective cohort study, and one used a Q-technique as study design. The studies included in this scoping review took place in the United States of America (n=5), Denmark (n=4), Sweden (n=2), Australia (n=2), and Norway (n=1).

Definition of early discharge

Most of the included studies define early discharge as taking place within 24 hours after birth^24-33. However, some of the studies use other definitions like discharge on the day of birth³⁴, discharge within one day or less³⁵, discharge six to eight hours after birth³⁶, or six to 17 hours after birth³⁷.

Definition of uncomplicated birth

The definition of an uncomplicated birth is not specified in most of the studies. In six studies, the criterion for early discharge is described as an uncomplicated pregnancy and birth, without further definition^27,30-33,37. Other studies used criteria for early discharge that included all routinely discharged healthy newborns at term^29,34 or all mothers discharged with a live newborn³⁵. One study²⁵ had the following specific criteria for early discharge:

The factors that might influence the first-time parents' decision or readiness to be discharged within 24 hours after birth identified in this scoping review were parental education, social support, and follow-up strategies after discharge. The following four outcomes of early discharge were identified: the parents' sense of security, the parents' satisfaction with early discharge, breastfeeding, and neonatal readmission. In addition, five factors that might influence one or more of the outcomes were parental education in pregnancy, social support from relatives, follow-up strategies, availability of support from healthcare professionals, and the parents' readiness for discharge.

Factors that influence the first-time parents' decision or readiness to be discharged within 24 hours after birth

A study found that first-time parents can be divided into two categories related to the parents' choice of early discharge after birth³⁷. One group of parents had ‘decided beforehand’, and another group wanted to ‘take it as it comes’³⁷.

Parental education

A descriptive study documented, that prenatal classes had minimal effect on the mothers’ readiness to be discharged from the hospital 24 hours after birth²⁴. Of the 10 hours of classes, four and a half hours were focused on postnatal issues, but further details were not described²⁴. Of the 59 mothers in the study, eight mothers changed their opinion from a preferred longer stay to being discharged 24 hours after birth. Only three of the mothers attributed their change in opinion to the information given in the prenatal class²⁴. A total of 20 of the 59 mothers changed their opinion after birth, from wanting discharge within 24 hours after birth to wanting discharge later. However, 15 of these mothers attributed the change in opinion to the birth experience and not the prenatal education²⁴. Lemmer²⁵ found no difference in attendance in childbirth classes for first-time mothers who chose discharge before or after 24 hours after birth. In another study including 540 first-time mothers, 27.6% stayed in the hospital for less than one day³⁵. Approximately 80% of all the first-time mothers in this study received prenatal education³⁵. However, the proportion of first-time mothers discharged within one day and received prenatal education was not reported³⁵. Furthermore, the content of prenatal education was not described³⁵. Prenatal education seems to have little impact on the mothers’ readiness or decision to be discharged within 24 hours. The studies all lacked a detailed description of the content of parental education.

Support from relatives

A survey compared two groups of first-time parents who were discharged before or after 24 hours after birth²⁵. The study found that the mothers in the short-stay group reported more sources of support than the group that chose to remain in the hospital for more than 24 hours after birth²⁵. Furthermore, the social support came specifically from the mother’s husband, mother, and mother-inlaw²⁵. This indicates that social support from the nearest relatives might positively influence the parents' readiness for discharge within 24 hours after birth.

Follow-up strategies

One study examined the mothers’ choice of the postpartum length of stay when the mothers were offered one home visit from a midwife between the second and sixth day after birth²⁹. This study found that only 4% of first-time mothers left the hospital within 24 hours after birth²⁹. In comparison, none in the control group, that did not receive an offer of a home visit by the midwife, left the hospital within 24 hours²⁹. The home visit by the midwife included guidance in breastfeeding and about baby care, a physical examination of the mother and baby, and dialogue about the birth and the mother’s experience²⁹. Therefore, it seems that a follow-up strategy with one home visit by a midwife between the second and the sixth day after birth was not enough to make the parents want to leave the hospital within 24 hours after birth.

The first-time parents' sense of security when discharged within 24 hours after birth

A qualitative study including 10 first-time parents (7 mothers and 3 fathers) found that first-time parents were particularly dependent on their respective network of family and friends²⁷. They expressed a sense of confidence and praise for their accessibility to family and friends when they needed assistance²⁷. The availability and support from relatives had a positive effect on the parents' sense of security. On the other hand, two first-time mothers felt pressure from the health professionals at the hospital to be discharged within 24 hours after birth, which generated a sense of insecurity among the parents²⁷. Therefore, if the parents do not feel ready for discharge, it might have a negative effect on the parents' sense of security after discharge. Another study of a new home-based model of midwifery care found that 9 out of 10 first-time mothers felt safe or very safe when being discharged within 24 hours after birth²⁸. The home-based model included a systematic follow-up strategy with a pediatrician and midwife examining the newborn and a health examination of the mother before discharge²⁸. Furthermore, an information package regarding the mother’s and newborn’s health and breastfeeding was handed out²⁸. After discharge, the follow-up strategy was daily telephone contact during the first week and an offer of a home visit and a hospital visit²⁸. In a qualitative study, one first-time father reported that they wanted a healthcare professional nearby to provide a sense of security, especially at night²⁷. Another qualitative study found that first-time parents felt safe to be discharged within 24 hours after birth when they could easily contact midwives, day and night, and know that a midwife’s home visit was planned for the day after discharge³⁷. Therefore, healthcare professionals’ availability and frequent contact with the parents are important to the parents' sense of security, and the parents must feel ready for discharge to feel secure.

The parents' need for information in pregnancy and before discharge within 24 hours after birth

Two studies examined how the mothers prioritized their need for the information they received in pregnancy and before discharge from the hospital^35,36. The first study found that first-time mothers discharged before 24 hours after birth were less likely to want information about feelings of fatigue, breastfeeding, bottle-feeding, night-feeding, and circumcision (males only) than those who stayed longer than 24 hours after birth³⁵. First-time mothers under 25 years and discharged within 24 hours after birth were more likely to want information on self-care items, such as getting along with their husbands and the side effects of medication. Mothers with less than high school education were more likely to want more information on most baby care topics than mothers who graduated from high school or college³⁵. The baby-care topics included changing, breastfeeding, their baby’s schedule, calming a crying baby, and recognizing illness³⁵. First-time mothers discharged within 24 hours after birth with low levels of social support were more likely to want information about various topics. The topics included feelings of fatigue, resuming sexual activity, getting along with their husband, night-feeding, and their baby’s schedule³⁵.

In the second study, 14 first-time mothers discharged within eight hours ranked the information they wanted after birth before being discharged³⁶. Most mothers ranked information about identifying signs and symptoms of the newborns’ illness as the most important information before discharge³⁶. The following important areas were signs and symptoms of maternal illness, what to do if a newborn was choking on mucus, and how to know if the newborn was getting enough milk³⁶. Of medium importance was feeding and infant care, comfort measures, uterine massage and involution, rest, and breast care³⁶. The resumption of intercourse and frequency of perineal pad change was ranked as least important for first-time mothers³⁶. Subjects concerning a mother’s body change were consistently ranked lower than those related to infant care and feeding, and explanations of maternal body changes were almost consistently lower ranked than practical or ‘how-to’ information about the newborn³⁶. The two studies show that the mothers need for information differs regarding discharge time after birth, education level, age, and amount of social support. A study based on focus group interviews and interviews with couples of 21 firsttime parents discharged between 6–17 hours after birth found that some parents felt uncertain about nursing and caring for the newborn³⁷. However, some first-time parents did not have concerns about this³⁷. A qualitative study including three first-time fathers discharged within 24 hours after birth reported that they felt it was nice to go home but felt unprepared²⁶. One of the fathers wanted more information before he and the mother returned home from the maternity ward²⁶. The details about parental education or information the parents received before discharge were not described in the latter two studies mentioned above. A study explored how mothers discharged within 24 hours experienced a follow-up strategy to access an app offering online chat with the midwife³⁰. The mothers also had access to information material via the app³⁰. Furthermore, the app automatically sent messages with information about signs of the baby’s well-being according to the baby’s age and information about breastfeeding³⁰. One first-time mother found it easy to get an overview of the information and said, ‘I have read it all. I also look things up that I would not ask the nurse’³⁰. The parents who used the app reported that the app provided timely information and guidance, and the parents felt that their needs for support after discharge were met³⁰.

The first-time parents' satisfaction with discharge within 24 hours after birth

A qualitative study, where early discharge was voluntary, found that first-time parents who were discharged within 24 hours after birth expressed positive feelings about freedom, self-reliance, shared responsibility, and independence³⁷. However, there was also a feeling of ‘unreality’ of the newborn being there³⁷. Another qualitative study found that home-based postnatal care is well accepted by first-time mothers leaving the hospital within 24 hours after birth²⁸. The parents in the study were asked if they were interested in early discharge followed by home-based postnatal care²⁸. Most of the first-time mothers had a positive postnatal care experience²⁸. In a final study, the first-time mothers that chose to leave the hospital within 24 hours reported that a home visit significantly influenced their ability to handle the care of their newborn, benefited their mental health and their feeling of being recognized and supported²⁹. The common denominator of the parents who were satisfied with early discharge in all the studies was that early discharge was voluntary, indicating that the parents' influence on the decision to be discharged early affects the parents' satisfaction of early discharge.

The parents' feelings of stress when discharged within 24 hours after birth

First-time parents who were discharged within 24 hours with an app that send messages automatically made some first-time mothers feeling stressed when, for example, they received a message such as: ‘Now, your baby should have at least four full nappies a day’³⁰. Another qualitative study including three first-time fathers discharged within 24 hours after birth reported that these fathers found the time from birth to discharge stressful and hectic²⁶. The fathers found that the midwives were busy, the parents spend much time waiting for the midwives, and the amount of information the parents had to receive before discharge were all factors that contributed to the feelings of stress²⁶.

Breastfeeding incidence after discharge within 24 hours after birth

A descriptive survey including 101 first-time parents found no difference in breastfeeding six to eight weeks postpartum for mothers who had a 24- or 48-hour length of stay after birth³². The group that was discharged after 48 hours did not receive a home visit, and the parents discharged within 24 hours after birth received a home visit by a midwife on the third day after birth³². A qualitative study found that breastfeeding is described by first-time mothers who are discharged within 24 hours after birth as the ‘main thing’ and important, but challenging³⁷. Some mothers felt breastfeeding was difficult, boring and took too long, but it became easier over time³⁷. Through breastfeeding, mothers learned to trust themselves and their newborns. Breastfeeding was described as an interaction between the mother, the newborn, the father, the midwife, and the environment³⁷. Another qualitative study, including 12 mothers, found that breastfeeding support with emotional reassurance, promotion of positive self-efficacy and accessible breastfeeding support after early discharge were important for a mother’s breastfeeding experience and sustaining breastfeeding after early discharge³³.

Readmission of the newborn after discharge within 24 hours after birth

A retrospective cohort study including 1214545 births found that newborns of first-time parents discharged on the day of the birth had a statistically significant higher risk (OR=1.21) of readmission than newborns discharged after a one- or two-night stay in the hospital³⁴. Two studies reported that the parents experienced a lack of sleep, inexperience, and insecurity from discharge to neonatal readmission^26,31. The lack of sleep and insecurities left the fathers feeling ill-prepared, and some felt powerless^26,31. The mothers reported that they appreciated the calmness at home but ended up worrying, experiencing breastfeeding problems and being in pain^26,31.

Factors that need to be considered when interpreting the results of the included studies

Overall, the studies were conducted in countries with different healthcare systems, which might influence the outcomes and make it difficult to compare the results. Thus, five studies were performed in the US and were conducted between 1987 and 1997. From 1996 the Newborns’ and Mothers’ Health Protection Act ensures a hospital stay if the mothers are covered by a group health plan or individual health insurance policy¹⁰. Between the years 1997 to 2000, approximately 15% of all people in the US did not have health insurance³⁸. Seven of the studies were conducted in western countries and all after the year 2010. In Norway, Sweden and Denmark, the healthcare systems are tax-funded with free access to the healthcare system in pregnancy, birth, and postpartum^8,9,39. The last two studies were performed in Australia in 1995 and 2020, and there has been free access to the healthcare system since 1986⁴⁰. Moreover, the paid maternity leave differs substantially between the countries where the included studies were conducted. Thus, in 2016, mothers in Sweden had 35 weeks paid leave after birth⁴¹. In Norway, mothers had 45 weeks paid leave, and in Denmark, mothers had 27 weeks paid leave⁴¹. In contrast, Australian mothers had eight weeks paid leave, and in the US, mothers did not have any paid leave⁴¹. All the above factors must be taken into consideration when interpreting the results of the included studies.

Furthermore, the time for discharge varied in the included studies from six hours after birth to 24 hours after birth. The different discharge times might influence the parents' satisfaction with early discharge and the information they receive before discharge. It could also influence breastfeeding incidence since the mothers that stay 24 hours receive more guidance before discharge. Therefore, it could potentially affect the neonatal readmission rate. The criteria for early discharge in the studies is another factor to consider before comparing the results. The study by Lemmer²⁵ was the only study in this review describing the criteria for early discharge in detail according to the obstetric factors. For example, it is well documented that a blood loss of over 500 mL after birth increases maternal morbidity and mortality and increases the risk of delayed breastfeeding initiation⁴².

The parents' readiness to be discharged early after birth

Three studies identified in this scoping review concluded that parental education had minimal effect on the parents' readiness or decision to be discharged early^24,25,35. However, the three studies were from 1987, 1995 and 1997, and more updated research is needed to explore if the educational programs today have improved regarding preparing the parents for early discharge. One of the studies showed that the birth experience had much more impact on the mother’s decision to stay longer than 24 hours after birth. We speculate that the mother’s birth experience still needs to be considered when deciding when the parents are discharged. In conclusion, there is a need for more and updated research on improving the parents' readiness for discharge within 24 hours.

The parents' sense of security when discharged early after birth

The maternity wards follow-up strategies might impact the parents' feelings of safety when being offered early discharge after birth. Thus, Aune et al.²⁹ found that parents offered as many home visits as the parents needed up to the fourth day after discharge, made nine out of ten mothers feel safe regarding early discharge. However, the study lacked a description of how many home visits the parents received after discharge. Furthermore, Johansson et al.²⁹ found that only 4% of the first-time mothers chose to leave the hospital within 24 hours when they were offered one home visit, between the second and sixth day after discharge. Thus, a gap in the literature has been identified regarding the number and content of home visits the parents need to feel safe with early discharge.

The parents' need for parental education in pregnancy and information before discharge is also a factor that can influence the parents' sense of security. Three studies addressed the issue of prenatal education in pregnancy^24,25,35, however, the studies lacked detailed descriptions that addressed this issue. Therefore, the lack of a detailed description of the content and form of the education programs makes it difficult to compare the results. A randomized controlled trial compared two parental education programs in pregnancy for first-time mothers⁴³. There was no difference in the length of hospital stay in the random allocation of the two groups of mothers when measured on discharge before or after 48 hours after birth⁴³. The two educational programs were similar regarding the topics, and both programs contained seven lessons, two-hours long before birth and one meeting six weeks after birth⁴³. The lessons in the experimental group had more focus on pregnancy, birth, and early parenting as a life transition, where the control group prepared the parents for the topics as isolated events⁴³. Furthermore, the experimental group used more group learning and fewer lectures by the facilitators than the control group⁴³. Finally, the experimental group included activities for the parents to take home, where the control group did not have any activities to practice or discuss at home after the lessons⁴³. The study found a significant difference between the parents' self-efficacy and perceived parenting knowledge in the two groups⁴³. Thus indicating that the content and form of the parental education might also have a different impact on the outcomes of first-time mothers who are discharged within 24 hours. Therefore, we recommend that information about the content, form and setting of prenatal education is described in detail in future research. When healthcare professionals develop policies at the maternity wards regarding postnatal care for first-time parents, they must consider that first-time mothers under 25 years, with a low education level and little support at home, might differ in their need for information³⁶. Only one study from 1989 examined how the mothers prioritized the information they received before discharge³⁶. The study found a difference between first-time mothers and multiple mothers’ priorities of information that needs to be considered when the maternity wards organize the care from healthcare professionals after birth. However, more updated research of first-time parents needs for information before discharge is needed.

The parents' satisfaction with early discharge after birth

Overall, the parents were satisfied with early discharge when the parents influenced the decision to be discharged early. The results of two studies in this scoping review emphasize the importance of support at home on the parents' satisfaction with early discharge^25,27. The findings correlate with other studies that showed that support primarily from the husband and the women’s mothers positively influence a first-time mother’s confidence in infant care practices, breastfeeding and satisfaction^44,45. However, the sample size in the two studies in this scoping review was small and more research is needed regarding how mothers and fathers best can be supported after early discharge. Furthermore, research of how healthcare providers can help prepare the father or family to support the mother is warranted in the future. The first-time fathers in the study by Feenstra et al.²⁶ reported that the time from birth to discharge was stressful, revealing a potential gap in the literature to be explored in future research. Furthermore, more knowledge about the parents' characteristics that report having a positive versus a negative experience of early discharge is needed. Knowledge of any characteristics that might predict dissatisfaction with early discharge would aid in developing policies regarding early discharge at the maternity wards in the future. Finally, healthcare professionals should prioritize continuously care in the first hours after the birth to increase the parents' satisfaction and reduce stress after early discharge. The identified studies in this scoping review provided little knowledge of the parents' satisfaction immediately after birth and before discharge. Therefore, a gap in the literature has been identified, and more research about the parents' satisfaction with the time between birth and discharge is required in the future.

Breastfeeding incidence after early discharge after birth

Discharge within 24 hours did not negatively influence breastfeeding incidence, compared to discharge after 24 hours. Furthermore, a home visit by a midwife on the third day was found to positively influence the mother’s experience of breastfeeding and the duration of breastfeeding. However, the different definitions of early discharge found in the literature can make the data ambiguous, e.g. according to breastfeeding, where we speculate that information differs for parents who are discharged within eight hours after birth compared to parents who are discharged 24 hours after birth. Little evidence was found regarding the impact early discharge has on breastfeeding incidence. Only one study by Quinn et al.³² found no difference in breastfeeding incidence between two groups discharged 24 hours after birth and 48 hours after birth; the study from 1997 included 101 firsttime mothers³². However, the study lacked a sample size calculation of the numbers of first-time mothers needed in the study to detect any significant difference between the two groups. More updated studies with more power are needed in future research. Only one study examined the mothers’ breastfeeding experience after early discharge³³. The study found that breastfeeding support with emotional reassurance, promotion of positive self-efficacy and accessible breastfeeding support after early discharge, were important for the mothers’ breastfeeding experience and to sustain breastfeeding after early discharge³³.

Readmission after early discharge after birth

A large retrospective cohort study found that newborns of first-time parents who were discharged on the day of birth had a 21% higher risk of being readmitted than newborns of first-time parents who were discharged later³⁴.

There was no information regarding follow-up strategies available in California at that time, making it difficult to generalize the results to other maternity wards. More updated studies are recommended in the future. No studies examined the severity of the newborns’ illness or duration of neonatal readmission when newborns were discharged early. Furthermore, no studies of maternal readmission were found, thus leaving a gap in the literature for future research.

Early discharge after birth and maternity ‘blues’ and postpartum depression

This scoping review has identified a gap in the literature relating to maternity ‘blues’ or postpartum depression after early discharge. A study of 49 first-time mothers discharged within 48 hours after birth reported no difference in the mean depression score compared to those first-time mothers who were discharged on the third day after birth⁴⁶. One-third of the first-time mothers left the hospital within 24 hours after birth⁴⁶. However, the study did not clearly distinct between the mothers discharged before and after 24 hours after birth. Therefore, the study was not included in this scoping review. Postpartum depression can have profound implications in both the short- and long-term for the mother, the family, and the child’s development^47,48. Therefore, research relating to the incidence and impact of maternity ‘blues’ and postpartum depression are essential in the future.

Early discharge after birth and the fathers or co-parents

In this scoping review, most of the identified literature focused on the mother and the newborn. Very little evidence was found focusing on the father or co-parent. Therefore, there is a gap in the literature regarding the fathers or coparents experience of early discharge. Furthermore, we have little knowledge of what information the father or co-parent needs before taking care of the new family at home, which needs to be addressed in future research. Finally, there were no studies of the fathers or co-parents incidence of depression after discharge within 24 hours after birth.

Systematic reviews of early discharge after birth

Two systematic reviews in 2010 and 2017 compared early discharge with the standard length of hospital stay after the birth of healthy mothers and newborns^14,15. The first review by Benahmed et al.¹⁵ found no statistical difference between early discharge in neonatal or maternal outcomes. The studies included in the review were rated as of low to very low evidence¹⁵. This review did not examine the results separately for first-time mothers and multiple mothers, making it difficult to transfer the results to first-time mothers. The other review from the Cochrane Collaboration found no statistical difference in neonatal or maternal readmission or breastfeeding incidence¹⁴. Moreover, no difference in postpartum depression was found in the Cochrane review regarding discharge time. The authors of the Cochrane review had planned subgroup analysis of firsttime mothers compared to multiple mothers but was unable to perform the sub-analysis. Furthermore, the definition of early discharge in the two reviews varied from 6 to 96 hours. Moreover, the length of the standard stay after birth also varied from 48 hours to four or more days from birth^14,15. Thus, the above mentioned make it difficult to transfer the results to first-time parents discharged within 24 hours.

Strengths and limitations

This scoping review is strengthened by the rigorous methods based on prespecified criteria in protocols for scoping reviews. However, our review was limited by screening only articles available in English or Scandinavian languages. In addition, many articles were excluded from this scoping review because there was a lack of clear distinction between primiparas and multiparas, vaginal birth or caesarean section, and discharge before or after 24 hours following the birth. Therefore, there may be evidence relevant to the topic of this scoping review that has not been included. Due to the heterogeneity in methodology, terminology and assessment procedures used in the included articles, the generalization of study results is limited. Findings of this review highlight the importance of identifying factors and outcomes related to early discharge.