Making U.S. Maternal and Child Health policy: from "early discharge" to "drive through deliveries" to a national law.

OBJECTIVES: 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.