For a patient at 29 weeks with tocolytic therapy, which statement best describes discharge planning?

• A. Discharge when the patient is stable and can access home health visits and neonatal support
• B. Discharge immediately after contractions stop
• C. Discharge only after full-term gestation
• D. Discharge after tocolytics are completed

Answer: (A)

The main idea here is safe discharge planning for a patient in preterm labor who is receiving tocolytic therapy. At 29 weeks, the goal is to delay birth enough to give steroids for fetal lung maturity and to arrange for appropriate neonatal care if delivery occurs. Discharge is appropriate when the patient is clinically stable and has a clear plan to continue monitoring and receive support after going home.

Being stable means contractions are controlled, there are no new signs of infection or fetal distress, vitals are within normal limits, and there are no concerning bleeding or other symptoms. Equally important is access to resources: the patient should have home health visits or reliable outpatient follow-up to monitor uterine activity, maternal wellbeing, and any return of contractions, as well as a clear plan for rapid return to care if symptoms worsen. Additionally, having neonatal support arranged—meaning access to a facility that can provide NICU care if needed or a plan for safe transfer—helps ensure the baby will receive appropriate care should birth occur or complications arise.

Discharging immediately after contractions stop isn’t ideal because preterm labor can recur; there needs to be a plan for ongoing monitoring and quick return if symptoms recur. Waiting until full-term gestation isn’t feasible in this scenario, and the decision isn’t contingent on completing tocolytics per se, since the pregnancy still carries risk and management continues after discharge if stable and well-supported.