Meconium questions

[morganlefay]

Is meconium staining always a cause for alarm? Also, if it occurs during one birth is it more likely (than average) to occur in another birth?

Back story, if you wanna know: I had planned a homebirth and when I was in labor with DD my water broke at the beginning of what I believe was transition. There was fairly heavy light brown/slightly greenish meconium. (Note: DD was not "past due"; she was born on her due date.) My midwife was not present at the time because up until this point my contractions were still far apart (and apparently I was handling them a lot better than I thought I was) so she did not believe I was in labor and basically had refused to come over. So when I called her about the water breaking/meconium she just told us to go to the hospital (when we arrived I was ready to push and DD was not in distress) and DD came out just fine (she had a big poop soon after birth). DH and I are contemplating TTC #2 and I would love to fulfill my dream of having an out of hospital birth (though probably not with the same midwife). However, I am scared of this happening again and having to transfer (the transfer ended up being very expensive because we had to pay both the hospital and the midwife, and insurance covered none of the midwife's (above average) fee since she did not deliver the baby). I asked my midwife about the situation after I gave birth, but I don't feel like I got a straight answer since (I am guessing) she felt guilty about not being there to make a judgment call as to whether the meconium warranted hospital care.

As you can probably tell, I am still having issues with this. So, I'd appreciate any comments anyone could offer

[Astraia]

I did a lot of research while pregnant with my daughter. From what I read, meconium is fairly common and is not always a sign of a problem. If meconium is light to medium and fetal heart tones aren't showing any problems then likely you'll have no problems.

From what I recall- could be wrong- there's a higher incidence of problems with thick meconium, but if fetal heart tones are reassuring and birth is imminent, then as long as your MW is prepped to suction & recus if necessary then there shouldn't be too much of an issue.

My water broke when I was at about 10 cm and starting to feel pushy. There was light to medium meconium staining. The protocol is to transfer to hospital with ANY meconium. I had the MW take a listen to heart tones- looking good. I made the decision to stay home.

DD was born about 2 hours later, crying and pinked up immediately, no issues at all. They did listen to FHT more frequently once they were aware of the meconium, but everything else was fine.

I very firmly believe that meconium by itself is not a reason to transfer. This is, of course, my own non-medical-professional opinion

(and FWIW, DD was born only 2 days after her due date. Not sure what caused the meconium, or if it's more likely to happen again, but if it happens again with this little dude I'm not going to worry about it this time either!)

ETA: I like this page!
http://www.gentlebirth.org/archives/...tml#Evaluation

[kltroy]

Well the two things about meconium are (1) it's in indicator of fetal distress, and (2) meconium aspiration syndrome can be bad. As for whether it is likely to happen again, I can't imagine any factor about you as a mother that would cause you to have babies who release meconium - it seems to be more an indication of how well the baby is tolerating labor.

[woodchick]

This is purely anectdotal, but DD1 was born with severe Meconium Aspiration Syndrome (ambulance transfer to the big city, intubation, medical paralization, 2 week hospital stay- severe).

DD2 was fine and dandy.

I'm not sure there's any way to predict it.

[Yvaine Undomiel]

Originally Posted by woodchick

This is purely anectdotal, but DD1 was born with severe Meconium Aspiration Syndrome (ambulance transfer to the big city, intubation, medical paralization, 2 week hospital stay- severe).

DD2 was fine and dandy.

I'm not sure there's any way to predict it.

[woodchick]

Originally Posted by Yvaine Undomiel

Thanks for the hug! It was a scary two weeks, but at 3.5 you'd never know there had been anything wrong with her. What a miracle!

[josie423]

Both of mine were born with light meconium in their water. DS was born four days before his due date and DD 1 day after. My midwife wasn't concerned, simply recorded it on my chart at the time and they weren't suctioned either. The only sign I saw of the mec. was some of it in both of their spit ups later that night (yuck! and with the first it scared me half to death).

Sorry you went through that woodchuck!!

[JennTheMomma]

No, it's not always a sign of fetal distress, but it can be. With my son he had a lot of meconium when my water broke. OB checked his heart and said he was fine. He was 1 week late and was on oxygen for a few seconds at birth. After that he was just fine.

[Happiestever]

This is something I think about as well. My first was 12 days past EDD, with clear water. Second was 11 days past, but my water was broken while I was pushing (mw didn't want to get sprayed) 20 minutes before birth. Now I assume it was pretty thick because she told me we may have to resusitate, but baby was fine. I do remember her coughing up a little green spit the next morning. I sure hope that it doesn't happen again myself. But I will have to evaluate everything when it happens (timing of water breaking, degree of thickness).

[Yvaine Undomiel]

Originally Posted by woodchick

Thanks for the hug! It was a scary two weeks, but at 3.5 you'd never know there had been anything wrong with her. What a miracle!

I just can't even imagine the stress you went through.

I have been so lucky, I just can't knock on wood enough.

[Defenestrator]

I just had a baby in my practice with meconium aspiration syndrome. I felt like there were several things going badly/not normally with the labor and we transported. The mom labored for another day at the hospital and then had the baby by c-section.

At this birth the meconium was thick, like pudding or motor oil. Also the labor was non-progressing -- the mom never got past 2 cm at home.

I have attended about 20 births at home with meconium in the waters and it is the first I have experienced with MAS. So it is absolutely not a cause for transport all on its own for me. In fact, this is the first birth I have transported for meconium as well.

The following week, I attended a doula birth where the baby was born vaginally after having the same kind of motor oil meconium. She was totally fine, with no MAS. So, you never can tell what might happen.

[Lovemy3babies]

My last son was also like a previous poster. Planned homebirth. Severe pain made me go to the hospital after hours of no progress, placental abruption causing meconium aspiration syndrome. My son has respiratory failure and pulmonary hypertension. 3 weeks in the NICU and they didnt think he was going to make it. I would consider mec pretty serious myself.

I am pregnant with my 5th, and planning a homebirth after 3 sections, if that gives you any indicator as to what I think about csections verse meconium

[Adasmommy]

I'm not making a recommendation but telling you my decision: that if there is no other sign of fetal distress, I will not transfer for meconium in the waters.

I will definitely be going with my instincts, so if instinct says go to the hospital, I'll consider that a sign of fetal distress!

[annekh23]

I would definitely factor in the gestation of the baby as well as the type of meconium, as there is a correlation between gestational age and presence of meconium, I think it goes up to about half of babies by 42 weeks, so I'd react quite differently to a 42 week baby with meconium to a 40 week or earlier baby with meconium.

My 2nd baby had passed meconium before she was born at 39+3, so fairly unlikely that maturity was the cause, so we assume that at some point before birth, but not during labour that she was in distress, probably a cord compression as she had very low fluid, which wasn't discovered until labour. We were already in hospital and we were told that they'd have the paediatrician in the room when she was born and the resus equipment was wheeled in, but I was still able to deliver her on to my tummy and there was no automatic suctioning, they checked her on my tummy declared her ok and vanished pretty quickly!

I think in this situation, had it been discovered at home, that I would have transferred, though I suspect we'd have already transferred, because neither of us were in good condition at the onset of labour.

[rachel65655]

My last DD was born with thick merconium at 36 wks. I was also given a shot of demerol less than an hour before she was born and went from 2cm to her being born in about 45 minutes. She was absolutely fine except for being all drugged up when she was born. We went home the next morning.

[niken]

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[calpurnia]

hmm, interesting thread for me to read.

we transferred to hospital after 16+ hours of labour had stalled at 7cm & there was thick meconium in the waters. baby at 42 weeks. we were monitored at hospital & baby was eventually born by emergency forceps about 10 hours after transfer. she was fine, although i do remember her bringing up mucousy green stuff in the first couple of hours (as far as i can remember through the daze). she never did any of those famous terrible meconium poos, presumably because she had already got rid of it all.

[morganlefay]

Thanks for all the replies so far. to all the mamas whose little ones had complications with this. And Astraia, thanks for the link.