Meconium

[mellie-bellie]

Hi ladies,

Wanted to hear your thoughts on meconium, as in it's presence in broken bags of water. I know in the hosptial setting (and midwife-attended homebirths too) it's a cause for alarm, so I'm wondering if any of you have ever had experience with it. Did you have a "plan" prior to labor about what you'd do if it were present once your water broke, or did you figure your line of reasoning out "on-the-spot"? I haven't given much thought to it but it's been recently on my mind so I thought I'd ask.

My experiences have been such that my waters have been intact until I started pushing (3 homebirths, one of which was UC). There was never any meconium present so it wasn't an issue. However, in my UC (baby #3), he was most likely a "post-term" baby (almost 2 weeks "overdue" and I'm certain of his gestational age and day of conception) and his waters broke as he came out of me. Once he was out I just cuddled with him and waited for the placenta to come out. He was pretty quiet after emerging, took his first breath, gave a tiny cry and then was just quiet. While holding him against my skin under a blanket, he eventually started getting very fussy and started crying and I eventually noticed, upon changing position and wanting to get a full look at my lil guy, that he released TONS of meconium ALL over me and himself and that's why he was fussing. When I say lots I mean LOTS. It wasn't until years later that the thought occured to me, "what if he woulda released that in utero, what would I have done, how would that have affected the outcome of his birth?". So yeah, just going through these thoughts again (he's 5 1/2 now) and trying to formulate my opinion about meconium.

Thanks!

[PreggieUBA2C]

Ds3 was my first freebirth and was born 44+2 after conception. When he emerged, water rushed out after him and it was all green. When the placenta came out, it was stained dark green. I mean stained, like it could not be washed off.

Ds had long curled nails on his fingers and toes and no vernix, but his skin was not peeling and even though the placenta was dark green, it was in great shape. Our friend who is also a midwife and who was there for my dp, looked at it afterward and said that it had no signs of post-maturity and neither did ds3 other than lng fingernails, but she'd seen that with lots of babies some of whom were not even forty weeks.

So, I don't know. Obviously whatever meconium was released in the sac was dilute and didn't have any ill effect. Ds3 was screaming as soon as his head emerged and his body didn't come until the next contraction. His eyes were open and he watched open-eyed as he was born onto the floor. He, like our other babes, had superb muscle tone, held his head up from the start, like his brothers who were all earlier, and was and is very strong and healthy.

The mec was obviously in there for quite a while though, given the staining of the placenta.

[cocoanib]

subbing

[Cetan Luta]

I think it is not so much the meconium itself that is a concern, but rather that the early release of meconium usually signals that the baby is distressed for one reason or another, plus you don't want them to inhale it when they take their first breath. That's my understanding anyway? HTH

[Sheryl1678]

I am no expert and no midwife but this is what I learned when researching my UC. If you dont want meconium, have a gentle, peaceful birth and don't stress the baby unnecessarily (ie: hospital birth inductions and other interventions). Fresh meconium (ie: thick stuff that can aspirate) is rare in homebirths.

In addition, the hospital standard procedures for dealing with fresh meconium (suctioning on the perineum) are harsh at best, cruel at worst and the babies do not have better outcomes than the ones left alone.

Old meconium stained amniotic fliud is no cause for concern as it is diluted in the fluid and not aspirated.

[claddaghmom]

DD was the same way. Water didn't break until pushing and right when she popped out she mec'd everywhere. I remember it didn't even phase me, I was wiping it off her leg and foot and loving every nanosecond haha.

(Side question, is it bad to mec right after birth??)

I can't say I would be worried about the meconium itself, but I would become more aware if I saw it b/c IIRC it can indicate stress/problems.

My mom had one UC w/ mec before birth. She was covered in it, even in her hair, but it was stained fluid more than actual "thick stuff." She was the smallest of all her babies and came out very quickly. I remember her little nose was smooshed almost flat. Maybe the precipitous birth was the reason for it.

Anyways, a few years later my mom was asking her if she remembered being born and she said, "Yeah mommy, I had to go poop so bad! I looked everywhere in you and couldn't find a potty, so I went in you, sorry!"

[readytobedone]

Originally Posted by Sheryl1678

I am no expert and no midwife but this is what I learned when researching my UC. If you dont want meconium, have a gentle, peaceful birth and don't stress the baby unnecessarily (ie: hospital birth inductions and other interventions). Fresh meconium (ie: thick stuff that can aspirate) is rare in homebirths.

In addition, the hospital standard procedures for dealing with fresh meconium (suctioning on the perineum) are harsh at best, cruel at worst and the babies do not have better outcomes than the ones left alone.

Old meconium stained amniotic fliud is no cause for concern as it is diluted in the fluid and not aspirated.

Crashing, I am not a UC-er, but I saw this in new posts and wanted to say...personally, I think it is offensive and dangerous to suggest that meconium only occurs, or is only a problem, in interventionist settings. Yes, my daughter was a hospital birth, and she had meconium aspiration syndrome, but it was a very scary thing.

I'd hate to think someone would decide that UCing could prevent any danger meconium poses.

ETA: It's also important to note that in MW-attended homebirth, heavy meconium is reason to transfer...so you're going to see less mec in homebirths, but not because the hospital causes meconium.

[chirp]

if my water broke and it was stained lightly but I was close to delivering I would remain at home.

if my water broke and it was stained heavily and/or I was not close to delivery I would transfer to the hospital.

by close to delivery I mean dilated and pushing and feeling the head crowning or almost crowning. I'd be calling the hospital to let them know we were on the way.

I'd be willing to take my chances with hospital staff over trying to resuscitate a baby who had aspirated it's own poopy. My strength of will skills are better than my baby resuscitating skills.

[Stace]

Originally Posted by Sheryl1678

I am no expert and no midwife but this is what I learned when researching my UC. If you dont want meconium, have a gentle, peaceful birth and don't stress the baby unnecessarily (ie: hospital birth inductions and other interventions). Fresh meconium (ie: thick stuff that can aspirate) is rare in homebirths.

In addition, the hospital standard procedures for dealing with fresh meconium (suctioning on the perineum) are harsh at best, cruel at worst and the babies do not have better outcomes than the ones left alone.

Old meconium stained amniotic fliud is no cause for concern as it is diluted in the fluid and not aspirated.

This is incorrect. Meconium in the amniotic fluid can indeed be aspirated and most certainly can be a cause for concern. A chain of events that caused me to aspirate meconium led to me being born at 32 weeks and spending a month in the NICU. Needless to say, I'm pretty glad that someone showed concern for me.

[chirp]

Originally Posted by Stace

This is incorrect. Meconium in the amniotic fluid can indeed be aspirated and most certainly can be a cause for concern. A chain of events that caused me to aspirate meconium led to me being born at 32 weeks and spending a month in the NICU. Needless to say, I'm pretty glad that someone showed concern for me.

that's what i was thinking...because don't they practice breathing in the amniotic fluid in the last trimester??

if the meconium was old I would think that would be more a cause for concern, since there has been for time for the baby to aspirate more meconium.

[fyrebloom]

I have had 2 mec births. The first was particulate and my son was deep suctioned even though he was ready to cry and was ok. As a result he wouldn't nurse for a month. My last baby was also mec stained but the mec was old. He had no breathing problems, and was great (I UPed and transfered after 24 hours of labor). Mec can be a problem, this is true, but it's often caused by stress to the baby so a peaceful UC is less likely to cause it then say an induction for example. If the baby is depressed and had mec in the fluid I'd say transfer, but if the baby is fine and vibrant at birth there's not a prob. Particulate Mec is more likely to cause a prob then mec staining but I'd wait and see personally and probably would use a bulb syringe to suction. Both of my boys were born at 41.5 weeks. One showed heavy calcification of his placenta and other signs of postdates and the other looked normal and term.

[MamaRabbit]

Fresh meconium does happen in homebirths. Babies can be stressed for a number of reasons. Meconium can be a cause for concern. Most babies are fine with it, and some are not.

[savithny]

Originally Posted by Sheryl1678

I am no expert and no midwife but this is what I learned when researching my UC. If you dont want meconium, have a gentle, peaceful birth and don't stress the baby unnecessarily (ie: hospital birth inductions and other interventions). Fresh meconium (ie: thick stuff that can aspirate) is rare in homebirths.

In addition, the hospital standard procedures for dealing with fresh meconium (suctioning on the perineum) are harsh at best, cruel at worst and the babies do not have better outcomes than the ones left alone.

Old meconium stained amniotic fliud is no cause for concern as it is diluted in the fluid and not aspirated.

You can't really make that jump from the data, because fresh, thick meconium is a reason to transfer for many homebirthers. Therefore, thick mec babies are more likely to be born in the hospital - but that does not mean the hospital caused the mec -- it means, in a way, that the mec *caused* the hospital.

Babies can be born in *old* meconium -- days or weeks old, clearly before the start of labor. Old mec is obviously not caused by hospital birthing. And the kind of distress that causes thick mec is not generally brought about by the hospital environment (a possible exception might be the unwritten policy some OBs have of "pit to distress" by cranking up pitocin so hard and fast it does cause fetal distress to trigger a section).

Both mine pooped vigorously shortly after birth. My older child's waters were lightly stained at birth with mec that was clearly old. Both were born *on* their due dates (based on BBT charting, not U/S, so very accurate). The midwife was completely unconcerned about the mec staining with #1.

[sunflwrmoonbeam]

I haven't UC'd but I'm considering it for next time, and thus lurking here a lot.

My DD was born by c-section at 42+3 and was positively covered in meconium. She was fine, and it was totally not a big deal. The hospital suctioned her a lot, but my midwife says (I was trying for a homebirth) she probably wouldn't have done vigorous suctioning.

[Sijae]

Meconium by itself isn't a valid reason to transport in my opinion. It's also not considered a reason to transport by all midwives - That would depend on the midwife and the legal climate in her area.

Like MamaRabbit said, most babies do fine. Sometimes it is a problem but if a baby is stressed you are going to see other signs besides the meconium. I think a wait-and-see attitude is usually appropriate for meconium situations.