If your labor started with water breaking & moderate to heavy meconium

[Ambivalent Dreams]

Did this happen to anyone else? What did you do? Did you go straight to the birthing center or hospital? Was your MW or OB concerned? Did your labor take off right away? Did you use fetal monitoring? If so, how did the baby look on the monitor? Did you end up augmenting labor? How long did you labor last after your water broke?

I am still sorting through what all happened during my son's birth and thought hearing others stories my help me understand. Thanks.

[MyFullHouse]

When it happened to me (#3, very heavy mec), my mws were not all that concerned. I chose to go straight to the hospital to make myself feel better, and because I wasn't sure if I was communicating exactly HOW MUCH mec there really was.

Contractions took about an hour to kick in. I had intermittent monitoring, and she looked fine the whole time. She was born about 6 hours after the contractions had started.

She DID have some breathing difficulty at first, and they came very close to intubating her. Fortunately, they were able to avoid that, and they agreed to just monitor her in the nursery (with dh) for an hour. Our ped strongly encouraged us not to leave the next day so they could spend another 24 hours checking in on her every couple of hours. We stayed. She was fine.

FWIW, my 1st had a moderate amount of mec (AROM) and had zero issues. Still, even with 2 great outcomes, meconium freaks me out, and I really hope we don't have to deal with that this time!

[loveneverfails]

I would probably transfer because mec can be a sign of distress and I wouldn't want to wait for my midwife to come over with a doppler to tell me if the mec was a sign of distress or not. It's not a 100% "immediate transfer" for me, but it's leaning towards immediate transfer.

[Ambivalent Dreams]

Thanks for sharing your experiences. When my water broke and I saw heavy meconium, we went to the hospital within 30 minutes. This was a VBAC for me so I was very nervous going to the hospital without being in very active labor, but I was scared for the baby and wanted to make sure he was OK.

There was a nurse who acted like my baby was on the brink of death, who said that there were late heart decelerations on the fetal monitor, that the cord was pinched, that my uterus was about to "give out" etc., etc. It all sounded like scare tactics to me and I refused/rejected almost everything she said because she seemed equally freaked out about stuff that I absolutely knew was not a problem, like the fact that I wanted juice to drink during labor. (None of the other nurses that came in seemed concerned about anything except a lack of variability in the baby's heart rate and even then they didn't seem petrified, just concerned.)

Now that it is all over, I am wondering if there was a grain of truth in her dramatic nonsense and that I foolishly risked the baby's health. He is fine and I am fine, and I got my VBAC. But, his 1 minute Apgar was 4. I wonder if I took too many risks. I held off on the pit the nurse tried to get me to take for her entire 12 hour shift. I ended up taking it later when nipple stimulation wasn't enough to keep my labor going hard and fast enough to keep the OB from being concerned about the risk of infection due to ruptured membranes. I ended up laboring for 25.5 hours and I wonder if it was all just too long. I wonder if I got lucky despite my foolishness.

Sorry for all that. Like I said, I am just still trying to sort through what all happened. I hope I am posting this in the right place.

[Wittyone]

The recommendation in neonatal resuscitation and meconium is that if the baby is not vigorous at birth (spontaneous crying and good tone) that the providers should NOT stimulate the baby and should intubate and suction for meconium. This process takes a while and often the 1st Apgar is low because they are not doing anything to encourage the baby to breathe until the suctioning is done. If the 5 minute score is below 7 that is more concerning for "was the baby too stressed?" and correlates with poorer long term outcomes - the 1 minute score correlates with pretty much nothing. I wouldn't look back with too much regret - it sounds like you made the right decisions at the right times, had a successful VBAC and a healthy outcome for both yourself and the baby - well done!

[Ambivalent Dreams]

Originally Posted by Wittyone

The recommendation in neonatal resuscitation and meconium is that if the baby is not vigorous at birth (spontaneous crying and good tone) that the providers should NOT stimulate the baby and should intubate and suction for meconium. This process takes a while and often the 1st Apgar is low because they are not doing anything to encourage the baby to breathe until the suctioning is done. If the 5 minute score is below 7 that is more concerning for "was the baby too stressed?"

Thank you. I didn't know they were trying not to stimulate him. That makes sense. His 5 min Apgar was 9.