Around here the rule is that if the baby passes meconium during labor it automatically means that an entire pediatric team has to be present at the delivery and baby has to be assesed before being returned to the mother. I am just wondering if passing meconium is a sure sign of fetal distress.
I have been to births where baby passed meconium but there were no other signs of fetal distress (no decels, baby came out pink, etc) I was even at a birth were they delivered the baby and after the body came out, then all the meconium rushed out. If they had known about the meconium, they would have done a c-section.
Anyway, that is my question, does the presence of meconium automatically mean that a baby is in distress?
No, but it is a big red flag that the baby MAY be in distress. Which is why hospitals can't afford (in this current legal climate) to take it lightly.
Say a mom had meconium in the fluid. Doc says "no worries - it's pretty common in women past 41 weeks, and there's no other sign of distress."
Baby born, apgars of 4 & 5, floppy. Call in peds team, which takes 5 minutes for all parties to arrive. Baby has some problem down the road (meconium aspiration, seizures, learning disability, whatever) that may or may not be related.
Guess what? Failure to call a peds team in could be a HUGE issue in a malpractice suit.
I don't see that kind of practice changing until and unless people stop suing so often.
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My DD passed it and she showed no signs of any distress. She was 1 day shy of being 41 weeks.
I do agree that it CAN be a sign but it is not a definate sign in all cases.
At a HB in this area light meconium is not a major cause for concern but dark meconium is an automatic transfer. All the hospitals around here call in the "team" when meconium is present just in case.
My first two babies passed meconium before birth. My first was not pinking up like they wanted right away and was taken to the nursery. I think her being posterior (and born that way), and all the time we were on Pitocin and the epidural, and then her forceps delivery contributed to that for sure.
My second one had meconium fairly early in my labor and it hadn't been a particularly difficult labor, compared to my first, other than him being posterior (and born that way). But he did aspirate his meconium and was transferred to the NICU at Rainbow Babies and Children's.
They did call in the "team" for both births due to the meconium they knew about. With my son, that team must have checked him out and worked on him for at least 45 minutes and then gave the "all clear." It was I who noticed something was wrong just moments after getting him back. I could tell something looked odd about what he was doing with his mouth or something...apparently the way he was breathing. Strange how the team had left after all that time and said he was fine...then he wasn't.
Anyway, I know in OH where we were for those births, it was standard for the team to be called in for mec.
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Everyone here is correct. In MOST cases, the baby is fine and does not need suctioning. They do call in the "team", however, as a precaution. If baby does inhale mec, it can lead to pneumonia and so is taken seriously. Babe is suctioned for inhalation and for thick mec....not always for very light mec if it's not inhaled.
While Meconium doesn't always mean a baby is in distress (it could just be a more mature baby as postdates babies are more prone to mec), it means the probabilty is greater.
My hospital ALWAYS calls in the NICU for a baby with Mec (or ANY higher risk birth- multiples, c/s, preemie, possible fetal distress, etc.) as it means that qualified staff (NICU Nurse Practitioners or Neonatologists) are on hand for the birth not down the hall. While it might only take them 45 seconds to come in if called unexpectedly, it's 45 seconds that they'd prefer not to waste. I've always perceived that the reason for calling in NICU wasn't just about the possibility of distress and low apgars but trying to avoid meconium aspiration.
Generally speaking, if I was CHOOSING a hospital birth, I'd want to know that if they anticipated a problem it was being dealt with immediately. Most of the time when our NICU is called they get the baby stabilized within a few minutes in the LDR, and baby can stay with mom and dad. Very few babies actually need a trip to the NICU.
I've never seen Mec alone lead to a c/s, but if there were other signs of distress (decels, etc.) it's not unlikely.
I have seen it go a few different ways in hospitals out here and differences with practices too. Some Dr's think it's no big deal and they don't even do an amnioinfusion and some Dr's freak out and have the whole team there. I have never experienced a problem with a baby who had mec.
In one instance the mec was soooo thick I swore they were going to do an amnioinfusion. I prepped my clients and everything for it and then the Dr. came in and said, "I just returned from a conference and learned that this is not needed because it doesn't change the outcome, so we aren't going to do an amnioinfusion." I about fell out of my chair but it was AWESOME! She suctioned the baby with the other thing, not the bulb syringe ON the perineum but still handed baby to mom first. He had MAJOR decels before birth too. All was fine and he is an amazing kid.
I would personally be worried about an amnioinfusion -- that's pretty invasive, imo.
My second baby was born posterior, and he passed mec on his way from my vagin to my tummy -- all over me. My midwife swears he lost two ounces, lol.
my last born also did this. She was my 9 lb 3 oz baby. I am pretty sure the midwife wanted her out fast as she was directing me pretty sternly to get the baby out fast! Come to find out the cord was wrapped around her body three times and neck twice....eeekk! She passed her meconium right at delivery also....before she could even be passed to my chest.
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Hmmm, it usually is not a big cause for concern here. They just suction well. They have never called in a ped. at least not at any of the births i have attended.
I had an amnio flush and I hated it. My DD ended up blocking all of the fluid inside of me and I kept GROWING. It was awful.
They did call in a pedi team for my baby
They didn't call anyone in with mine, when my water broke it was all nice and clear, but when she came down she trapped a bubble, and when they popped it so she could come on out, some nasty sludge came with it, but the MW said it was no concern since it had just happened, I was 42 weeks and it was a precipitous (fast) labor, so she was fine! They put her on my chest and her face was clean but she had all this meconium on her head where her head had trapped the bubble!! LOL So she was a poo poo head when she was born!
good responses so far, it can be a sign of distress, however it in and of itself is not a sure fire indicator.
Cant add anything that hasnt already been said.
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Does meconium = fetal distress?
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my last born also did this. She was my 9 lb 3 oz baby. I am pretty sure the midwife wanted her out fast as she was directing me pretty sternly to get the baby out fast! Come to find out the cord was wrapped around her body three times and neck twice....eeekk! She passed her meconium right at delivery also....before she could even be passed to my chest.
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