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Old 08-22-2013, 12:00 PM   #1
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Meconium in fluid question

What is the evidence-based care regarding meconium found in amniotic fluid? I'm shopping around for a birth center and the one I just found said that if your water breaks and there's meconium, they transfer you to the hospital. Unless you're so far along that you're already pushing.

Seems like a big overreaction to transfer to a hospital. My second was born with meconium in her fluid, and she was fine.

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Old 08-22-2013, 12:14 PM   #2
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Re: Meconium in fluid question

My lo was covered in meconium when he was born and was in respiratory distress. The meconium was not evident until he was born. I had a long and hard labor and he probably pooped while he was in the birth canal (way after my water had broke). He was immediately sent to NICU from the labor room. He had to be on a CPAP and was in NICU for 3 days. Our saving grace was that he did not inhale the meconium. Otherwise, he would have developed pneumonia and his chances for survival would have decreased dramatically. An acquaintance of mine - her granddaughter had the same problem and the baby did not survive. I think it's a matter of whether the baby inhales the meconium or not and you can't control that. Personally, if I knew that there was meconium in the amniotic fluid, I would want to be at the hospital so that they could rush the baby to the NICU if needed.
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Old 08-22-2013, 12:56 PM   #3
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Originally Posted by neuro_mom
My lo was covered in meconium when he was born and was in respiratory distress. The meconium was not evident until he was born. I had a long and hard labor and he probably pooped while he was in the birth canal (way after my water had broke). He was immediately sent to NICU from the labor room. He had to be on a CPAP and was in NICU for 3 days. Our saving grace was that he did not inhale the meconium. Otherwise, he would have developed pneumonia and his chances for survival would have decreased dramatically. An acquaintance of mine - her granddaughter had the same problem and the baby did not survive. I think it's a matter of whether the baby inhales the meconium or not and you can't control that. Personally, if I knew that there was meconium in the amniotic fluid, I would want to be at the hospital so that they could rush the baby to the NICU if needed.
Agreed... It's just one of those chances that aren't worth taking, it's probably a liability for a birth center
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Old 08-22-2013, 02:27 PM   #4
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Re: Meconium in fluid question

With homebirth midwives I'm aware of it seems to be standard practice to transfer if there's meconium. It's about being able to get it out of the baby as quickly after birth as possible to avoid problems. I had planned a homebirth, but transferred to the hospital because labor wasn't progressing, I had mild pre-e, and my midwife wanted to make sure the baby was okay. We had an ultrasound and NST and they broke my water to see if that would put me into active labor (it did). There was thick meconium and my midwife and doula both said it was good we were already in the hospital, as the meconium is an automatic transfer. So, when my DD was born the OB milked the cord since they wouldn't allow delayed clamping because of the meconium then handed her to the ped team. They suctioned her and wiped her off, then gave her to me for skin to skin. While I would have liked to have a home birth and still plan to try for one again, I'm glad we were in the hospital. By the end my DD was having pretty bad decels and she was initially unresponsive when she came out. She did cry on her own before they started working on her and didn't have other problems, but from what I understand, sucking the meconium out as thoroughly and quickly as possible is key to the baby's health in that situation. Minutes can mean the difference between a baby that's fine and a baby in the NICU with pneumonia. The meconium in the amniotic fluid did mean constant monitoring for me, but the hospital I was at has telemetry units, so I was able to labor in the bath tub when I wanted.
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Old 08-22-2013, 03:37 PM   #5
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A friend of mine had a long labor with her first baby who was born at home, 2 days I believe. When her baby was born there was meconuim in the fluid, baby inhaled it. They brought baby to the hospital where she spent 2 weeks in the nicu and then died.

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Old 08-22-2013, 05:29 PM   #6
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With DS1 my water broke and had meconium in it at the hospital. They told me they would monitor him and give me 12 hrs to have him before they would recommend a c section. 12 hrs later I had been pushing for about 3 hrs and he was stuck. They wanted to do a c section and I agreed to it. They told me he may not be crying or breathing when he was born and I would not get to hold him right away because he would have to go to the pediatric team in the surgery room right away. They took him and checked him out and he seemed to be ok. I am glad to have been in the hospital because if he wasn't breathing there would be doctors there to help him right away.
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Old 08-22-2013, 06:56 PM   #7
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Re: Meconium in fluid question

The girlfriend of someone we know just had their baby at the beginning of August and he was born with meconium (not sure if it was just in the fluid or what) but he wound up getting an infection and spending 2 weeks in the NICU. I believe he just got to go home last Saturday. I wouldn't want to risk it, personally, and it doesn't seem like an overreaction.
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Old 08-22-2013, 07:24 PM   #8
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Re: Meconium in fluid question

It also totally depends on the type of meconium. A little green tint to the water isn't all that unusual and isn't as big of a concern. Thick particulate meconium is a major risk sign.
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Old 08-22-2013, 07:50 PM   #9
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Re: Meconium in fluid question

This happened with my daughter. Her head had been stuck at a 90 degree angle for an extended period of time, so she wasn't coming out. After turning her (ouchie!!) we still weren't having much progress. Then the meconium happened, which they determined to be a sign of disress, so they used forceps to get her out to avoid c-section (I had been in labor long before going to the hospital and had already pushed for hours while there). So she was over on a side table being suctioned out instead of with me. She did not have any other interventions after that, but boy were we glad there was a crew of people to come charging in asap!! She does have low muscle tone and some sensory stuff, but I attribute that to oxygen deprivation (also was blue w/ cord...) more than the meconium situation - but that's another story.
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Old 08-22-2013, 08:02 PM   #10
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My oldest was washed/rinsed before pushing....I guess I think of smoke inhalation type of situations when comes to meconium in fluid. they want to help asap....
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