Great article from Midwife Thinking's blog:
"Dear unborn baby,
Please consider holding your poo in until after you are born. The big people on the outside get very stressed about your poo and will want to change the way you are birthed if they find any evidence that you have failed to keep it in. Your mother will be told that you are in danger, and will be strapped to a CTG monitor. This will: reduce her ability to help you through her pelvis by moving; prevent her from using water to relax; and increase your chance of being born by c-section. Your mother will also have her time limits for labour tightened up. This may lead to labour being induced or augmented which will put both of you at risk of further interventions. You will be expected to get through your mother’s vagina quickly and if you take too long you will be pulled out with medical instruments. As you are being born you will have plastic tubes pushed into your nose, mouth and throat to suction your airway. Once born, your cord will be cut immediately and you will be given to a paediatrician who may also put tubes into your nose and mouth. You will only be given back to your mother once you are crying effectively. You may not feel like breastfeeding after being suctioned – don’t worry, this is normal. In the first 24 hours after birth you will be disturbed regularly to have cold items put onto your skin to monitor your temperature, breathing and heart rate. In some hospitals you will be taken away from your mother to be observed in nursery. So, if at all possible do your mother and yourself a favour and try to hold on to your poo until after you are born...
So you would think that the sensible thing to do if a baby has passed meconium (for whatever reason) is to create conditions that are least likely to result in hypoxia and MAS. This is where I get confused because common practice is to do things that are known to cause hypoxia, for example:
- Inducing labour if the waters have broken (with meconium present) and there are no contractions or if labour is ‘slow’ in an attempt to get the baby out of the uterus quickly.
- Performing an ARM (breaking the waters) to see if there is meconium in the waters when there are concerns about the fetal heart rate.
- Creating concern and stress in the mother which can reduce the blood flow to the placenta.
- Directed pushing to speed up the birth.
- Having extra people in the room (paediatricians), bright lights and medical resus equipment which may stress the mother and reduce oxytocin release.
- Cutting the umbilical cord before the placenta has finished supporting the transition to breathing in order to hand the baby to the paediatrician..."
The Curse of Meconium Stained Liquor