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After researching the issue, I have come to the conclusion that suctioning on the perineum or in absence
of any respiratory problems once the baby is born is futile, since it has not been proven to change the outcome
in these situations.
~Carrie
UC Board CL
A baby will usually only poop its meconium in the belly if it is under distress-- in a pregnancy
and birth that is not interfered with, and with a mother that is not fearful, fetal distress is highly unlikely. If your water
breaks, and you notice thin, pale green meconium, then it probably was passed much earlier, and is not likely to clog up the
baby's lungs. If the baby's head comes out clean, but then there is meconium on the rest of her body, then it won't be a problem
(because it won't have gotten into the baby's mouth/lungs)-- you'll just have a nice clean-up job to do!
If the baby's
face is covered in mec., I would try to wipe it off *gently* before the baby begins to breathe, and swipe what I can out of
the mouth (some baby's may have it all over their faces, but have kept their mouths tightly shut, and won't have taken any
in)-- then do some gentle mouth to mouth suction to get more out (I would be very careful not to encourage the baby to breathe
until she is ready). After that, I would watch baby carefully to be sure that her breathing was all right-- not fast and shallow--
and that she was pinking up nicely. If I felt that the baby's breathing was bad enough to compromise her health, I would probably
go to the hospital to get her checked out/get oxygen.
I feel that most of the hyper vigilant interventions done to
baby's with mec staining can *CAUSE* respiratory distress, rather than prevent it-- deep suctioning (with a DeLee trap or
bulb syringe) when only the baby's head is out may cause the baby to initiate breathing before it ordinarily would have, drawing
the mec further in, and further distressing baby; using tubes down into the throat to flush with water and suck the mec out
will certainly distress the baby (it can cause such severe distress that the baby shuts down completely); intubating baby
can cause all sorts of problems... Not to mention that any sort of interventions involving tubes etc. into the baby's mouth/throat
are known to cause oral aversion, and can seriously hamper nursing.
Another thing to remember is that a baby that
has not been interfered with during birth will usually *spit out* whatever is in her mouth *before* beginning to breathe--
and that includes meconium. Mostly, I wouldn't worry about the possibility of problems at the birth-- the more relaxed we
are, the less likely we are to have problems-- and the more we worry about them, the greater likelihood there is of bringing
the problems to us!
Beatrice-- mama to Max (6, CNM hospital birth), William (4, LM home waterbirth), Dora (2, family
UC), Wee One (in belly, arriving late-Winter, UC)
*Bee's Official Disclaimer: All of my answers express my own personal
opinion, and as I am not a trained birth professional, but better, an experienced mother, none of it ought to be construed
as medical advice.*
Follow my instincts....
I would still birth at home, but evaluate baby after birth. I might
use a bulb suction if I felt it was needed.
Annabelle Mom to 4 girls and a boy! Makaley 2/24/94, Arden 2/24/94, twins
by c/s, Anniston 11/12/95, HB w/ midwife, Taegan 12/30/98, UC, and Balen 12/7/00, UC.
I think it depends on how far *before* the birth it is present. If the water breaks before contractions/before
baby's head is descended/birth is imminent and meconium is present, the chances of baby ingesting/swallowing meconium is greater
and additional help might be sought (if the mother feels it necessary). If the water breaks directly before the birth (as
head is crowning) and the baby birthed very soon after, the risk is significantly less that any harm would come to baby. I
think again it comes down to the mother's intuition and feelings on it... if she feels something is wrong then she should
listen and follow those urgings and seek additional help.
karly
I'd follow my instincts...
My water never even broke until I was pushing with my
first two. You can't see meconium unless it's coming out in the amniotic fluid. If a little came out during pushing, I wouldn't
worry. If my water was broken for a while, the water wasn't clear, and birth didn't feel imminent, I'd probably transfer to
a hospital.
One of the reasons I feel safe with homebirth is that most problems present themselves with plenty of
time to seek extra help if needed. I'd consider meconium stained amniotic fluid a sign that something was wrong.
Ruth
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