What is Meconium Stained Amniotic Fluid – Is it Normal?
“Meconium in the water; Baby is in danger. We need to get the baby out!”
So many birthing women have heard something similar to this while in labor. There is nothing scarier than hearing baby could be in distress. Without batting an eyelash, you do whatever the doctor says from that moment forward. “Save my baby!” you think. But what if your baby is not actually in danger at all?
You see, current research has disproven the need of immediate alarm that occurs when poop is found in the amniotic fluid. Meconium staining may not only be ‘not scary’ for almost every birth, but it is actually quite normal for babies born between 37-42 weeks gestation. Meconium is the name given to the first poop a baby has. It is 70-80% water and a combination of everything your baby has ingested while in utero: mucus, amniotic fluid, intestinal epithelial cells, and lanugo (the little hairs that cover baby in the womb). It is, thankfully, odorless, but quite hard to wipe clean. It generally takes about 3 days to clear the newborn’s system, and then the “mustard seed” poop arrives. Approximately 15-20% of all babies will have meconium present when water breaks in labor.There are three theories as to why the baby passes meconium before being born: Source
- The digestive system has reached maturity and the intestine has begun working. A working intestine allows meconium to pass. This is believed to be the most common reason, as 15-20% of babies passed 37 weeks and 30-40% of babies born passed 40 weeks will have passed meconium in-utero.
- During labor, the cord or head can be compressed (especially during second stage- pushing, which is the most common time for the bag of waters to break). This is the same reflex that causes variable heart rate decelerations, which are a normal physiological response and can happen without fetal distress.
- True fetal distress resulting in hypoxia. This has been disproven through research because hypoxia occurs without meconium being present, but the theory is that lack of oxygen relaxes the anal sphincter and allows meconium to pass.
- Most babies who are born in a poor condition do not have meconium stained amniotic fluid
- Most babies with meconium stained fluids are born in good condition
“During labor and birth it is very unlikely that a baby will inhale liquor (and any meconium in it). This will only happen if the baby becomes extremely hypoxic and begins to gasp in utero in an attempt to get oxygen. So, meconium alone is not a problem. Meconium + a hypoxic baby = the possibility of MAS (Davies & MacDonald 2008).”An abnormal heart rate predicts fetal distress much more accurately than MSAF (Meconium Stained Amniotic Fluid); and an abnormal heart rate along with meconium in the water may be an even better indication that a baby may be in trouble. In addition, thick meconium rather than thin meconium is associated with complications in these conditions. (Source).
Meconium Aspiration Syndrome (MAS)Having meconium in your amniotic fluid gives your baby a 0.06% (1:1667) chance of dying from MAS. This risk will go up and down slightly depending on each mother’s circumstances. Risk factors for increasing the chance of baby inhaling meconium (remember, the presence of meconium is not only normal, but safe.): Source
- Induced Labor
- Pitocin Use
- Labor Complications
- Traumatic Birth
- Cesarean Section
- Bluish skin color (cyanosis) in the infant
- Difficulty breathing (the infant needs to work hard to breathe)
- No breathing
- Rapid breathing
- Limpness in infant at birth