Meconium in Labour: What is it?

By Jenna Armstrong

September 5, 2019

My name is Jenna and I am am The Mama Coach in Winnipeg, MB. I am a Registered Nurse, lactation counselor, sleep coach, prenatal educator, CPR instructor, and a mom of 3 little ones! I am here to help!

What’s meconium?!  It is a fancy name for babies’ first poop! Meconium is dark greenish black in colour, it is thick and sticky in consistency…really best way to describe it is like tar!  When I teach prenatal classes and let parents know what to bring to the hospital, near the top of that list is diaper wipes, they are the best at handling this viscosity of poop!  Don’t worry babies’ poop doesn’t always stay like this…

Meconium is made up of all things that float in the amniotic fluid such as skin cells, lanugo (hair that covers baby), mucus, bile, and water.  Newborns poop transitions from meconium to more of a yellow colour as baby gets more milk into his or her diet. This usually happens within the first couple days of life.  

Poop happens

Sometimes, babies poop while they are still inside the womb.  This is more common if babies are past their due date or are under stress.  Stresses to the baby decrease oxygen flow leading to intestinal activity increasing.  This then leads to the relaxation of the anal sphincter allowing the meconium out into the amniotic fluid which surrounds the baby.  When a pregnant mom’s water breaks, we expect the amniotic fluid to be clear.

If there is a green tinge to it, this is meconium. It doesn’t necessarily mean mom or baby is going to get sick or that baby is not going to tolerate labour, it is more of a heads up to healthcare providers that potentially baby is under some stress. As health care providers we will make sure mom has an intravenous in place, we will do continuous fetal monitoring, and we prepare for extra staff dedicated to the baby to be present for delivery in case baby needs assistance.  

Babies can swallow this fluid while they are still inside the womb and that is okay  When it can become a problem, is if baby swallows this meconium fluid during or after delivery.  This is not an issue as long as babies are born vigorous, meaning strong respiratory efforts – crying, good tone, colour and heart rate.  Meconium can be dangerous when babies are born and are not vigorous. Their airways can become blocked with this thick substance and cause trouble with babies’ ability to breath.

When I was in labour with my first, I was getting close to delivering but his heart rate was not reassuring.  I remember the doctor came in to break my water to get the show on the road and surprise surprise there was meconium in the amniotic fluid.  I was overdue and he seemed to be under some kind of stress. Thankfully, it wasn’t long and he was born.

During delivery he inhaled the meconium fluid, was not vigorous at birth, and was taken over to the newborn team.  They put a tube in to suction out the meconium, that then allowed him to be able to get air through on his own. When the newborn team brought him to back to me, he had an intravenous for antibiotics and we stayed in the hospital a couple extra days.  Meconium aspiration can be serious but, in most cases like mine, it is not usually severe.

From the moment we find out we are expecting the worries set in.  As the pregnancy progresses the worries remain, just change. By the time we get close to the due date we are wondering how the labour will go and we are hoping for an uncomplicated birth and a healthy baby to be passed to us.  There is nothing we can do about the unknown but we can get prenatal education and prepare ourselves for how things can look and what can happen. Please reach out to the Mama Coach in your area to book a prenatal class!!    

 

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