by SP Turgon
Modern research often reveals the errors of routine practices that used to be considered good. Suctioning babies at birth is one such practice. The modern debate questions whether it’s necessary to suction all babies who have meconium (fetal poop) in their amniotic fluid. Let’s talk about what meconium is, why it matters, and what women and care providers can do to prevent meconium during pregnancy and delivery.
WHAT IS IT?
Meconium (meh-cone-ee-um) is the dark green, thick stuff that’s the first feces of a fetus. It ranges from very thick when it’s new to very thin when it’s old and is diluted by amniotic fluid.
Although we think of it as poop, it’s really a combination of mostly water plus amniotic fluid, intestinal cells, lanugo (fine hair that covers the fetus), mucus, and bile. About 20% of babies are born with meconium in their amniotic fluid.
Babies in good condition at birth can have meconium-stained amniotic fluid and be fine. Babies in poor condition can be born with no meconium but still have breathing problems.
Understanding what contributes to meconium in your baby’s amniotic fluid helps you know how to prevent it. Some of the decisions can be part of your birth plan. When you’ve discussed your birth preferences with your midwife or doctor, you can work together to prevent meconium or to deal with it in the least traumatic way possible.
WHY DOES MECONIUM MATTER?
In the 1970’s, it became routine practice to suction all babies born with any amount of meconium in their amniotic fluid. Birth teams use either a bulb syringe or a tube to suck out the meconium from baby’s airway or lungs. But it’s uncomfortable, even painful, for a brand new baby – and it usually isn’t necessary.
The medical concern is, a baby who inhaled meconium in utero or during birth could develop breathing problems caused by meconium aspiration syndrome (MAS).
True MAS is serious – it can even kill a baby. Conditions like prematurity or other labor complications can increase the chance of it developing. If the meconium is new and thick, the chance of MAS is greater. In this case, suctioning can prevent serious breathing issues.
Under most circumstances, simply inhaling meconium doesn’t cause MAS. We mention the risk only to be thorough, not because it’s likely.
WHAT CAN MOMS AND CARE PROVIDERS DO?
The presence of meconium in baby’s amniotic fluid is a good example of how unnecessary medical interventions can cause problems for mom or baby.
Meconium is often the result of previous medical interventions that caused a lack oxygen (hypoxia -“high-pox-ee-a”) for baby.
Research now shows that most infants with MAS inhaled the meconium in utero. This often happens when outside influences cause a lack of oxygen, your unborn baby becomes distressed, and she poops meconium.
These common medical interventions can create a lack of oxygen for your baby:
- Inducing labor
- AROM – artificial rupture of membranes (breaking the bag of waters)
- Stressing out mom causes reduced blood flow to the placenta – confining her to bed, too many people or too much activity in the room, bright lights, medical equipment, etc.
- Directed pushing to speed up labor
- Cord clamping and cutting before the cord has stopped pulsing
In your birth plan, you can say that you refuse these interventions.
BABIES BORN VAGINALLY HAVE THEIR LUNGS COMPRESSED AS THEY GO THROUGH THE BIRTH CANAL.
It’s a natural process designed to push most fluids like meconium out of their lungs and prime them to take a nice big breath when the compression releases as they are born. This natural compression and fluid expulsion is one of the benefits babies lose when they’re born by C-section.Your birth preferences can influence many factors that help prevent meconium at birth.
Some choices you can include in your birth plan to help prevent meconium are:
- Letting labor happen naturally without induction
- Leaving the bag of waters intact, not breaking it to start or speed up labor
- Deciding who can be in the room with you
- Limiting the number of vaginal exams
- Pushing according to your body’s signals instead of being directed when to push
- Letting baby’s head birth slowly to allow fluids to be pressed out
- Delay cord clamping and cutting 
Putting baby immediately on your skin makes you both feel better, and helps baby’s body begin the job of being in the outside world, in your world.
When you understand the issue, you and your care provider can write a birth plan that acknowledges there are rare circumstances that require suctioning. But in most situations, your new baby doesn’t need the trauma of being suctioned at birth.
In the final version of the birth plan on your hospital bag checklist, be sure to state your preference for using only those methods that lower the chance of your baby experiencing distress – before, during, and after her birth.
To learn more about peaceful birthing, download our free Birth Plan eBook now. After three years of research, collaboration with more than 100 childbirth experts and resource centers from Healthy Child Healthy World to the American Association of Neonatal Nurses, the Best Ever Baby Birth Plan Guide is available for a free download.
This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and the GraceFull Birthing founder, midwife Elizabeth Bachner. These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.
Published: January 10, 2016 | Reviewed by: Kim Walls, Natural Products Expert, Elizabeth Bachner, LM, CPM, L.Ac., Midwife | Last reviewed: January, 2016