If a woman's waters are meconium stained, how the caregiver will react or intervene will depend on the thickness of the meconium, when it is first noticed and any other health considerations for that particular mother and baby. Different caregivers and different birthplaces may also have slightly different ways of dealing with meconium stained liquor (MSL).
When the baby is about to be born, it may be the policy of the birthplace, or the preference of the caregiver, to call a paediatric doctor to attend the birth and carry out any necessary interventions and / or check the baby soon after birth.
Interventions before or during the labour and at birth can include:
Monitoring
Inducing the labour
Fetal scalp blood sampling
Amnioinfusion
Delivering the baby
Suctioning
Observing the baby
Meconium aspiration
Monitoring
Meconium stained liquor is usually recognised as a possible sign of
fetal distress. As a sign on its own it may be of minimal value, but if used in combination with what the baby's heart is doing, in relation to the contractions, then it can be a more accurate predictor of the baby being unwell.
Sometimes meconium staining is not apparent until late in the pushing phase or after the birth of the baby's head. In these cases the caregiver may just suction the baby's nose and mouth out at birth, as monitoring at this point will not have any benefit. If the heart rate is very low they may perform an
episiotomy so the baby's head can be born quicker.
Light meconium staining does not usually require the baby's heart rate to be continuously monitored with a
CTG machine throughout the labour. Although the caregiver may suggest a 20 minute recording soon after the meconium is noticed (when the waters break). If the meconium becomes heavier or the baby's heart rate is noticed to be lower after a contraction (when listening in periodically) the caregiver may then suggest continuous monitoring.