Meconium and Complications During Labor

Parent changing newborn child's diaper

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Meconium is a thick, green, tar-like substance that lines your baby's intestines during pregnancy. Typically this substance is not released in your baby's bowel movements until after birth. However, sometimes a fetus will have a bowel movement prior to birth, excreting the meconium into the amniotic fluid.

Meconium in Labor

If meconium is present during your labor and birth, you will be watched more closely for signs of fetal distress. On its own, meconium staining of the amniotic fluid does not mean that your baby is suffering from fetal distress, but your labor and birth team will look for signs of distress

Light-colored meconium is not as much of a risk to your baby, nor is it as likely to be a sign of fetal distress, but rather the maturation of your baby. Thicker meconium is more of a danger to your baby. One type is so thick that healthcare providers refer to it as "pea soup," both in consistency and because of the greenish shade of meconium.

Meconium in Amniotic Fluid

Meconium in amniotic fluid is more common if you are well past your due date. When meconium is in your amniotic fluid, it can put your baby at risk for complications after birth. One of the concerns is that the baby will aspirate the meconium during labor or birth.

Your baby might swallow meconium, which is not usually a problem. Or, they can inhale it into the lungs. This can cause a problem known as meconium aspiration syndrome.

Meconium Aspiration Syndrome

Since meconium is a thick, sticky substance, if it gets into the lungs it can make it hard for the baby to inflate the lungs immediately after birth.

If meconium is found in your amniotic fluid, the birth team will administer vigorous suctioning of the baby's mouth and nose immediately upon the birth of your baby's head, even before the body is born. This can lessen the amount of meconium available for your baby to aspirate. If your baby inhales, or aspirates, meconium, it can lead to meconium aspiration pneumonia.

Both meconium aspiration syndrome and meconium aspiration pneumonia can be very serious problems resulting in a stay in the neonatal intensive care unit (NICU) for your baby for treatment consisting of several days to weeks depending on the severity of the problem.

Diluting Meconium in Amniotic Fluid

If there is meconium present in labor, the baby will be monitored more intensely to watch for signs of fetal distress. Your doctor or midwife may also decide to perform an amnioinfusion in cases where there is poor fetal monitoring. 

Amnioinfusion is where sterile fluid is placed inside the uterus via a catheter to help dilute the meconium. It also can be used to add to the amniotic fluid volume. This could be done more than one time if needed and may increase your baby's tolerance of labor.

Labor Interventions

If your baby is still not tolerating labor well or shows other signs of fetal distress that aggressive therapy has not corrected, your doctor or midwife may decide that you need to discuss an operative delivery depending on how far away you are from a vaginal delivery. This may include forceps, vacuum extraction or a cesarean section.

Meconium After Birth

If your baby does not have meconium prior to birth, you will still see it within the first few days of life. This is not a problem. However, it's messy and hard to clean off of your baby's bottom.

A tip for making newborn diaper changes easier: Coat your baby's bottom with some ointment or oil after washing up during diaper changes. This prevents the meconium from sticking.

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By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.