Fetal hypoxia (reduced oxygen supply to the baby).This is a normal physiological response and can occur in the absence of fetal hypoxia. Compression of the head or cord during labour may cause a reflex gastro-intestinal peristalsis (movement of the gut) in the baby.MSAF is associated with term/post-term pregnancy and is thought to occur because the digestive system has reached maturity.The unfortunate part of this is that the vast majority of these deliveries will result in a worse outcome for both mother and baby than if a vaginal delivery of the baby had been allowed under attentive super vision and care.' 6 Reasons for MSAF 'As a result, they usually perform caesarean delivery within the next few hours. Naoli Vinaver, a Mexican home birth midwife, writes: 'Unfortunately, most conventional medical care providers in most countries around the world misdiagnose the mere presence of meconium as 'fetal distress'. 6 This suggests that the management of labour was affected by the clinicians' perception that MSAF was an indication of fetal distress, and therefore they were quicker to intervene. 5 In this study, obstetric management was significantly affected by the presence of MSAF although outcomes for the babies were similar, the caesarean section rate for labours with MSAF was 17.4% compared with 9.6% of the non-affected labours and the vaginal operative delivery rate 13.9% versus 6.2%.

4 For example, a retrospective case control study from Germany (11,226 women, including 1123 who had MSAF in labour) found that the mean arterial pH (measure of oxygenation of the fetal blood) was the same for both groups. For example, a 1988 midwifery textbook has one sentence on the subject, stating 'a greenish colour is indicative of meconium stained liquor and is usually a sign of fetal distress.' 3 Since then, however, there have been many research studies and the consensus now is that meconium passage alone is not a sign of distress in the baby. In the past it was generally believed that MSAF alone was a sign of problems with the unborn baby. Approximately 30% of babies born at 40 weeks, and nearly half of babies born after 42 weeks of gestation will have MSAF. Meconium stained amniotic fluid (MSAF) occurs when the baby opens his/her bowels before birth, and is found in about 13% of labours overall. Healthy amniotic fluid smells 'like fresh, clear, warm sea water : heavy, salty and clean.' 1 It is normally clear, but sometimes has a yellowish, greenish or brown tinge when it is stained with meconium. The fluid is secreted from the membranes and the placenta throughout pregnancy it is continually being 'inhaled' and 'exhaled' by the baby's developing lungs as well as swallowed in and urinated out. It plays a vital part in the baby's development, creating a warm protective environment in the uterus where it can grow and move freely. Sarah Davies looks at the significance of meconium in the amniotic fluidДЄmniotic fluid is the fluid surrounding the baby inside the amniotic sac.

Does amniotic fluid have a smell