I'm not a homebirth midwife but this is a subject
I'm keenly interested in after seeing many mabies subjected to incredibly
invasive suction and 'resuscitation', even when kicking and
screaming.
The australian neonatal resuscitation
guidelines, which were adopted from the WHO infant resuss guidelines and
are in common use all over the world, suggest orophanyngeal
suctioning on the peri in the presence of mec liquor (not going right down to
the stomach or as far down the bronchial tree as can be managed which has been
an ongoing problem where I work) and direct inspection of the chords and suction
only in the case of thick meconium or an unresponsive infant with any
meconium. It has taken a lot of reiteration and bringing this to the
attention of our paediatric staff who often seem to think of a mec delivery as
the chance to improve their intubation skills.
When we are able to enforce this and only suction mouth and nose most
babies seem to be born very vigorous and in need of little other
intervention.
As an aside to another thread, I was also taught
that babies entering secondary apnoea gave a gasp whether they were born or
still inutero and haveseen numerous babies who most definitely did not breathe
after birth before being suctioned, who developed MAS. I don't know how this
works with the closed glottis. Maybe the extreme insult causing the secondary
apnoea overcomes it? I've also washed and dressed stillborn babies who have
drained copious amounts of thick mec from mouth and nose, clearly more than the
volume that can be held in a baby's upper resp. tract. More than could be
accounted for by the altered muscle resistance after fetal
death.
mariette
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- Re: [ozmidwifery] Homebirth experiences ... mmhh
- Re: [ozmidwifery] Homebirth experie... Marilyn Kleidon
- Re: [ozmidwifery] Homebirth exp... Mary Murphy
- Re: [ozmidwifery] Homebirth... Marilyn Kleidon
- [ozmidwifery] Homebirth... Mary Murphy
- Re: [ozmidwifery] ... Marilyn Kleidon
- Re: [ozmidwifery] Homebirth experie... barbara glare & chris bright