Facilitating normal physiology in the presence of meconium stained liquor

There is sufficient evidence to support the practice of optimal cord clamping in normal labour and birth. In this paper, the physiology of meconium stained liquor (MSL), meconium aspiration syndrome and the practice of optimal cord clamping in babies born through MSL, is discussed. Guidelines suggest not stimulating babies born through MSL, at birth, to avoid aspiration. However, the obvious stimulation resulting from early clamping and cutting the cord, leaves a baby with no choice but to inhale, but this appears to be overlooked in practice. Midwives in their role as supporters of normal physiology are in a position to question this routine intervention in the absence of any evidence to support it.