Jaundice and meconium; Minimum service levels

[leigh pettingill]

Lack of passage of meconium in the first 24 hours may well contribute to rising jaundice but jaundice in the first 24 hours is an abnormal finding that requires general assessment of the baby.  I would be concerned that if the first thought was about meconium or lack of it, maybe other things might be missed.  Maybe these were also checked for.   I would like to ask the list for thoughts on minimum levels of service in the post natal period.  The question was asked at a regional midwives forum regarding what might be possible in a small rural township that had ceased providing a birthing service due to insufficient midwives (to provide for a traditional roster pattern) and no medical back up.  My initial responce presumed that the mother and baby would be well or not returning to the small hospital.  I think this could be equated to the situation of women birthing at home where 1-2 visits of 1-1.5 hous on the day of birth and the next day and then daily visits to at least day five.  Using this arrangement a roster would not need to be filled, rather, the needs of individual women could be met - some more, some less.  What do other listers think?  Cheers Leigh