Another indicator of fetal distress which has already been mentioned is meconium-stained amniotic fluid (greenish or blackish liquor). Lightly stained amniotic fluid may not necessarily indicate fetal distress, unless it is accompanied by persistent fetal heart rate deviations outside the normal range. The following observations are made at each vaginal examination and recorded on the partograph, immediately below the fetal heart rate recordings.

If the fetal membranes are intact, write the letter 'I' (for 'intact').

If the membranes are ruptured and:

Box 4.2 Extent of meconium staining

Refer the woman in labour to a higher health facility as early as possible if you see: