The Ultimate Guide to Preparing Children to Witness Birth
As you prepare to welcome the second, third, or even tenth child into your family, you may be faced with another important decision: Where will your older children be during labor, birth, and those first postpartum hours? While many families, particularly those birthing in the hospital, choose to arrange for family or friends to care for older siblings, the choice to invite them into the birth space is increasingly common. While this is a deeply personal decision unique to each family, witnessing the birth of a younger sibling can be a monumental life experience for children of all ages, which has the potential to deepen sibling bonds, further connection between parent and child, and normalize birth as an everyday life experience.
Even so, it’s not as simple as just having your children present when your baby arrives. The process of birth presents sensory experiences that most children have never experienced. Although birth is certainly a natural experience, modern culture doesn’t create a lot of room for portrayal or discussion of birth. Putting forth the effort to thoroughly prepare siblings to witness birth can do a lot to ensure that it’s a positive and stress-free experience for everyone—including you.
How to Educate Kids About Birth
Do you remember when you had your first baby? How much of what you experienced was new and foreign to you, even as an adult? Most children are even less prepared than new parents and let’s face it, we really don’t do a great job of preparing adults for birth either. Luckily, there is a growing body of resources that are available to help you prepare kids to witness birth. It is my hope that this article may serve as a resource for all the things that kids may see, hear, and experience, complete with images and videos whenever possible.
What Happens During Labor
During early labor, the birthing person can be talkative, excitable, and engaging with the people around them. But as labor progresses and the intensity increases, their behavior often changes. While not all birthing people respond to the intensity of labor in the same way, it is important for kids to be prepared for all possible behaviors to ensure that it is not startling or confusing for them if/when they occur.
Yelling
During transition it is not uncommon for people to become much more vocal through contractions. Humming, yelling, screaming, & cursing are all commonplace during the late phases of labor.
Image by Kayla Grey
Image by zenmamalove
Crying
Childbirth is an emotional journey, without a doubt. Crying is another normal response to labor, which can be brought on by any number of things: response to pain, fear (of birth, or even of becoming a parent), feelings of defeat, changes in birth plan, etc.
Image by Bianca Enriquez
Nausea & Vomiting
Nausea and vomiting can occur at any time just before, during, or even after labor, but is particularly common during transition, the shortest and most intense phase of labor. This can be triggered by:
the intensity of contractions as they become stronger
the shift in hormones during the labor process, particularly an increase in adrenaline
dehydration
the slowing of digestive functions
a drop in blood pressure in response to an epidural
Image by Megan Angstadt-Williams
Hypersensitivity to Touch (Tactile Defensiveness)
I’ve seen it many times: A laboring person, who previously responded positively to gentle touch, counter-pressure, or massage, suddenly cannot tolerate touch of any kind, and may even lash out at any attempt! Although I can’t find any reliable information about why this happens, this much is true—it is definitely not personal!
Image by Jacinta Lagos
What to Expect from Pushing through Birth
Poop
Yes, it’s true! Pooping during labor is a completely normal occurrence. As the baby descends further into the birth canal, their head places an immense amount of pressure on the rectum. And if that wasn’t enough, the muscles that you use to push your baby out are the same muscles that you use during a bowel movement. If there’s anything in there, it’s almost certainly coming out with your baby as you push!
Two-Step Delivery
During physiological birth, or one that is without intervention, most babies emerge in two stages: the birth of the head, and the birth of the body. On average, the elapsed time between these two stages is just under 90 seconds.[1] This is perfectly normal, and is associated with improved neonatal outcomes. A study from 2014 even concluded that a “head-to-body delivery interval of up to four minutes between contractions is common, is safe, and may reduce the incidence of shoulder dystocia.”[2]
Image by Danielle Saforek
Neonatal Color
During and immediately following birth, newborns are generally a shade of dark red or purple, and sometimes a bit more blue. There is a pretty wide variation of normal here, as it is influenced by the baby’s race, ethnicity, and how oxygenated the baby was during birth. Sometimes, particularly during a short pushing phase, the baby can develop bruising (often on the face) which may deepen the baby’s blue or purple color. As the baby begins to breathe air for the first time, this color changes to a shade of red or pink, usually within the first 5 to 10 minutes of life.
Moulding
The newborn skull is actually comprised of 5 separate bones that meet along sutures, a fibrous tissue that holds the bones together. During birth, this allows the bones to move independent of one another, even overlap each other, in order to mold to the tight passage of the birth canal. Depending on how long the baby spends navigating these tight spaces, their head may have what is called “moulding,” or an abnormal and often elongated shape. The baby’s head will usually return to its normal shape in the first few days following birth, although some take a little longer.
Image by Jessi Ann Photography + Films
Image by Alex Mooney
What is Normal in the Hour after Birth?
Vernix
Vernix caseosa (of Latin origin “varnish” and “cheesy nature,”) is a thick, wax like substance which protects the baby’s skin in utero and supports the transition to life outside the womb.[3] The amount of vernix present at birth varies, with earlier babies typically expected to have more, while babies born beyond their due dates are expected to have little to no visible vernix at all. It is known to help with thermoregulation of the newborn, to hydrate the skin, and to have antioxidant and antibacterial properties as well.
Image by Danielle Wilstead
Image by Danielle Wilstead
Meconium
The first bowel movements a new baby produces are called meconium. Unlike the bowel movements they’ll have later, this poop is thick, sticky, and dark green/black in color. Many babies have their first bowel movement in the first couple of hours following birth, and most have passed all the meconium within the first 48 hours of life. Sometimes, a baby will have this first bowel movement before birth, and meconium will be present in the amniotic fluid. When this happens, the baby, and any vernix present, may be more yellow or green in appearance at birth.
Blood
Some blood loss is to be expected during and following birth. During labor, there is usually a small amount of bleeding, which occurs when the blood vessels in the cervix rupture as it dilates (opens) and effaces (thins). At birth, the emergence of the baby can sometimes cause trauma inside the vagina, or to the vulva, including the labia and the perineum. Following birth, the separation of the placenta from the uterine wall causes significant additional bleeding. How much blood a person can lose varies because total blood volume is not the same for all individuals. The average person has 4.5 liters of blood before pregnancy, and this increases by an average of 40-50% by the end of pregnancy. A healthy individual can lose up to 15% of their total blood volume without symptoms (Class 1 Hemorrhage), and up to 30% with only mild symptoms (Class 2 Hemorrhage).[4] After a vaginal birth, 500mL is considered acceptable blood loss.
For children, even acceptable blood loss can be a startling sight to see. For this reason, I’m including a larger collection of images from births which has positive outcomes and little or no intervention to assist in controlling blood loss.
Image by Holly Cordova
Image by Photo Doula—Taryn Starkey
Image by Jacinta Lagos
Image by Vanessa Mendez
Placenta
The placenta is a most fascinating organ. During pregnancy, the placenta has many functions that support the growth of the baby. It delivers oxygen, nutrients, and antibodies to the baby via the umbilical cord, filters waste and carbon dioxide from the baby’s blood, and produces hormones to support pregnancy, labor, and birth. After the baby is born, the placenta detaches from the uterine wall and is expelled from the body in the first hour or two following birth.
Image by Mykayla Robertson
Image by zenmamalove
Additional Resources
Kids Books About Birth
I’ve searched far and wide for book recommendations from parents and birth professionals. These are the best kids’ books about birth!
Hello Baby
Written by Jenni Overend
Illustrated by Julie Vivas
Recommended Age: 2-6 Years
Welcome Home
Written by Alisha Bourke
Illustrated by Catie Atkinson
Recommended Age: Baby-10 Years
Our Water Baby
Written by Amy Maclean
Illustrated by Jan Nesbitt
My Mother Is the Strongest: A Story About Homebirth
Written by Cynthia Durand
Illustrated by Andreann Larouche
Foreward by Sarah J Buckley
Birth ABCs
Written & Illustrated by Hailee Wilburn-Ervin
Mama Says Homebirth
Written by Miquailaue Young
Illustrated by Chase P. Walker
The Birth of Our New Baby: Including Children in Pregnancy and Birth
Written & Illustrated by Ashley Comer
The Waterbirth Story
Written by Lisa Marie Sanchez Oxenham
Illustrated by Tegwyn DeForest
A Child Is Born*
Images by Lennart Nilsson & Linda Forsell
Text by professor Lars Hamberger & midwife Gudrun Abascal
*Although A Child Is Born is not a book intended for children, it is full of fascinating pictures of babies in utero that many children have loved looking at while following along their parent’s pregnancy.
Birth Videos
The Birth of Maeve by Kayla Grey — Dripping Springs, TX
Content: homebirth, siblings at birth, vernix
The Birth of Camila by Jessi Ann Photography + Films
Content: homebirth, labor sounds, purple baby, crying/emotional reaction to birth
The Birth of Maeve by Kayla Grey — Houston, TX
Content: homebirth, labor sounds (moaning, yelling), blood
[1] Hishikawa, K., Kusaka, T., Fukuda, T., Kohata, Y. and Inoue, H. (2020), Neonatal outcomes of two-step delivery in low-risk pregnancy: A prospective observational study. J. Obstet. Gynaecol. Res., 46: 1090-1097. https://doi.org/10.1111/jog.14272
[2] Kotaska A, Campbell K. Two-step delivery may avoid shoulder dystocia: head-to-body delivery interval is less important than we think. J Obstet Gynaecol Can. 2014 Aug;36(8):716-720. doi: 10.1016/S1701-2163(15)30514-4. PMID: 25222167.
[3] Singh G, Archana G. Unraveling the mystery of vernix caseosa. Indian J Dermatol. 2008;53(2):54-60. doi: 10.4103/0019-5154.41645. PMID: 19881987; PMCID: PMC2763724.
[4] Johnson AB, Burns B. Hemorrhage. [Updated 2022 May 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542273/