All in the Family Including children in the birth of a sibling. by Elizabeth Bauchner My 7-year-old daughter Briana peeked over the midwife’s shoulder as my son’s head emerged from the birth canal. “Oh!!” she exclaimed, hands flying to her face. “Oh! It’s so.... cute.” Then she disappeared from view, returning only moments after her baby brother was born. Marveling over how purple he looked, she stroked his vernix-coated hair and spontaneously sang “Happy Birthday.” When my husband Adam and I planned for Adrian’s birth, it never occurred to us that Briana should not be present, since we viewed his birth as a family event. We also viewed the birth as an important educational event. Most people grow up to fear birth; we wanted our daughter to learn that birth is a normal part of life. It turned out that Briana gained more than just an education. Her immediate contact with Adrian set the tone for a positive, loving sibling bond. Since the first few moments of his post-womb life, Briana has enjoyed touching, holding and cuddling Adrian, and jealousy has hardly been an issue. Certainly her age and abilities played a role in her acceptance of Adrian; however, since she was part of the pregnancy and birth process, she found it easier to welcome him into the family. The Planning Stage We began planning and preparing for childbirth in the first trimester by discussing our intentions with a group of certified nurse-midwives. They assured us that the birth center would welcome our daughter at the birth. Our preparation including making sure Briana understood the physical aspects of childbirth, listening to her fears, and helping her overcome them. When we first discussed having her at the birth, she wasn’t too keen on the idea. “You want me to watch the birth?” she asked incredulously. “That’s kind of gross.” I replied, “Well you don’t have to be there. It’s just that you could be there if you wanted to.” Over the course of my pregnancy, Briana slowly came around to the idea of attending the birth. We never pressured her to make a final decision. We reassured her that she could come for a while, stay the whole time, or leave any time she wanted. Whenever the subject came up, her typical response was, “Well, we’ll just have to see what happens.” I liked that attitude, because it showed her willingness to be spontaneous and flexible— necessary characteristics while attending a birth. At the urging of our midwives, we arranged for two caregivers for Briana during the labor and delivery. David and Laura both agreed to be “on call” and to come whenever we needed them. It was important that Briana and I felt comfortable with who we asked, because I would possibly give birth in front of them, and Briana needed to feel secure enough to be herself and speak up for what she wanted or needed. Preparing for the Birth Once we decided to plan on Briana attending the birth, it was time to prepare her for what may lie ahead. Our midwives gave us an article entitled, “A Family Centered Event? Preparing the Child for Sharing in the Experience of Childbirth,” by Susan Parma, a maternity nurse, childbirth educator and midwife. Parma recommends not building specific expectations for the child since labor can take many turns. For one, the mother may change her mind about having her child present or complications may arise which prohibit the child from attending the birth. We explained to Briana that in case of an emergency, she would not be allowed at the delivery. She didn’t seem to mind the possibility, since she spent most of the pregnancy wavering between excitement over attending, and expressing an interest in just staying with David and Laura. Parma also recommends that the child understand the basic anatomy of pregnant women and the physiological process of labor and birth. We would find out where Adrian was in his stage of development, and while we looked at the pictures, questions about how he was growing inside me would naturally arise. She became fascinated by the story of her own birth and asked me to tell it again and again. In this manner, pregnancy and childbirth became regular discussion topics. The words cervix, dilate, uterus, crowning, vagina and episiotomy became household utterances. In addition to understanding basic anatomy and the stages of labor, Parma writes that children should be aware of several specific “manifestations” of childbirth: the “wetness” of birth, i.e. the amniotic fluid, vernix and blood; the hard work and intensity of labor; the sounds of labor; the pain of labor; episiotomy or tear and repair; and last, but not least, the placenta. Here’s where things got sticky for us. At any mention of blood, amniotic fluid, vernix or placenta, my daughter grew pale. She understood their presence as normal and healthy, yet she remained squeamish. Eventually, she came to accept that blood associated with childbirth is a “good” thing, as opposed to blood associated with a wound. Briana attended childbirth classes with us that were taught by our doula, Jan. She made a point to include Briana in the dialogue, and often paused to ask if Briana understood what she said. In class, we watched videos of home births, birth center births and a couple of cesarean sections. The day we watched the cesarean section video, Briana whispered to me when it was over, “When I have a baby, I think I’d like to push it out instead.” Our final preparation was a sibling readiness class that our midwives offered. The nurse, Marcia, showed pictures of births from the community as well as from published books. We talked about how I might act while in labor and what kinds of things Briana could do if she wanted, like massage my forehead or hold my hand. We made it clear that it was not her responsibility to help me. Labor and Delivery For parts of my labor, I sat on a physical therapy ball and tried to stay calm by moaning low from my diaphragm. These low, guttural sounds intimidated Briana. She was free to wander in and out of my room, but she would leave every time I had a contraction and started moaning. Five hours after we arrived at my birth center, I was ready to push. Briana watched some of the pushing and refused Adam’s offer to ask David or Laura if they wanted to come in with her. I think she liked having them outside the room so that she could leave and go to them whenever she felt like it. She was so excited by this time she burst out, “I just can’t wait! I don’t care if it’s a boy or a girl or whatever!” As soon as she saw Adrian, her previous fears of witnessing a lot of blood melted into the distance. She couldn’t take her eyes off our newest member. When Adam and the nurse took him to get weighed, Briana followed and read the scale, “9.6, 9.7, 9.8 pounds, Mommy! Is that a lot?” Our experience made me wonder if there might be less sibling rivalry if children were adequately prepared for childbirth as young as 2, and if parents take the time to research, plan and pay attention to their child’s particular needs. Almost three years after Adrian’s birth, both of them participated in the birth of their little sister, Lily. Briana’s reaction to seeing her brand-new brother, fresh out of the womb, was a visceral and raw experience for her. She didn’t witness his whole birth, but she came away stronger by learning for herself how to act on her own behalf according to her feelings, intuition and needs. Although she still occasionally mentions how childbirth “must really hurt,” she also sees childbirth as a potentially empowering, joyous and normal event. Elizabeth Bauchner is a freelance writer and mother of three. She writes a weekly par-enting column for the Ithaca Journal in Ithaca, NY.