When a Baby Is Born with Surprises

Editor’s note: This article first appeared in Midwifery Today, Issue 131, Autumn 2019.
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Every baby is born a surprise. Even if one has had 10 ultrasounds and named the child in advance—that first encounter with one’s baby is always an exploration: So this is you! For most of us, there is a combination of deep recognition of the little being who grew inside of us, as well as utter fascination. Some women are so exhausted from the birth itself that they may take minutes or days to really focus in on their baby.

Some cultures believe it is bad luck to praise or name a baby in the first weeks, for fear of the “evil eye” or because some babies don’t live long and they don’t want to become “too attached” initially. The intention of this article is not to explore the variety of cultural norms about newborns as much as it is to point out that what is a pleasant surprise to one family could be perceived as devastating to another. In reality, every single baby deserves to be welcomed and every set of parents congratulated and praised for bringing in new life, regardless of what condition the baby comes in with. In fact, how we as caregivers and support people respond to the baby often sets the tone for how the family will perceive the baby, which in turn, the baby itself internalizes as “Phew! I came to the right place!” or, “I won’t be safe here. I am not welcome here. Something is wrong here.”

For example, once I was examining a newborn in our local clinic in Mexico and noticed that she had two lovely white teeth already in place, front row and center. As an anthropologist I knew that in some cultures a newborn with teeth was considered cursed, a sign of the devil, or bad luck for all. The mother fell silent for the rest of the exam, having gasped when the midwife pointed out the teeth in a serious, sorry tone. I worried they thought it was bad. I wanted to make sure the new baby was treated with awe and not punished somehow for having teeth. When the new mom was back in her room, I went to visit and found her snuggled in a narrow bed with her baby with a woman who looked like the grandmother seated on a chair nearby.

After greeting them, I asked “Have you tried nursing?”

The young mother smiled shyly and nodded. “She’s been nursing already nearly this whole time!”

“Wow, good for you!” I said, “I just wanted to congratulate you for the birth,” I said, “And about those teeth! You know, in my culture it’s a good omen when a baby is born with teeth. It’s good luck for the whole town. It means the baby is someone very special, very blessed. Very good.”

Both mother and daughter relaxed their faces. They could brag about this back home. They could share this with their baby daughter as she grew: she was born blessed.

Sometimes it’s the skin color. Or the sex of the baby. Or an extra digit on the hand. Sometimes it’s born by an unwanted cesarean. Surprises. And our response, our words when we first greet this baby, can make a huge difference. As midwives and birth workers, we are trained to let the parents discover the baby’s sex rather than call it out. Our job is to help re-frame the findings if the initial response is fear or rejection. Because every baby deserves to be greeted with welcome to our planet. And every baby came to fulfill its destiny: to teach and learn love. So even simple things like: “What? Another girl?” or “Looks like an old prune.” “Poor kid, got dad’s nose….” or “I can’t believe I had a cesarean….” are imprinted on a newborn’s open energy field and nervous system, not as the words themselves but as the feeling-place of arriving and finding people upset or displeased with that arrival and not actually knowing why. Babies don’t know what dad’s nose is like or why that’s “bad.” Babies don’t know why not having a cesarean was the most important thing to their mother—they just came in. They just did the most magnificent metamorphosis anyone will do. They came in to a human body ready to love and be loved, open-heartedly.

When it’s a visible difference nobody was expecting or understands (unkindly referred to as a “birth defect”—sounding as if a baby is defective just for showing up), it can be hard for parents to assimilate at first. I remember one couple whose baby came fairly quickly. After he tumbled out, we wrapped a receiving blanket around him and the mother took him in her arms while I began exclaiming: “Welcome, welcome, beautiful baby! We are so glad to see you!” while my midwifery partner raised her eyebrows in a funny way and pointed at the baby surreptitiously. I paid no attention until she cleared her throat loudly. The baby turned his head away from the mother’s breast momentarily and I saw that half of his face was a deep maroon color while the other half was pale white. Was this the “port wine stain” I’d read about? I wondered to myself. But out loud I said: “What a beautiful baby.”

Quietly, the mother, who was a calm German woman, held her baby out toward me and said: “He has this big mark on his face.…”

“Yes, he does.” I agreed, stroking his cheek, “Later we can check on the rest of his body and see if there’s more, but he’s fine here with you for now.”

“What the….” her husband shouted. “Look at that huge mark! I told you not to go out when the moon was eclipsing. This is totally wrong. This is bad. I can’t believe you … I’m out of here.”

He grabbed his jacket and raced down the stairs, slamming the front door behind him. He didn’t come back or call for two days. Meanwhile, his wife lovingly nursed her baby, rested, did what any mother does in the immediate postpartum—settles in. When she was ready, we called in a pediatrician for a consult. He examined the baby and said it might be a big birthmark and it might be part of a greater syndrome but it was too early to tell. Meanwhile the baby acted like any other baby and was loved. The husband came back, apologized for being a jerk, and lovingly settled in with his new family. “Forgive me,” he said, “I was scared.”

In another case, I was helping a family have their third child, a second homebirth with me. Their little girl came after a quick and intense labor and, although she seemed fine, within five minutes she became floppy and I noticed she had a blue circle rimming her mouth. We gave her fly-by oxygen and she pinked right back up and began nursing. But this fine-then-floppy behavior persisted. Her vitals were fine, other than this, but to be safe I called our back-up physician. He came and said we needed to get her to a hospital for a full pediatric workup because it was not normal behavior. So we all set out in their car for the clinic. On the way, the parents marveled at their little girl.

“It’s funny,” the mother smiled, “She doesn’t look like the other two. Who knows where she got this little crinkly nose? And her eyes … they look almost Chinese!”

The pediatrician on duty took one brief look at her and said: “Well, obviously, she has Down syndrome. We’ll need to do some further tests on her heart function,” and he rushed off.

A team of nurses swooped on the bassinette and wheeled the baby away, while the parents were ushered quickly into a little cubicle-sized room to wait. And weep. My first reaction was denial. “How can he just say that like that? They didn’t do any tests or anything. He barely looked at her.”

At that point, our back-up doc pulled me out of their cubicle and said: “She had the ears lower than the nose. The line on the palms of the hand. The eyes … and probably has a concurrent heart condition which is why I said we needed to get here right away.”

I was a self-trained homebirth midwife. I hadn’t ever seen anyone with Down syndrome until then. This mother was 26 years old, not in any risk category. I felt foolish and yet grateful that the baby had been greeted as a little girl first, not as a “syndrome.” I went back into the tiny room with the parents and held them while they cried, not out of rejection of their baby, but of fear for her: Where did they take her? What will she need? When can she come home with them? What sort of special care will they need to learn and from whom?

From these sorts of experiences and many others, I have compiled some ideas to help guide people when they are met with surprises at birth.

  1. The importance of our initial reactions. Emphasize love, welcome, and the baby. The beauty of the baby. Not the condition; the baby. Leave room for the anger, shock, fear, and even denial of the parents or others initially. Give them alone time to be with the baby and/or each other. Be nearby, though. Make space and time for the questions that will come little by little. Provide honest answers, including “I don’t know.” Hold space. Hold the baby, if you can. Listen more and talk less.
  2. Don’t forget that there is a postpartum mom in the mix. Sometimes all the focus goes immediately to the baby, especially if it’s in danger. A newborn mother feels a mix of hormones, milk production, love, worry, fear, shame, aloneness, and guilt. Protectiveness, helplessness, and discouragement. Shock, love, caring, and fierceness. She needs support! Sleep. Companionship. Warmth. Nutrition. Extra liquids. Listeners. Hugs. Kleenex. Massages. People to praise and reassure her and her baby. Eventually, she needs answers and information, as well.
  3. Designate someone to accompany her to every single doctor visit for the next months or even years—to simply be there as support and to keep the notebook in which this third person writes down the name, date, and purpose of each visit, and the salient points that were discussed, discovered, prescribed, prognosticated, etc. This could be you at first.

It doesn’t have to be the same person at each visit, but it does have to be the same notebook because, especially in the surprise cases, the hard, never-dreamed-of situations, full of anxiety and unknowns and new vocabularies and technologies and tests and medical opinions, it’s overwhelming for the immediate family. Often only a fraction of what the doctor says can enter their conscious minds. They may grab on to the one thing that sounded comforting and not understand the gravity of the next thing that needs to be addressed, or vice versa. I have found that it may take months, and sometimes even years, to integrate and understand fully who one’s child is and how to best meet their needs, especially in those early years when everything is changing and decisions are being made that will influence the rest of their lives.

  1. Familiarize yourself with Pam England and her excellent description of the “nine birth healing journey gates” (England and Horowitz 1998) as relates to exploring and leaving space for the many layers of how women integrate and relate their birth experience to themselves and others, bit by bit, over time. This model helps us to have compassion around the fact that each mother has her own timeframe for coming to peace about what did or didn’t happen at her birth and with her child. It helps us as helpers to honor the fact that each of us can only handle what we can when we are ready, without judgment.
  2. Collect resources and offer them non-judgmentally to the family if/when you are asked for them. You may say, “I have some resources on this topic for you if you are ever interested,” and then wait until they ask you. These resources may include national support organizations and their websites, local parent support groups, chat rooms, or local families with children in similar situations. I find the best experts are other mothers who have lived through similar situations, so seek some out and talk to them for yourself, as well.
  3. Help the family reframe and celebrate their baby as a person, not an illness or a syndrome, for example, not “our Down’s baby” but “our baby.” One can add, “Yes, (s)he has Down syndrome/a heart condition/is in the ICU” or whatever. Some choose to announce: “Our beautiful precious baby is here! For the time being we will not be receiving visitors until his/her health stabilizes but we appreciate your good wishes.” Some parents announce the birth and name/sex of the baby, then do not communicate or post pictures until the issue is in the clear, often several months or up to a year later. This is up to each family. Although this is probably “easier” on the parents, it also reduces the amount of loving goodwill, prayers, and caring from many of their circle who could actually be sending supportive energy and perhaps adds to the layer of shame surrounding babies who are “different” or in poor health.
  4. Don’t focus on bonding. Especially if there was an unexpected emergency and/or cesarean birth, or the baby is separated in an ICU, bonding can be difficult at first. Well-meaning doulas or friends may get insistent about the urgency of the mother’s and baby’s need to bond and be together. Bonding will happen. Don’t stress out the already devastated parents about this. Strengthen the mother physically. Visit the baby every day. Take turns. Send it so much love, in meditation and in person, and encourage others to do so, as well. Light candles. Pray. Make art and music, tape the mother’s voice talking to the baby and take it to where the baby is. Remember, babies are still in the delta brain wave state predominantly for the first two years of life; this means they are in a very expanded, receptive state of consciousness and all of your well wishes are being received by them. Send the baby your love, not your fear. Remind it how very welcome (s)he is.
  5. Have gratitude. This may be hard at first but gradually, as parents, we come to accept and honor what is. This is what is. This is who our baby is. One day at a time. A child is not a problem to be solved. There may be many problems ahead that will seek resolution, but they are the problems, not your child. One’s child, as Khalil Gibran said in his book The Prophet, is not one’s own (1923). They, all of us, are life’s longing for itself, love incarnate, here to learn how to best realize and express this. There are as many ways to do this as there are people on the planet. Thank you for being here, each and every one of you.


  • England, Pam, and Rob Horowitz. 1998. Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation. Partera Press.
  • Gibran, Khalil. 1923. The Prophet. New York: Alfred A. Knopf.

About Author: Alison Bastien

Alison Bastien, CPM, (previously Alison Parra) was an independent homebirth midwife in Mexico for 12 years. She now teaches classes in midwifery, childbirth education and herbalism, and together with her family runs a natural products dispensary and store. She has lived in Mexico over 30 years, and was one of the founders of the MANA Mexican region.

You can see Alison’s herb work at www.Lavictoriana.com.

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