Nothing, they get their oxygen supply through the umbilical cord attached to the placenta attached to the mother’s uterine wall. The mother and child essentially share a blood exchange.
Babies’ lungs *are* filled with amniotic fluid when they’re born. That’s why they’re often held upside and patted on the back. The first crying jag they experience is them spewing out the fluid. In modern medicine, suction is employed to remove some of it through their mouth so they don’t drown.
Birth is painful for the child as well as the mother.
Babies “breathe” in utero to prepare their muscles for breathing air. They are inhaling and exhaling amniotic fluid. The higher viscosity of the fluid causes their muscles to develop more rapidly, just like swimming would make you build muscle tone more than swinging your arms around with no weights or resistance. Their oxygen comes from their mother’s bloodstream. They even get the hiccups.
Fun sidebar from emergency childbirth classes: if, when you deliver the child, they don’t start breathing on their own, one of the advised initial techniques is to blow on their face. The thinking being this remind/shocks the body into taking a breath.
Never had to try that technique myself and not sure how evidence-based it is, but I’ve seen and heard it a few times since then from healthcare colleagues.
The lungs are filled with amniotic fluid, and there is no distress from it. When the baby is being born, between the head being delivered, and the restitution of the head and shoulders, the chest gets a really good squeeze, which usually forces lots of the fluid out, and prepares the lungs to start gas exchange.
My second child was born via c section and ended up needing a stay in the NICU because of this. When babies are delivered vaginally, the pressure from passing through the birth canal can help squeeze some of the fluid out of the lungs, but c section babies don’t have that benefit. My child ended up developing pneumonia because too much fluid remained in his lungs after birth and he needed a 10-day regimen of antibiotics to cure him.
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