While the Sims series has its fair share of realism, as well as its own spins on realistic topics or events, one thing that it keeps as simple as possible is pregnancy and childbirth. If you’re one to want your game as realistic as possible, or if you just want to be more involved when your sims decide to expand their family, Pandasama’s Sims 4 Realistic Childbirth Mod has you covered!
Pandasama, the creator of the Realistic Childbirth Mod, has three new features to add even more realism to your Sims 4 gameplay; Pregnant sims and their partners can attend Llamaze Class, babies can now be born prematurely and enter the NICU, your sims can now attend and graduate Nursing School!
Trigger Warning: Talks of Pregnancy Complications, Neonatal Illness, Premature Labor in Virtual Surrounding
The Sims 4 Realistic Childbirth Mod Walkthrough: 2025 Updates and Features
What is the Realistic Childbirth Mod?
The Realistic Childbirth mod by Pandasama is a multi-feature mod that has the overall goal of making pregnancy in the Sims 4 align more with real life, as well as to make it feel more involved for the player. It adds new gameplay features, animations, and moodlets to take your sims through every exciting and terrifying aspect of pregnancy and childbirth.
Outside of the new features, the mod also includes a new animation for pregnancy tests and sharing the news with your sims’ partner. Your sim and their partner can attend pregnancy checkups, receive ultrasounds, take naps together, play music for their baby, and so much more! It also adds detail by allowing for labor progression in both home and hospital births including natural births, water births, cesarean sections, and even unassisted births!
If you’re new to installing mods, take a look at our beginner’s guide to modding The Sims 4!
Set-Up for the Mod
For all the features of this mod to work properly, it is recommended to travel to the hospital for a check-up or for the birth itself and use the cheat bb.enablefreebuild to edit the hospital lot. You can either manually edit these yourself and place down the additional objects, found by searching “Pandasama” in Build/Buy mode, or you can download a hospital off the gallery where many users have uploaded edited versions under the tag #Pandasama (Make sure to checkmark “includes custom content” when searching so hospitals uploaded with the objects placed show up!)
I personally chose Lissaa85’s Willow Creek Hospital.
(Note: If you are planning for your Sim to have a baby in the NICU, make sure that no other bassinets are on the hospital lot besides the incubator provided by Pandasama. It functions as a bassinet, so it needs to be only option available for the baby(ies) to spawn in.)
While this is not required, many of these experiences and animations can be improved by having a partner attend them with your sim. Make sure to ask a sim to accompany your pregnant sim to childbirth! It is found under the “Friendly” category, specifically under “Deep Thoughts”. These do not have to be romantic partners, just someone your sim is good friends with.
How To Attend a Llamaze Class
A Llamaze class provides your sim with confidence and preparation prior to them or their partner going into labor. To attend a llamaze class, go under the “Home” app on the phone and choose to “Go to Llamaze Class”.
Once your sim arrives at the hospital, either place or find where the Llamaze Table is placed. Make sure to place enough chairs for Sims to sit down during the class, although Sims may sit on the ground either way.
You must pay §100 to hire the Llamaze instructor, and once they arrive, wait for them to stand next to the board and click “Start Class”. If your sim doesn’t autonomously join once the class begins, click on the Instructor to “Join Class”.
Your sims can socialize with others while listening to the class. Once they’ve completed the class, they will receive a mood-bosting moodlet and they may also receive a book on parenting that will boost their parenting skill!
NICU Gameplay
Your sims can now give birth early, either by choice or by chance. When they do give birth early, you will either travel to the hospital manually or be given a pop-up to automatically do so, dependent on the situation.
During Pregnancy
If your sim goes to the hospital when after discovering their pregnancy to receive an ultrasound and discover that they are having twins or triplets, they will be told that they can opt for an early induction.
Early Induction
If your sim chooses to go through with an early induction, they can use the “Call Obstetrician” function to travel to the hospital alone or with a Sim of their choosing.
Once your sim arrives at the hospital, click on a hospital bed to receive an epidural from a doctor of your choice. It may take a few tries, but your sim must have an in-place and working epidural to get the C-Section. If it does not place correctly and they receive an uncomfortable moodlet, click on the bed again and have the doctor replace it.
Once your sim has it placed correctly, you can click on the surgery machine and select the doctor you would like to perform the C-section. After that, your sim will join the doctor at the machine to get the procedure done; If their partner or the accompanying sim is present on the lot, they will likely join as well and sit on a stool next to the table.
Pregnancy Complications
The mod introduces two specific pregnancy complications that lead to preterm labor; PPROM (Preterm Premature Rupture of Membranes) and Placental Rupture that can both trigger premature labor if your sim is in the second or third trimester. If your sim is in the first trimester, both can be detected by ultrasound during a hospital check-up and treated.
If your sim experiences a pregnancy complication, they will immediately get a pop-up notification informing you and recommending you go to the hospital. There is currently no harm if you choose not to go to the hospital. You can also trigger them by shift-clicking on your sim, using the “Childbirth Settings”, and selecting one of the complications under “Pregnancy Complications”.
Once your sim arrives at the hospital, you will need to select a doctor to get checked out, and then it will progress as a standard C-section. This will require your sim get a properly placed epidural, and then click on the surgery machine to proceed with the C-section.
NICU Newborns
NICU Conditions and Health Statuses
Once your baby is in an incubator bassinet, make sure you stay at the hospital, otherwise the baby will be kicked back home and cannot return.
The health condition of the baby will be visible in the form of outlines; Red is critical, yellow is stable, and the standard white outline is healthy. Your sims interactions with their baby will be limited or expanded by the baby’s current status and specific condition.
Your baby can have one of three conditions, which they can recover from all of them on their own, but they do recover quicker when given treatments for these conditions.
Pneumothorax – This is a collapsed lung. Babies with this condition must be treated with an oxygen hood, placed via the “NICU” interactions menu when clicking on their bassinet.
Anemia – This when someone lacks iron in their blood. Babies with this condition are treated by tube feeding with iron-enriched formula or breastmilk. You can pump breast milk or make formula, and then use the iron drops to add iron. Use the “NICU” interactions menu when clicking on the bassinet to tube feed.
Jaundice – This is when a baby is born with yellowed skin or eyes, often due to an underactive liver. This can be treated with bili lights, which can be placed similarly to an oxygen hood by clicking on the bassinet.
Incubator Interactions
For most interactions, a dining or desk chair must be placed next to the incubator. It will have a slot available for one.
Your sim has multiple adorable interactions with their baby, which can be limited if the baby is not in stable condition. For babies who are in critical condition, their parents or visitors may bond with them, sing to them, or tube feed them through the incubator. Once they’re stronger, they can be held gently.
Nursing School Gameplay
Your sims can now go through a nursing school program, allowing them to learn the ins and outs of the medical system with graduation and a bonus in the Doctor career at the end!
How to join Nursing School
To join nursing school, go under the “Job” app on the phone and click to Join Nursing School, which costs §30,000. Your sim will immediately receive a job as a First Year Nursing Student and receive three textbooks, allowing them to study and boost the new Nursing skill.
Years 1-2
In your Sim’s first year of nursing school, they will primarily be studying and attending classes. The textbook they’ll be reading is given to you upon joining, and is called “The Fundamentals of Nursing”. This is a slower portion of the career, and is primarily just studying and attending class.
However, once your sim is “promoted” to a second year nursing student, they get some more interactions. They now get to practice inserting IVs on fruit! Any fruit will do; You can grow it, buy it from a shop, or just buy it in a packet of seeds.
Year 3
Year 3 is where your sims have to really buckle down and get serious if they want to pass and upgrade to being a fourth year student. In between their classes, they need to study from their note binder. To know if your sim is prepared for the exam, watch for the “Ready to Ace it” Confident moodlet, and then click on your sim to send them to take their exam.
However, if your sim doesn’t study for enough to receive this moodlet prior to taking their exam, they have a high chance of failing it. Thankfully, this just means they have to study more and retake when they get a chance. One way to make this easier is to have them study while Inspired, or have another sim help them with studying. This will cut the time required in half.
Once they pass their exam, they’ll move on to their final year as a nursing student!
Year 4
The final year of nursing school is an active career, where your sim goes to the hospital to take care of patients and handle administrative work. The shifts are much shorter than a standard hospital shift, although you can choose to stay late. Your sims receive a single task at a time which can range from mopping puddles to collecting blood or urine samples from patients to entering patient data on the computer.
Graduation
Finally! Your sim has worked their way through their program and are now free to pursue higher ambitions. Although there is no nursing career, once your sim has graduated after attending an active shift at least five time, they can enter the doctor career with a boost to Level 4: Medical Assistant with increased pay!
Is realism something you strive for in your Sims gameplay, or do you prefer the Sims’ original spins on real world experiences?
We have several other guides on The Sims 4 Realistic Childbirth Mod available. Check out our Mod release guide to learn all the essential features, the Home Birth Update and other features added by the end of 2023.
