Meskhenet was a goddess who presided at child birth. In her form of a tile terminating in a female head (called in the Book of the Dead "cubit-with-head") she represents one of the bricks upon which women in ancient Egypt took a squatting position to give birth. Her presence near the scales in the hall of the Two Truths, where the dead person's heart is examined and weighed to ascertain suitability for the Egyptian paradise, is there to assist at a symbolic rebirth in the Afterlife. Her symbol of two loops at the top of a vertical stroke has been shown to be the bocornuate uterus of a heifer.

In addition to ensuring the safe delivery of a child from the womb, Meskhenet takes a decision on its destiny at the time of birth. In the Papyrus Westcar the goddess helps at the birth of the future first three kings of the 5th Dynasty. On the arrival of Userkaf, Sahure and Neferirkare into the arms of Isis, she approaches each child and assures it of kingship. Similarly she is the force of destiny that assigns to a scribe promotion among the administrators of Egypt.

A hymn in the temple of Esna refers to four "Meskhenets" at the side of the creator god Khnum, whose purpose is to repel evil by their incantations.