Inside a woman's trauma of losing her baby at birth

The hospital room was ready to celebrate new life: flowers waiting, tiny beautiful blankets and clothes neatly folded beside the bed. But when the moment came, joy turned into heartbreak and unforgettable memories. For some mothers and fathers, childbirth is the moment their world shatters.

For nine months, Valerie Akinyi* dreamed of the moment she would finally hold her baby in her arms. She imagined the first cry, tiny fingers wrapped around hers, the little feet that had been kicking inside her, and kissing that soft, beautiful face.

But the journey to welcoming this new life ended not with a baby’s first cry, but with silence. Baby loss, whether during pregnancy, delivery or shortly after birth, leaves behind silence and stories that words often struggle to hold.

When the day came, after all she had endured through her pregnancy journey — emotional distress, physical exhaustion and psychological strain — Akinyi was very hopeful.

“I had loved this baby since conception. Everyone was happy when they heard the good news and, and when I say everyone, I mean those who mattered to me. They were eagerly waiting to bring gifts and hold the baby,” she says.

For her, the labour pain that is often talked about did not scare her; she was psychologically prepared. For more than eight hours, she laboured.

“It was around 2am when things took a different turn. I was helpless and I remember calling my doctor to help me. After minutes of pushing with the help of the medical team, the baby came out. I heard the nurse asking the doctor to help, saying the shoulders were stuck. I only remember the doctor placing the baby on my chest. This was the best feeling ever,” she narrates, tears in her eyes.

She says the nurses carried out the procedures on the mother immediately after delivery. Shortly after, they joined the doctor at the table where her baby was. Her heart raced as she wondered why her baby had not cried, yet the babies of women who had given birth hours before her had cried immediately.

“After some minutes, the doctor stood beside my bed, sweat rolling down his face. In a low tone, he said, ‘I know you are waiting for your baby’s first cry, but unfortunately, we are sorry. We have tried resuscitation but all has been in vain.’ This statement will live with me forever,” she says.

She recalls that the delivery room was quiet for about five minutes, all eyes on her. At first, she thought she was not herself — perhaps because of the trauma she had undergone — or that she had imagined what she heard, as she struggled to process the information.

“I was helpless, traumatised, blood all over the delivery bed and drips hanging from both hands, my body shaking non-stop. I looked at my baby from a distance. I requested the nurse to bring him to me so I could hold him. I wished he could just breathe once for me. I spoke to him from my heart, I asked him to open his eyes for mummy, but he refused,” she remembers.

“For the two days that I was admitted, I requested the nurse to clean and dress him up, and she honoured my request. I slept with him in my arms, hoping that God would restore his breath. I remembered in the Bible when God resurrected Elijah four days after he was buried, hoping He would do it for me too, but He did not,” she emotionally narrates.

“When I lost him, part of me was taken away. Many questions and blame linger, but I believe with support from my loved ones and my psychologist, I will come out strong. I am not just a mother, but a mother to an angel baby. My love for him will always and forever be there in every breath I take,” she says.

According to Dr Reginald Yang’, a medical officer currently pursuing a master’s degree in public health, healthcare providers at the frontline witness both the joys of childbirth as well as rare but devastating emergencies that can occur.

“In Kenya, every safe delivery is a success story for a family and for the health system. However, complications such as shoulder dystocia remind us that childbirth, while natural, can sometimes turn into a race against time. Raising awareness about these conditions is essential because understanding them helps families appreciate the importance of skilled birth attendance and well-prepared health facilities,” Dr Yang explains.

Shoulder dystocia is an obstetric emergency that occurs during delivery when the baby’s head has already been delivered, but one of the shoulders becomes stuck behind the mother’s pelvic bone. “Under normal circumstances, once the head is delivered, the baby’s shoulders rotate and pass smoothly through the birth canal. However, in shoulder dystocia, that rotation fails to occur properly and the shoulder becomes impacted. The baby’s body cannot be delivered easily and the umbilical cord may become compressed, which can interfere with the baby’s oxygen supply if the situation is not resolved quickly,” he states.

The condition occurs in approximately 0.2 to 3 per cent of vaginal deliveries worldwide, with similar estimates in Kenya.

While that percentage appears small, the impact is significant because it is an emergency requiring immediate and skilled intervention. He highlighted several factors that increase the risk of shoulder dystocia.

“One of the most important is foetal macrosomia, meaning a baby with a high birth weight, often above four kilogrammes. Mothers with diabetes during pregnancy, including gestational diabetes, are also at higher risk because their babies may develop broader shoulders relative to the head. Other risk factors include maternal obesity, prolonged labour — especially during the second stage — instrumental deliveries such as vacuum extraction, and a previous history of shoulder dystocia,” he states.

He emphasised that many cases occur in women with no identifiable risk factors, which is why every delivery must be attended by a skilled healthcare professional.

Yang’ says predicting shoulder dystocia before labour begins is very difficult. Even when risk factors are present, most women will still deliver normally without complications. Because of this unpredictability, obstetric care focuses heavily on preparedness rather than prediction.

“During delivery, healthcare providers watch closely for warning signs. One well-known sign is the ‘turtle sign’, where the baby’s head emerges but then retracts slightly back towards the mother’s body because the shoulders are stuck. Difficulty delivering the shoulders after the head has come out is another indicator,” he says.

Reducing the risk starts with good antenatal care. In Kenya, this includes early booking, screening for conditions like diabetes, monitoring foetal growth, and ensuring women deliver in facilities equipped to handle emergencies.

In certain situations, if the baby is estimated to be extremely large, doctors may recommend a caesarean delivery to prevent complications.

Management

“The first step is to call for additional help so that more trained personnel are present. One of the first manoeuvres used is the McRoberts manoeuvre, where the mother’s legs are flexed tightly towards her abdomen. This simple change in position can widen the pelvis and free the baby’s shoulder in many cases.

“At the same time, suprapubic pressure may be applied to push the baby’s shoulders downwards so that they can slip under the pelvic bone. If those measures are not successful, doctors and midwives may perform other techniques. These include rotating the baby’s shoulders internally, delivering the posterior arm first to reduce shoulder width, or repositioning the mother,” he says.

The key is to use a series of well-practised manoeuvres calmly and systematically. The first few minutes are extremely critical. Once the baby’s head has been delivered but the body remains stuck, oxygen supply can be compromised if delivery is delayed.

For this reason, obstetric teams are trained to respond rapidly while minimising injury to both mother and child.

Risks

“One of the most recognised complications in the baby is a brachial plexus injury, which affects the nerves controlling movement of the arm and shoulder. In many cases, this injury is temporary and improves with time and physiotherapy, but in some situations, it may lead to long-term weakness.

“Fractures of the clavicle or upper arm can also occur during delivery. In difficult situations, prolonged lack of oxygen can lead to brain injury, neonatal asphyxia, or death. Although these outcomes are rare, they are the reason shoulder dystocia is treated as a true emergency,” he explains.

For the mother, complications may include severe perineal tears, postpartum haemorrhage, and trauma to the birth canal. Physically, recovery can be challenging, and emotionally, the experience can be deeply distressing.

“In the most severe cases, stillbirth or neonatal death can occur when the body experiences prolonged oxygen deprivation during delayed delivery. These tragic outcomes highlight the need for rapid recognition and skilled intervention,” he says.

“Healthcare professionals are trained to handle shoulder dystocia through structured training programmes and simulation exercises,” Dr Yang’ notes.

He calls for strengthening emergency obstetric care, training more skilled birth attendants and improving referral networks across the country.

Yang’ says that when shoulder dystocia results in the loss of a baby, the emotional impact on parents can be profound. Families may experience grief, shock, guilt, anger and long-lasting psychological distress.

In Kenyan communities, where childbirth is deeply tied to family expectations and cultural significance, such losses can be particularly devastating.

The doctor says hospitals should provide compassionate communication, clear explanations about what happened, and access to psychological support or grief counselling. Bereavement services and follow-up care can help families begin the difficult process of healing.

The key message for expectant mothers is that regular antenatal care and delivering in a facility with skilled healthcare professionals significantly improves the safety of childbirth. Many complications can be managed effectively when trained teams and proper equipment are available.

Dr Yang adds that if a woman has experienced shoulder dystocia in a previous delivery, her next pregnancy should be monitored more closely due to the increased risk of recurrence. Doctors will carefully monitor foetal growth and maternal health throughout the pregnancy. In certain situations — especially if the previous case was severe or the current baby is estimated to be large — a caesarean section may be recommended to reduce the risk of recurrence.