Childbirth: When NICU becomes an agonising wait of anxiety, prayers and fragile hope

Mary Waithira Paul has gone through the NICU journey with her two babies.[ Sylvia Wakhisi]

When Dr. Laura Munyazi Mwangi went for an ultrasound at about 25 weeks of pregnancy, she expected reassurance that her unborn baby was growing well.

Instead, she received news that would turn the final weeks of her pregnancy into a race against time.

Doctors found that Laura had very little amniotic fluid and that her baby was severely growth-restricted. Further tests revealed placental insufficiency, meaning the placenta was no longer supplying the baby with enough oxygen and nutrients. They also detected reversed blood flow, a warning that the baby was struggling to survive inside the womb.

From then on, the pregnancy became a delicate balance of monitoring, prayer, and hope that the baby could remain in the womb for as long as possible.

“On 17th March, at 28 weeks, the CTG (cardiotocography) showed that the baby was having decelerations. She was no longer coping well inside me. I underwent an emergency Caesarean section, and Zoe Neema was born weighing only 550 grams,” says Laura.

Zoe was not only extremely premature but also had severe intrauterine growth restriction (IUGR) caused by placental insufficiency. Her weight dropped to about 510 grams after birth, meaning doctors were dealing with an extremely tiny baby whose organs were still immature.

She was immediately admitted to the Neonatal Intensive Care Unit (NICU).

As NICU Awareness Month comes to an end this September, stories such as Laura and Zoe’s offer a glimpse into the medical, emotional and psychological realities faced by families whose newborns require specialised care.

For Laura, the NICU was not simply a hospital ward. It became a place where fear, uncertainty, hope and resilience collided.

“Fear crept in. As a pharmacist, I understood enough medicine to know how serious the situation was. But at the same time, I was a mother. Those are two very different positions,” she says.

“The pharmacist in me understood terms like reversed end-diastolic flow, severe IUGR, and extreme prematurity. The mother in me was simply thinking, ‘Is my baby going to live?’”

Zoe’s 103-day stay in the NICU was marked by several frightening moments. She developed infections, experienced apnea, required blood transfusions and needed oxygen support.

Dr. Laura Munyazi Mwangi holds her baby Zoe while at the hospital at AIC Kijabe. Zoe was admitted at the hospitals NICU for 103 days.[ Sylvia Wakhisi]

One incident remains particularly vivid in Laura’s memory.

“One moment I will never forget happened during a bottle-feeding trial. Zoe choked and a Code Blue was called. As a mother, seeing medical personnel suddenly rush towards your child is terrifying,” she recalls.

Zoe required respiratory support, feeding through tubes, blood transfusions and treatment for infections. She also developed bronchopulmonary dysplasia (BPD), a chronic lung condition that can affect very premature babies.

“Oxygen became a major part of our journey, including after discharge. We also had liver issues which required monitoring and treatment,” Laura says.

She underwent eye examinations for retinopathy of prematurity, brain scans, blood tests, specialist reviews and continuous monitoring.

Yet amid the fear, small milestones became reasons to celebrate.

“Imagine watching a baby grow from 550 grams to just over two kilograms, gram by gram. In NICU, 20 grams can make your day,” Laura says.

Zoe was finally discharged from AIC Kijabe Hospital on June 27, 2025, weighing about 2.05 kilogrammes. Her chronological age is now 18 months while her corrected age is almost 16 months.

Laura credits the medical team, including neonatologist Dr. Grace, doctors, nurses, therapists, nutritionists and other staff, for helping her navigate the difficult journey.

“The doctors, nurses, therapists and all staff who interacted with us did much more than provide medical treatment. They extended compassion,” she says.

“The nurses were with Zoe day and night. They taught me how to handle her, how to participate in her care and eventually helped me gain the confidence to care for her myself.”

But leaving the NICU did not mean the end of the journey.

Laura says premature babies require continued follow-up for issues including growth, nutrition, development, hearing, eyesight and lung health.

“You leave the hospital grateful beyond words, but you also realise that you no longer have a nurse or doctor a few metres away. You become the one watching the breathing, the feeding and asking, ‘Is this normal?’ she says.

For Laura, faith also played an important role.

She says John 10:10 became particularly meaningful to her during the ordeal.

“I wasn't simply praying for Zoe to survive. I was praying for her to live and flourish. And when I look at her now, that scripture means something completely different to me,” she says.

Laura also wants society to understand the emotional burden carried by mothers whose babies are admitted to NICU.

“A mother with a baby in the NICU has already given birth,” she says.

“Sometimes people make statements such as, ‘At least you can rest because the nurses are taking care of the baby.’ Know that there is no rest. Your body has delivered a baby, but your arms are empty.”

Laura’s experience is echoed by Mary Waithira Paul, who has walked the NICU journey twice.

After waiting for 10 years to have a baby, Waithira gave birth to her daughter in February 2023 at 38 weeks. Her waters had broken early and, although the baby cried after birth, she did not have enough oxygen. Doctors also discovered that she had hypoglycaemia, or low blood sugar, and admitted her to NICU for observation.

With little knowledge about NICU, Waithira became anxious and feared losing her daughter.

“My girl refused to feed and she started getting weak. I was so frightened. At that time, my husband was unwell, hence I had to figure out how I would navigate this phase. Amidst all the fear, prayer became my source of strength,” she says.

Her daughter spent two weeks in NICU, requiring oxygen, regular blood sugar checks and phototherapy for jaundice. She also underwent several blood tests.

While some nurses were supportive, Waithira says her experience was emotionally difficult at times, particularly because she was a first-time mother.

“When it came to breastfeeding, it was another issue altogether but I thank God for one particular NICU nurse who taught me how to go about it,” she says.

The experience eventually forced her to quit her job because her daughter needed special care.

Her second child also spent time in NICU, although his stay lasted only two days because of bilirubin issues and jaundice.

Today, her children who are now aged three and a half years and 1 year 5 months old are growing well, but Waithira says the experience taught her the importance of emotional support for mothers with babies in NICU.

She urges families and communities to encourage such mothers, give them hope and stand by them throughout the journey.

According to Dr. Elizabeth Kuta, a consultant paediatrician and neonatologist, babies may require NICU admission for several reasons, including prematurity, particularly those born before 34 weeks of gestation.

Term babies can also require specialised neonatal care because of severe congenital abnormalities, infections, perinatal asphyxia or the need for surgery.

“Globally, one out of 10 babies are born premature. In Kenya, approximately 7.1 per cent and a good percentage of these babies require NICU care for a good chance at life,” says Dr. Kuta.

According to her, premature babies can develop a range of complications. In the first days of life, they may experience respiratory distress syndrome, anaemia, bleeding, congenital heart defects, brain haemorrhage, severe infections and kidney injury.

Later, they may develop necrotising enterocolitis or chronic lung disease and face an increased risk of developmental difficulties.

Kuta opines: “Kenya has made progress in specialised newborn care, equipment and training over the past decade, improving the care available to premature and critically ill babies. However, access to quality neonatal care remains uneven. The country still faces shortages of well-equipped neonatal units and specialised healthcare workers, particularly neonatal nurses and neonatologists.”

She further notes that initiatives supported by organisations including the Kenya Paediatric Association and ELMA Foundation have increased training opportunities, while Newborn Essential Solutions and Technologies (NEST360) supports training and equipment for newborn care.

Kuta emphasises that care begins before birth.

“Good antenatal care can help identify risks early, while antenatal steroids can help mature the lungs when preterm delivery is anticipated. After delivery, keeping the baby warm, providing breathing support promptly, early feeding and kangaroo mother care can significantly contribute to survival and recovery,” she explains.

Expressed breast milk is particularly important, she says, as it supports growth, protects the gut and helps reduce the risk of infection.

But survival is only part of the journey.

Premature babies require regular follow-up to identify developmental, respiratory, nutritional, hearing and eyesight concerns early.

Kuta also stresses the importance of supporting parents.

“Hospitals need to be supportive, empathetic and educate mums with babies in the NICU on the complications experienced alongside providing timely updates on the baby’s condition,” she says.

Psychological counselling and support groups can also help mothers cope with the emotional burden.

NICU care can be expensive because premature babies may remain in hospital for weeks or months, placing enormous financial pressure on families whose insurance coverage is limited.

For parents going through the experience, Kuta’s advice is simple: take the journey one day at a time.

“To every parent with a baby in the NICU: take heart. This journey can be frightening and exhausting, and it is okay to feel overwhelmed. Take it one day at a time. Journal and take advantage of all the support you can get. Ask questions to help you understand your baby’s condition,” she says.

For Laura and Waithira, the journey that began with frightening news has become a story of survival, faith and resilience.

Their babies’ time in the NICU may have started with uncertainty, but their journey also demonstrates what specialised neonatal care, parental determination, family support and compassion can mean to a fragile newborn fighting for life.

And for families still sitting beside incubators, counting grams and waiting for the next good news, every small milestone remains a reason to hope.