Why you need to know about fetal kick counts - and how to do them
Plus a link to a helpful app that when used has been shown to decrease stillbirth rates. We love science that saves lives.
Sorry I got a little off of my Monday/Thursday posting schedule last week! I was recovering from an international trip and was feeling a little under the weather, but I’m back!
(Content warning: stillbirth)
Fetal kick counts refer to a method where a pregnant person monitors their baby’s movements over a specified time frame to ensure the baby is moving normally. The goal is to provide reassurance about your baby’s well-being, and to identify any potential problems that if left untreated could lead to a stillbirth.
Here’s an overview of how to perform fetal kick counts and why they are beneficial – with a website and app that help remind you to do these (note: I have no affiliation with them!).
The physiology behind it
Human activity levels are highly responsive to oxygen levels and blood acidity. A decrease in oxygen or an increase in blood acidity can affect heart rate and reduce movement. What does the mean for a fetus?? One example is if their umbilical cord gets squished (which can sometimes happen in cases of very low amniotic fluid, for example), this would limit the amount of oxygen getting to their brain. This in turn could decrease the baby’s movements, which you’d notice if you were monitoring your baby’s movement during this time. This would be a sign to call your provider and be seen to see if your baby is OK, or further testing – or even delivery – might be needed.
Key point: The good news is that the first sign of reduced oxygen supply to a fetus is decreased activity, which can occur days before a critical issue arises, allowing time for evaluation and intervention.
How do I do it??
There are various ways to track fetal movements, with different guidelines available. A commonly used method is to start daily monitoring at 28 weeks of pregnancy. The aim is to feel 10 movements within a 2-hour window each day. If 10 movements are detected sooner, counting can stop. If 2 hours pass without feeling 10 movements, it’s important to contact a healthcare provider for further assessment.
I do want to stress that this is but one method, and you know your baby best – so if something feels off or different even if you are hitting these numbers – it’s OK to let your doc or midwife know!
How do I remember?
One app that has some FANTASTIC research behind it is called Count the Kicks. They have both a great website and app that can help you remember to track your baby’s movements and see how things may be changing over time. This app led to decreased rates of stillbirth in Iowa and Norway when they were used in study populations. Definitely check them out!
What if I don’t feel my baby move as much as I should?
If decreased movement is noticed during a monitoring period, it’s often recommended to lie on your side, as this position can result in more noticeable movements. We also usually recommend going in a quiet room with no distractions (not even scrolling TikTok!) so you don’t miss movements you might otherwise not notice. Some suggest drinking water or juice to stimulate the baby, although evidence supporting this is limited.
If movements remain reduced despite trying these things, further testing with an ultrasound or monitoring in a clinical setting is usually the next step to ensure the baby’s well-being. This means your doctor or midwife will recommend you come into the office or Labor and Delivery to get monitored and checked out.
On average, pregnant people don’t physically feel all fetal movements that we can detect via ultrasound – it can be understandably hard to notice small movements like hands waving! Factors such as having an anterior placenta, excess amniotic fluid, or carrying extra weight in your midsection can also make it harder to feel your baby flipping around.
What are the downsides of doing kick counts?
There are some drawbacks to fetal kick counts. Starting too early can sometimes cause unnecessary anxiety. While babies may have active days before 28 weeks, movements are often inconsistent, making formal counts less reliable at this age. Additionally, abnormal kick counts frequently lead to further testing and interventions, which can cause additional stress, even if no issues are found. Nevertheless, any concerns about reduced movement should always be reported to a healthcare provider.
Take home message: you know your baby best! If you are worried your baby isn’t moving as actively as they have been, don’t hesitate to contact your provider or be seen on Labor and Delivery! We’d much rather see you and ensure all is well than have you sit at home and worry…or miss something potentially preventable.
Until next time,
Dr. Jen