The term “fetal kick counts” refers to a pregnant woman consciously monitoring her baby’s movements, usually over a specific period of time, to determine whether or not her baby is moving normally or not. This is done to reassure the mother and her obstetrics provider that her baby is doing well in utero.
For humans, our level of activity is very sensitive to our oxygen level, as well as the acidity of our blood. That means that if we are deprived of oxygen or our blood becomes too acidic, our heart rate will be affected and we will move less. How does this apply to a fetus? For example, if a baby’s umbilical cord is kinked for a prolonged period of time, this would deprive the baby of oxygen and result in decreased movement.
Fetal kick counts monitor a baby’s movements and let us know that, in theory, a baby is doing well in the uterus and getting the oxygen he or she needs, free of stress. Oftentimes, if there is a problem with the amount of oxygen getting to a fetus, the first sign will be decreased fetal movements. Luckily, this can often precede fetal death by a few days, giving time for evaluation based on decreased movements.
There are many ways to monitor fetal movements. One commonly used technique is monitoring fetal movements daily starting at 28 weeks of pregnancy. Each day, a pregnant woman should aim to feel 10 movements in two hours. If she reaches 10 movements before two hours, she can stop counting. However, if two hours have passed without 10 movements, she needs to alert her doctor or midwife for further evaluation.
If decreased movement is noted, a woman may be told to be sure to lay on her left side, as this position has been shown to correlate with the most perceived movements. Women are often told to drink some water or juice as this may help “wake the baby up,” but there is no data to support this.
If movement is still decreased, further testing by ultrasound or monitoring on labor and delivery or in the office is usually the next step to check on the baby. Interestingly, on average, pregnant women only notice about 75 percent of all fetal movements (and this doesn’t include small movements like opening and closing hands). Certain scenarios may make this number even less: having an anterior placenta, having a large amount of amniotic fluid, taking sedating medications, or maternal obesity all can make feeling fetal movements more challenging.
There are some drawbacks to fetal kick counts. First, starting too early can lead to increased anxiety. While you may notice days where your baby is more active before 28 weeks, in general it is not recommended to do official counts until after 28 weeks as the movements can be inconsistent until then. Additionally, many abnormal fetal kick counts are followed up and no problems are identified. This can lead to additional testing, intervention, and worry. However, you should still report any abnormalities to your doctor or midwife just to be certain.
- The American Congress of Obstetricians and Gynecologists
- PB#9: Antepartum fetal surveillance
Gabbe SG et al
- Obstetrics: Normal and Problem Pregnancies
- Antepartum Fetal Evaluation.
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