Trish: [00:00:00] My name is Trish Ware and I am obsessed with all things pregnancy and birth and helping you to navigate with the practical and the magical seasons of this journey called motherhood. I'm an all day coffee sippin mama of seven. I've had the amazing privilege of delivering many babies. In my 15 plus year career as a labor and delivery nurse, and as a mama of seven, I'm here to help you take the guesswork out of childbirth so you can make the choices that are right for you and your baby.

Quick note, this podcast is for educational purposes only and does not replace your medical advice. Check out our full disclaimer at the bottom of the show notes.

Hello. We are going to be talking about fetal kick counts today, [00:01:00] okay? I have a download for you guys, which is my fetal kick count tracker, and you don't have to print it. In fact, I wouldn't print it. You can put it on Notion. You can put it on GoodNotes.

and just, use your finger, your pen and check it off.. Sammy is 30 weeks Saturday. Hi from India. I don't know if you guys know, but I have a daughter who is adopted from India. Hello, I'm from New York. My name is Daira. Hi Daira. And Amy is from the Bay Area. My favorite place ever.

I love it. It's one of my favorite places to work as a labor nurse. My very first travel assignment was in Hayward and then I worked at Kaiser San Francisco and I came back to that area several times. I absolutely love that area. This is Nixamar from Orlando.

70 weeks today, fourth baby. [00:02:00] Just so you know, I am born and raised Florida girl, living in Knoxville, but I am obsessed with Disney. I still have my annual passes. My baby is not sleeping well. He's two months old, sleeping only seven hours a day. Is it normal? That sounds good to me, but it's been a while since I've had a newborn.

I wish I had Ashley on here. One of my team doulas is training to be a postpartum doula if you guys respond, if you write kick, reply kick, like comment kick, and you're going to be able to get this for free.

Otherwise, go to, labor nurse mama. com. forward slash kick if you just reply to this with the word kick, you're going to get it for free.

Okay.. So this mama here. Porta or Lisa is 13 weeks. Janice, 25 weeks pregnant. Hi, from Chicago. I have traveled everywhere. I lived in Chicago for 10 months with [00:03:00] my newborn.

24 weeks tomorrow. Oh my gosh, Jenny, goodness. Crystal from Riverview, Florida, 31 weeks. Welcome, crystal. Florida Girl. Two, and we've got Boston 31 weeks. My due date is June 20. Third, having a girl. Oh, Alexis, that's awesome. Hi, Liz from Kansas. 30 weeks. Hi from Belfast. 21 weeks pregnant baby girl. We went to Belfast two years ago.

No, three years ago. Gosh, so much fun. 30 weeks Saturday. Also, baby number two, Brittany or Brit. Hi from Nicole from San Antonio. First baby, 23 weeks. Casey is 29 weeks with twins. One of my doulas is a twin mama. So we are the right place for you to hang out. 21 weeks, first time mom from Orlando. Another one.

Let's see, Vera is 35 weeks and five days. Oh, Janice from Malaysia. [00:04:00] I was just having the fetal movement conversation because my baby girl mainly moves in the AM. So we'll talk about that. 20 weeks with Baby Girl from New York, baby number two, and it's a baby girl. I have a four year old boy. Oh, so exciting.

Okay, I love connecting with you guys, but let me go ahead and get to the class. That way, if you guys are on lunch break or you don't have much time, I know how y'all are. You're gonna drop off like flies.. So let me pull up my notes. Again, if you want to get the worksheet with the tracker, I personally would download it to your phone or your tablet, put it on GoodNotes or Notion, and then use it from there.

And then you have it for all the babies if you're having more babies. So we're going to talk about understanding fetal kick counts. And the very first thing I want to do is I say kick counts because that's what you guys know about it, but on your sheet it's going to say [00:05:00] fetal movement counts.

I don't know how it got reduced to kick counts, but I want you guys to hear me when I say it's actually fetal movement counts and all movements count. as a movement. So you could have big movements or small movements.

You could have kicks, you could have punches, you could have rolls. The one thing that does not count is a hiccup, and I'll tell you why in just a little bit. So fetal kick counts or movement, fetal movement counts are just a simple but effective way to monitor your baby's oxygenation. So like how well are they doing in their house?

And the thing that tells us is, are they getting enough? oxygen, because a baby who is lacking oxygen is not going to move. And I want you guys to put that in perspective. Have you ever been to I'm a Florida girl, and I went to Colorado for my first year anniversary with Steve, [00:06:00] and neither one of us could catch our breath.

We could not breathe. That made it really hard to walk up the four flights of stairs, because this one right here booked. a beautiful condo, four stories up with no elevator. I never even thought about checking because doesn't everything have an elevator? In the US, maybe not Europe, but here we need our elevators.

We're lazy. But in Colorado, my husband is 6'4 6'5 very big guy. He has asthma already. And we were having a really hard time catching our breath, which gave us no energy to walk up the damn stairs. I want you to think about that. Things that restrict your baby from getting enough oxygen could be something to do with the placenta or the cord, because that's how they get it.

And there's other things as well, but typically it's a cord issue or a placental issue. So the best way for us to know that your [00:07:00] baby is healthy and in a state of well being is that the baby is moving. And that's going to tell us your baby is getting enough oxygen. So this is another reason why at the end of pregnancy, we do some specific testing.

And if you come in because of decreased movement, we're going to do type of testing that I'm going to tell you about in a second. So the idea is that an active baby is generally a healthy baby. A decrease in activity does not mean your baby is not healthy, but it could mean that there's a sign of a potential issue.

So I don't want you guys to ever freak out, but I do want you to always take this seriously, always respond. If I can tell you there's one thing that labor and delivery will never, ever make you feel bad about, it's coming in for a fetal well being check. If you are concerned, come in. We want to see [00:08:00] you.

We want to put you on the monitor and say, Oh, baby's fine. That's what we want. We don't want the opposite, but acting quick can save your baby's life. So I don't want to scare you guys, but I do want you guys to understand that this is something that's so important. So fetal kit counts became standard in this OB world in the 1970s.

And it was Dr. Leopold, something like that. And the studies that Dr. Leopold did showed the importance of fetal movement connected to fetal well being. So that's why you're taught that. Now they're crucial as well because it can be an early sign of fetal distress. Usually, what we recommend is that you're doing these regularly once you hit 28 weeks because studies have shown that counting fetal movements, this [00:09:00] is huge you guys, okay, so perk up right now.

Counting fetal movements can reduce the chance of stillbirth by 30%. Real life stories in my practice over 16 years confirm that to me, okay? Because if we can catch it early, like a court accident or something going wrong early, we can save your baby. So that's why we tell you to come in if there's decreased fetal movement or no fetal movement.

So as soon as you start noticing that the baby is not moving as much, you need to perk up and you need to check on the baby, whether that's coming to us. And again, if We're not going to fault you for that. We want to know your baby is okay too, if that makes sense

I had a patient who came in Texas, and She came in because the baby wasn't moving, and [00:10:00] she had been noticing that for a week. We couldn't see, the baby was already, had already passed. Had she come in at the beginning of the week, that would have been a different story. So this is why I'm telling you guys, because I had a patient, in South Florida when I was working in South Florida, who she was not one of our patients at the hospital I was at, but she was out and she realized she had not been feeling the baby move and she was so apologetic when she got to the, to triage.

I was in triage that day. She was so apologetic.. I know the baby's probably fine, but the baby has not been moving. And the baby's very predictable, super active in the morning. And I have not felt the baby move since the middle of the night. And we were like, you know what?

Let us just get you on the monitor. Everything's probably fine. We got her on the monitor. The baby was having a massive decel. We did an emergency suction and saved that baby. If she [00:11:00] had waited even hours, We would have lost that baby. This is why I'm going to say it until I'm blue in the face. I don't care.

We want you to be wrong. We want you to come in because you're wrong. But go in. Never sit on this. Ever. When do you start doing kick counts? Because this is important. You don't start doing kick counts right when you start feeling movement. Most providers recommend 27 to 28 weeks pregnancy is when your baby's movements are going to get consistent and more noticeable.

Now, that's a little different for my mamas who have an anterior placenta. So if you have an anterior placenta, chances are that you're not feeling as much movement, but you're still feeling some movement. That's a pattern for your baby. So that's what's important. It's not what Susie Down the Street's baby is doing, or your mom's baby, you did.

It's what your baby's pattern is. So for instance, when I was pregnant with my first, Ian, [00:12:00] that kid was like a disco dancer from about eight at night until five in the morning. But during the day, the kid was like not as active. So why you want to do this every day and do it during the active time is that you're going to notice, you want to do it at the same time every day and it doesn't necessarily, like I didn't do it at two in the morning, but you want to do it during the same time of day so you can start recognizing if the baby is moving according to that baby's pattern.

Movements, again, get more consistent, more noticeable around 27 to 28 weeks. You want to count at the same time every day. Ideally, best case scenario is when your baby is most active, unless it's 3 in the morning. And the best time to do it, usually, typically, is after meals or in the evening. If you wait about 30 minutes after eating, that's usually when your baby is most [00:13:00] active because they've gotten the fuel from your food.

So here are some tips for your routine. You want to find a quiet, comfortable place to sit or lay down like a requiner or a couch or the bed. You want to pay attention. to the patterns and the changes by really engaging and like paying attention.

So maybe this is a time when you just have peace and quiet. You're away from Instagram. You're not following LaborNurseMama at that time. Okay, so here's how you do it. I have a guide for you, but you're going to choose the time, same time every day, time when baby is active and you're going to preferably be laying down.

You can do it like in a chair, reclining somewhat. The best way to do it is on your left side because that's where they get the most oxygenation and you're going to focus on all the movements. So that would be kicks, rolls, flutters. But [00:14:00] again, not hiccups. The reason you don't pay attention to hiccups is because hiccups can also be a neurological response, so it doesn't necessarily mean that the baby has good oxygenation.

So hiccups do not count. You want to do this until you feel 10 movements, whether it's 10 rolls, 10 flutters, 10 movements. if you're not feeling fetal movement yet, and you're not past 27, 28 weeks, you may not understand exactly what I'm talking about because you haven't gotten used to it, but you will.

I promise most babies make 10 movements within a 30 minute period. If the baby is in a sleep cycle, they may not move as muchif 30 minutes go by and you haven't felt movement and you're feeling a little flutter of fear, drink some orange juice, drink something that has a lot of sugar in it, unless you're GDM.

And then if you still haven't felt 10 movements [00:15:00] within the two hour period, you have a choice. So most providers will tell you to wait a little, drink something with sugar, and then do it again. If your baby has not moved in two hours, I would be getting my butt in.

I would be getting checked. I would not wait. If you felt movements, but you didn't feel 10 movements, then maybe drink some more juice, lay down and do it again. But I'm always going to tell you guys, err on the side of caution. Call your doctor, at least ask them. Because I can tell you, having been a labor and delivery nurse for 16 years, that if you call in and tell us that the baby is not moving as much as normal, we're going to tell you to come in.

That's our preference. So again, if the baby is not moving, your first line of defense would be, and I personally, if you don't feel any movement within 30 minutes, [00:16:00] don't wait two hours, do these things. Drink something cold and sweet, change your position focus, put down your phone, have your partner stop talking to you, distraction free, absolutely concentrate on the baby.

And it's really important as you're tracking it on the tracker, again, you can reply with the word kick and you'll get this for free. As you're tracking this, you're going to start seeing a pattern of when the baby is most active. So keeping the record will tell you if there's a significant change.

If you start seeing a significant change, please let your provider know because that could be a red flag, especially if it's suddenly. So if you've tried all those things, again, contact your doctor. I personally, I even with Grayson, I'm a freaking labor nurse. I've been a labor nurse for over a year. 10 years at that point and I still went in and I, baby was fine, thank God.

So when you [00:17:00] call, be clear and Say to your provider or whoever's answering, I'm this many weeks and I've noticed a significant decrease in baby's movement or no movement at all. Tell them you've already tried a kick count and you're not reaching 10 movements and ask if you can be seen. More than likely, no matter how you word it, your provider's going to want to see you.

Now if you call in your 24 weeks, 26 weeks, probably not. Okay, so let's sum it all up. I want to try to keep this nice and quick for you guys. Fetal kick counts or fetal movement counts is a very simple, easy way, non invasive way to monitor your baby's well being, your baby's health. You want to start around 28 weeks.

You want to aim for 10 movements within a two hour period. Most babies do that within 30 minutes. And don't ever hesitate to call to be seen. I don't care. If you [00:18:00] call four times in a row and come in. We do not mess around with this. Hopefully you found this helpful.

Share it with someone who is pregnant, because I cannot tell you this is the number one way you guys can pay attention to how your little one is doing.