Fetal Kick Counting: Dr. Thomas Moore UC San Diego Health


now fetal movement county has been used

for decades and recommended for decades

and there have been many different

methods that have been tried some of

them have been shown to you some kind of

moderate benefit most of the studies

have not shown a benefit of fetal

movement counting in a regular way we

did a study a few years ago where we

compared the still birth rate after we

instituted a program of fetal movement

counting that is based on the physiology

of the mother and fetus and when we

compared that to the still birth rate

that occurred for the year prior to the

institution of formal fetal movement

counting there was a mark reduction in

stillbirth since then in San Diego

County and at UC San Diego

we have been doing fetal movement

counting for the last several decades

and UCSD has one of the lowest still

birth rates in the state according to

the state data so we have reason to

believe that it's worth the trouble to

do the it's based on the physiology that

babies are awake at night and they sleep

during the day now new parents are very

well aware of this but in fact inside

the mother the baby is frequently not

moving during the day and it's not

helpful to really be counting baby

movements during the day whereas at

night babies are very busy and we can

get some kind of fetal movement counting

done pretty quickly at that time

unfortunately counting fetal movements

from 24 to 28 weeks doesn't go very well

because mothers don't feel a majority of

the fetal movements beyond 28 weeks

however the mothers feel over 80% of the

movements that can be detected on

ultrasound while watching the baby so

doing fetal movement counting from 28

weeks on until the baby is born is

something that has been shown

scientifically to reduce stillbirth and

which is we think very easy and quick to

do so you've reached 28 weeks and it's

the last third of the pregnancy and it's

time to talk about fetal movement county

why do we talk about it because of the

problem still birth

stillbirth occurs in one in 300

pregnancies and it's something that we

don't want and that we think we can

actually significantly reduce or even

eliminate the reason we recommend doing

fetal movement counting is the baby slow

down their movements if they start to

get become ill or get into risk so we

use a very simple system

it's a count to ten system we just want

to know how long it takes to feel ten

movements we recommend you do it in the

evening hours because that's when your

baby's awake

and so you can get your fetal movements

as quickly as possible we recommend you

wait until the baby wakes up before you

start counting because even in the

evening the baby sleeps a little bit and

wakes up and does stuff and goes back to

sleep so wait until the baby starts

moving and count to ten

this mother felt the baby move at ten

minutes to seven and said well I have

some time now I'm gonna pay attention

and she count to ten when she got to the

tenth movement she stopped and that

happened to take thirty-eight minutes

she wrote the time down on the card so

in 38 minutes is a good number but

actually the average number of minutes

to field ten movements is eleven and

that means half of women get there ten

movements in less than eleven maybe four

or five minutes

some nights 44 or even 55 minutes but

not allowed to go past an hour if it

goes over an hour you have to do one of

two things either wait till the baby

wakes up start counting again get a

number less than sixty you can put on

your card and you can fall asleep that

night knowing your baby's gonna be fine

the next day

if however it's late and we're worried

that we're gonna fall asleep and we

don't have a movement count for tonight

of less than 60 minutes then we always

go to the hospital tonight

that way we can reach out and find the

baby that needs us nine times out of ten

a baby that's brought to labor and

delivery because of an abnormal fetal

movement counting at night the baby is

fine but it's that one time out of ten

when the baby reaches out has a cord

problem has something we didn't ever

suspect could be a problem that we

reach out and help that baby so that we

have a mother and a baby and a family

together at the end of the pregnancy