About baby and fetal movements
Most women feel the baby's or fetus' first movements after 18-20 weeks of the pregnancy. A baby or fetal kick count is among the most important observations to ensure the baby's health. A fetal or baby kick count, counting the fetal movements, is among the most important observations to ensure the baby's health. Every pregnant woman should learn how to count her fetus' movements.
An active baby is usually a healthy baby and early detection of reduced fetal movement has been considered as an opportunity for fetal health screening.
You usually feel your baby stretch, kick, roll and turn every day. Some babies are more active than others. All babies have periods of sleep during which they are not as active. You will get to know your baby’s pattern of movements and when your baby is most active.
Regular fetal activity perceived by pregnant women has long been regarded as a sign of fetal well being. Many studies of fetal activity have found associations between decreased fetal movement and poor perinatal outcome. Decreased fetal movement has been associated with poor pregnancy outcomes including stillbirth, about 50% of women with a stillbirth reported that they felt a gradual decrease of fetal movements before intrauterine death. Therefore, many women and clinicians use a fetal movement count to assess the baby's well-being.
Maternal perception of decreased fetal movement has been reported in 15% of pregnancies during the third trimester and around 50% of women perceive a gradual reduction of fetal movement days before intrauterine death.
When will I feel my baby kick?
Most women will feel the baby's or fetus' movements after 18-20 weeks of the pregnancy. You should feel your baby’s movements throughout the day, each day from 24 weeks of the pregnancy until the baby is born. The fetal kick count is done usually after 24 weeks of the pregnancy to monitor the fetal health.
Ways to do a Kick Count
There are many different ways to do a kick count.
Here is the "count-to-ten" method to do the Kick Count (Download the graph HERE):
- Count fetal movements once a day, preferably at the same time every day and within 1 to 2 hours after a meal. Early evening after dinner is a good time because the fetus is usually more active then.
- Get a sheet of paper and pen to indicate the movements.
- Have a clock or watch nearby to observe the time passed.
- Lie on your side while counting, preferably on your left side.
- Mark down the start time.
- Count any movement you feel - a roll, a kick, or a "swish" - except for the smallest flutters.
- Count until you have felt ten fetal movements.
- Ideally, you want to feel at least 10 movements within 2 hours. Most likely you will feel 10 movements in much less time
- Mark down the finish time, and the total amount of time it took to count the ten movements..
Here is the "count-to-six" kick count recommendation from the Society of Obstetricians and Gynaecologists of Canada
There are numerous ways to count your baby's movements and numerous opinions on how many movements you are looking for within a certain amount of time. The American College of Obstetricians and Gynecologists (ACOG) recommends that the woman lie on her side and counts distinct fetal movements. You time how long it takes you to feel 10 kicks, flutters, swishes or rolls. Perception of 10 distinct movements in a period of up to 2 hours is considered reassuring.
The count is considered reassuring if it equals or exceeds the woman's previously established baseline count. In the absence of a reassuring count, further fetal assessment is recommended.
Most women will feel the four movements well below one hour.
Talk to your doctor or midwife about what you should do if there's a problem with the fetus' movements. Many providers ask their patients to contact them or go to the labor and delivery unit if:
- You don't feel your baby move all day.
- It takes progressively longer from one day to the next to count four movements.
- It takes more than an hour to count four movements.
You might want to start a notebook of your own or use a fetal kick chart like the one below. In a notebook or on your chart, record the time you start, place a check mark for the time of the 10th movement. This will help you observe patterns and discover how long it normally takes for your baby to move 10 times. Keep in mind that you are looking for significant deviations from the pattern.
What is the best time and position to do the kick count?
Try to schedule the kick count during your baby's most active time of day, but also a time when you will be able to record movements over three or four hours, if needed. You will need to record movements starting from about the same time each day.
You may want to have a meal or snack before starting as you probably have noticed, food often makes your baby active. Alternatively, try a few minutes of exercise or take a brisk walk. Some moms prefer sitting with a good back rest with their arms holding their belly. Other moms prefer lying on their left side, which they find most effective for monitoring their baby. Lying on your left side also allows for the best circulation which could lead to a more active baby. Be sure you have a clock in view, and note on the kick count chart what time you start to record movements.
When should I call my physician or midwife?
Your doctor may ask you to count your baby’s movements once every day. Count your baby’s movements to be sure that you feel at least 10 (in Canada some say 6) movements in 2 hours. If you think there is a decrease in your baby’s movements this is an important sign that your baby may not be well.
If you haven't concentrated on counting the baby movements then it's possible you may have missed them. Focus on the baby movements and count your baby's movements, lie on your left side with support under your bump. Stay still for a couple of hours, during which time you should feel at least 10 separate movements.
You're more likely to be aware of your baby's movements when you're lying down rather than sitting, and you'll probably be least aware of them when you're standing.
Here are some quick ways to encourage your baby to move:
If your baby starts to move around, all is probably well. But keep an eye on his movements from now on, and seek help sooner rather than later if you have any concerns.
- If you have followed the above recommendations and have not felt 10 kicks by the end of the second hour, wait a few hours and try again. If after trying a second time, you do not feel 10 movements within 2 hours you should contact your health care provider.
- If you notice a significant deviation from the pattern over the course of 3 to 4 days.
- Put your feet up, have a snack, and relax. Your baby may be rocked to sleep while you're moving around, in which case he may wake up when you stop and have something to eat.
- Have a really cold drink. Your baby may feel the change in temperature and try to move away from it. A sugary cold drink may also give him a sugar boost to encourage movement.
Make some noise.
- Play loud music or slam a door to see if he responds.