I’m wondering about kick counting in pregnancy. My midwives recommend the standard “count 10 kicks in two hours,” but I’m curious what the data is to support this. Is it just a made-up number (like eight glasses of water a day)? Is it just as effective to keep a general eye on the baby’s movements throughout the day and just get concerned if there’s a significant change/lack of any activity?
—Catherine
The goal of kick counting toward the end of pregnancy is to make sure that the baby is still doing well. Most babies do slow down their activity toward the end of pregnancy, but a significant slowdown could indicate a problem, which would need attention.
There are a few different ways to look for decreased fetal movement. One is to simply ask women to pay attention to fetal movement, but the vague nature of that request can confuse people and generate more stress. Kick counting, in various forms, is an alternative that can be simpler to implement.
The literature on the value of kick counting in reducing stillbirth is fairly limited. A 2020 review suggests we do not have enough data to conclusively argue for its success. Many of the arguments in favor of the approach come down to logic: it seems like it would work, and the downsides are very limited.
In terms of exactly how to do this, I think it is fair to say that the details are largely made-up. When researchers aim to study something like this, or try to implement some intervention, they have to choose the details of the approach. You can’t actually run a trial where the treatment is “keep an eye on the baby’s movements,” because it’s too imprecise. If the treatment didn’t work, you wouldn’t know if it was because it wasn’t effective or because it was poorly implemented by the participants.
One of the several approaches that is taken is 10 kicks in two hours while at rest and focusing on counting. Another is 4 in one hour. Another is 10 kicks within 12 hours but without focusing. These all capture the same basic idea: is the baby moving regularly? There is no particular reason to think one would be more informative than another.
Toward the end of pregnancy, it is generally a good idea to pay attention to the baby’s movements and call the doctor if you perceive them slowing down. If counting kicks in a formal way is the lowest-stress way to do this, go for it.
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