When Fernanda Sheridan was 30 weeks pregnant with her daughter Natalie, she noticed that Natalie started jerking a lot.
“I didn’t think much of it. I thought that she was going to be a soccer player,” Sheridan, 45, of Greenwich, co-director of medical innovation and advancement at PUSH for Empowered Pregnancy, told TODAY Parents. “The following day, she did not move much.”
Sheridan called her obstetrician and the doctor told her that babies don’t have to move every hour as long as they move during the day. Soon after, Sheridan started labor.
“I had a bad feeling,” she said. “They tried to find the heartbeat and they did not find a heartbeat. And there was no reason or explanation.”
As Sheridan grieved Natalie’s loss, she started researching stillbirth and learned about Rainbow Clinics in the United Kingdom, which aim to reduce stillbirth. She also learned about kick counts, which can be a way parents understand how much a baby moves. Many also use it as a chance to bond with their baby later in pregnancy.
“I was not educated,” Sheridan said. “The way you can monitor, the way your child is communicating with you (is through kick counts).”
How to do kick counts?
Kick counts help parents to track a baby’s movement in utero. There’s no standard way to really count it, which is why some doctors discuss fetal movement. “Often people talk about if your baby’s moving five to 10 times per hour then your baby is passing. And there’s really no evidence to suggest that that’s actually an accurate way to assess baby’s health,” Dr. Heather Florescue, an OB-GYN at Women Gynecology & Childbirth Associates in New York, told TODAY Parents. “Some babies move 100 times an hour. So telling a mom to do a kick count and be satisfied with her baby moving 10 times an hour is obviously a drastic reduction and moms still worry.”
Florescue, who uses British and Australian protocols to reduce stillbirth in her practice, introduces the idea of fetal movement or kick counts before a pregnant patient is worried. She encourages them to track when the baby moves regularly. As she noted, some babies might move 10 times an hour while others will move 70 times an hour. Over several days, patterns emerge and parents begin to understand their baby’s norm when it comes to activity.
“They can do fetal movement monitoring at any point, if they want to get to know their baby,” she explained. “(Or) they want to check on the baby.”
Dr. Joanne Stone, director of the Rainbow Clinic at Mount Sinai, said babies don’t move regularly until about “26- to 28-week gestation.”
“It’s getting a sense of your own fetus’ pattern,” Stone, the Ellen and Howard C. Katz Chair of Obstetrics and Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai, told TODAY Parents. “Pay attention to the pattern of movement because some fetuses might move more in the morning and not so much in the afternoon.”
Apps, such as Count the Kicks, allow parents to track their baby’s movements precisely.
“It’s the best in terms of evidence-based but also it doesn’t just do number of kicks. It goes into the timing, the frequency, the strength,” Florescue said. “(It’s) really assessing the baby’s overall growth movements.”
Myths about kick counts and fetal movement
Some parents learn their baby might move less later in pregnancy as they’re getting ready to be born. But that’s not exactly true.
“There’s a little bit of a myth that movements tend to decrease toward the end. They don’t really decrease in number,” Stone said. “They might not be these big kicks but they’re still rolls and turns. The fetus is so much bigger and has less room to have those big jabs. But they should still have the same number of movements as earlier in your pregnancy.”
Another myth? Parents might think the baby’s resting when they move less.
“They said, ‘Oh my baby’s sleeping,’” Florescue said. “They don’t even bother to call (their doctors) because they weren’t educated about decreased fetal movement, which is a known risk factor for stillbirth.”
Myths can mean that parents feel uncomfortable or don’t know when there’s a problem.
“They should always trust their instincts. And if they get evaluated and they don’t like what they hear, they should feel free to say I’d like further evaluation,” Florescue said. “It’s really just empowering people to say, ‘I get it, you may have this outdated information where you’ve told me my kick count is good enough, but I am telling you I’m worried about this baby.’”
With Sheridan’s leadership, PUSH for Empowered Pregnancy funded the Rainbow Clinic at Mount Sinai, the first in the United States, Stone said. They’re collaborating with the Rainbow Clinics in the United Kingdom to collect data “to look at our outcomes and compare them to the outcomes in the UK,” she added.
“They’re aimed at taking care of patients who have unfortunately suffered a stillbirth in the past,” Stone said. “They’ve had a stillbirth and they want to understand what happened. Can we find the cause?”
Sometimes doctors do discover a cause. Sadly other parents might never know why they had a stillbirth. In any case, doctors and staff try to help families who hope to get pregnant in the future.
“We come up with a plan for management for their future pregnancy,” Stone said. “It’s also taking an approach to understand exactly what they’ve gone through.”
There could be a “variety of approaches,” including reducing known risk factors, such as quitting smoking or providing better nutritional support. PUSH also made some training materials to help the staff be more supportive of parents who’ve experienced pregnancy loss.
“There are a lot of very sensitive issues like that we bring to this clinic,” Stone said. “As well as all the attention to medical detail.”
Parents raising awareness of stillbirth, kick counts
When Kate Forrest was 40 weeks pregnant, she noticed her baby Aurora Forrest-Dozier had stopped moving.
“I didn’t have any notable risk factors for stillbirth nor was I aware what stillbirth even was,” Forrest, 24, a MSW student at Boston College and early education teacher, told TODAY Parents. “I called my provider and they had me come in immediately but unfortunately by the time we made it there, it was already too late.”
Much like Sheridan, Forrest started researching about stillbirth after Aurora’s death.
“I could not see myself dedicating my time or my energy to anything else but stillbirth prevention,” Forrest said. “We were not always informed about kick counting and the importance of kick counting.”
In her role as lead change-maker at PUSH for Empowered Pregnancy, Forrest is helping organize The Big PUSH to End Preventable Stillbirth on October 15, 2022, in Washington, D.C. The group hopes that 23,000 participants will march past the Capitol with empty strollers “to represent all the lives that are lost each year.” The event occurs on National Pregnancy and Infant Loss Awareness Day. There will also be a display of 23,000 newborn hats, which they hope to donate to local hospitals.
Raising awareness of stillbirth remains essential.
“After our daughter passed away I thought, ‘Oh my God I must be the only person in the world this has happened to — no one can relate to the loss that we’ve just had,’” Forrest said. “I couldn’t have been more wrong. On one hand, I’m grateful to have found the community. But on the other had I wish more than anything that this was not the thing that we were connecting over.”