Thursday, January 10, 2008

Kick Counts, Myth, Whys, and How to Do Them: IN EVERY PREGNANCY!!!!

I have lost one child at 40 weeks to a cord accident. His death was 100% preventable. I see posts in pregnancy groups a lot and I just want to cry when I read people comment on low movement, how it is normal, how they don't do kick counts because they don't need to because "the baby always moves"

I had the world's easiest, most normal pregnancy with Curtis. I lost him one day before his due date.

I was never told to do kick counts and was brushed aside at a few doctor's appointments where I told my doctor the baby wasn't moving much. I was told "it changes as the baby gets bigger. The baby is gearing up for delivery."

This, in fact, is a myth. I often hear people say "I don't need to do kick counts, my baby moves all the time"

Doing kick counts is not about just making sure the baby is moving. It is about tracking patterns and knowing your baby's exact movements at the exact time. So, you will have a written record when it changes. Even with my daughter I had a genetic counselor tell me that I didn't need to do kick counts as long as the baby was moving. That makes NO SENSE! Which just proves to me that people don't really know how and why to do kick counts and what they are for. Since having my second child, I have learned the extreme importance of doing kick counts.

In fact, her movements showed she was in distress the night before she was born. We could have easily have lost her as well. She was taken at 35w 5d with a cord issue. Just like the one we lost her brother to. Below is a write up on how to do kick counts. This information is meant to EDUCATE and not scare. It puts the power back into your hands.

The doctor sees you 10 minutes every other week. You and your baby are together every single day. Quite frankly, you need to take control of the situation and not put your trust into someone who is not you. I did, and I lost my son. When I knew something was wrong.

I am going to give a run down here with antecdotal stuff I learned from my cord research doctor. He is working to prevent stillbirths. So many doctors tell you they can't be prevented and it is 'just one of those things". Which is a myth.We worked with him and he saved our daughter's life. Then I will link you to a few charts.

The point of kick counts is to know your baby's patterns, NOT just 'that they move'. It is to know what is _normal_ for your baby. It is to know it is normal for your baby to take 6 minutes to get 10 kicks, or it is for you to know it takes you baby 25 minutes to get 10 kicks. Not just that 'your baby moves'. Because, then if one day your baby takes 90 minutes to get 10 that greately varies from normal, you will have had history on your side to show this was not typical and that something could be wrong. You pick one time (I did two...) each day to track movements. It should be the same time each day. When you can lay down/sit down and just focus on the kid. You write down your starting time, and track how long it takes you to get to 10, and write down your finishing time and are done. I would suggest in the evening. Later at night is when your blood pressure slows as you wind down for the night and that happens for the baby as well. (Stillbirths usually occur when the mom is sleeping at night after her blood pressure has dropped and less blood flow has gone to the baby who already may be in distress due to a cord issue). So, I usually did it at 10pm at night or so. But, since I did it twice a day, I usually did it around 9am. After you get your 10, you are done.

If you do NOT get 10 in 2 hours, drink something cold/eat something and start over. If you do not get 10 in those 2 hours, go immediately in. Do not pass go. Do not call the doctor. (Why? because they will tell you to lay down and do the kick counts again. Often times, as long as there is some movement, they are not concerned ). Do not wait until there is no movement, because it may be too late. Honestly, I may not wait those extra 2 hours and try again. Personally, if it takes 2 hours and that is NOT your baby's normal pattern, I would go in. I would go in with any big deviation of the norm. If one day it takes 15 minutes, the next 20, the next 18, the next 20, and then one day it takes 95 minutes....okay, I would be concerned. Because you have had a pattern emerge and then all of a sudden there has been a complete variation of it. That is the whole point of kick counts, you WILL see a pattern develope. If you go straight in to the hospital, they have to see you.

If you call and leave a message, they can always push you off. (This was the cord doctor's advice! ) Baby's sleeping patterns CAN change which can screw up your counts. I did have one with my daughter where her pattern changed on me and it freaked me out, but she was okay. Also be aware of things like day light savings time, if that occurs (that really threw me off one day). Any movement counts as kick counts, but also be aware if the movements change to really sluggish. Baby's movements will change from huge jabs to more subtle....but towards the end if they are really slow feeling, really sluggish....I would go in. That can be a sign of low fluid. Also, if you have what is called hyperactivity, I would go in. This just isn't jarring movements for a few minutes or constant normal movement, this can only be decribed as flailing. That is the only way I can desribe it. It literally feels like the baby is fighting for their life. My daughter had this twice, the night before she was born and the morning she was born. It wasn't just painful, I seriously couldn't breathe, it didn't stop, she felt like she was trying to bust out. And it went on and on and on. She had plenty of other times where, yeah she was active, and yeah, it hurt...but nothing like this. When she was born later that day, she was tangled up in her cord. She had been in distress. (and it showed on the monitor, her heart rate was well over 220 beats per minute, not normal. Even though the nurse told me it was. My doctor, on the other hand, said 'let's get her out!')

Okay, so anyway, kick counts really can help you know that your baby's pattern is normal, that s/he is following her typical schedule. But if anything, and I do mean anything, concerns you do not hestitate. I even hesitated one night with her movements when it took longer to get the same number of movements. When a baby nears the end it is a myth that the movements "slow down" and the baby is "gearing up for delivery" (those statements drive me nuts too. Probably because I was told that 3 days before Curtis died). It is true the movements are not as hard or whatever, because the kid is bigger, but they will still be there. There still should be the same amount, in the amount of time.

You will see a pattern emerge after a week or 2 of doing kick counts and you really can use that as a launching point in the future to know if anything is wrong.chart:

I didn't use charts but they are a great tool, I just had a note book where I wrote down the start time, my tally, the end time and wrote on the side "12 minutes for 10 kicks" I actually like flipping through it on occasion now. It is a little record of our days together. I really do suggest writing it all down. I really feel with Curtis if I had *proof* like a kick count log my doctor would have believed me as opposed to my anectdotal "he doesn't move much" statements. But I didn't know anything about kick counts back them. I had even seen him on an u/s a few days before and he passed a biophysical. But he was NOT fine. Knowing what I know now, I know I could have saved him.

All this stuff isn't meant to scare anyone, it is meant to give you the power to help your baby if needed. My biggest compliant with doctors is they may even tell women to do kick counts but not WHY and what they can prevent. I know that scares people, but kick counts can and DO prevent stillbirths. My doctor with my daugher had plenty of patients come in and say "I was doing my kick counts and something weird is happening" and they would do an u/s and the baby had low fluid or whatever and was born with a short cord.... so, they can help prevent a tragedy. I wish more doctors would tell people the WHYs.

That is power in itself.

Two more myths/facts.Cord accidents do not happen suddenly. It is a process that takes place over days, possibly weeks. Hence, why knowing your babies pattern is so important. Cord issues are not flukes. It can and does happen again. My son and daughter are proof. If you have one baby with a cord issue (including live births) you are 10 times more likely to have another cord issue in the next if you have had one child with a nuchal cord or arm loop or whatever, it can happen again and this time the results could be much more dangerous.

Just think; we all know the Back to Sleep campaign, that has reduced SIDS deaths by thousands. Think of what would happen if everyone did kick counts.Cord issues CAN BE SEEN ON U/S. Often times "they" are not "allowed" to tell. Or that is what they will tell you, but they can see where the blood flow is going through the cord, and they can see if the cord is looped around the neck or leg or what have you. This is very important information to have. A friend of mine (an OB nurse!) who lost a child to a triple nuchal cord asked during her next pregnancy where the cord was. The tech told her she wasn't allowed to tell. She said there was even a mom in her room recently that had a double cord and they were not going to tell that mom. That info is SO important because that mom could be doing kick counts to look for a decrease.

A cord issue does NOT equal a cord death. With proper monitoring and kick counts, the baby can be born just fine!