Counting Kicks

Are you counting kicks?

Do you REALLY need to count kicks? Research shows that a noticeable change in your baby’s normal movement pattern can sometimes be an early sign of distress. Tracking kicks can help you recognize what’s normal for your baby so you can act quickly if something changes. Studies have found that maternal awareness of fetal movements can reduce the risk of stillbirth by prompting timely evaluation.

When to start:

Most providers recommend beginning daily kick counts around 28 weeks (or earlier if advised due to high-risk factors).

How to count:

• Pick a time when your baby is usually active. The key is to do it the same time every day!

• Lie on your side or sit comfortably with your feet up.

• Count how long it takes to feel 10 movements.
  Most babies will have 10 movements within 2 hours—BUT NORMAL VARIES FROM BABY TO BABY.
  
  Kick counting is not about obsessing over every movement; it’s about building awareness and connection. Think of it as a daily check-in with your baby. Use it as a time to chat with your baby, tell him/her how much you love them and how excited you are to meet them. They can hear you. 🙂
  

What to watch for:

**You don’t feel the "normal" pattern of movements for your baby.**

If that happens, call your healthcare provider right away. Trust your instincts—you know your baby’s patterns best.

Kick Counting Myths:

• ​You need 10 kicks within 2 hours.

  • Normal varies from baby to baby. Track the usual pattern of movements for YOUR baby. Count the Kicks app is very helpful (see below).

• Babies slow down because they've run out of room near the end of pregnancy.

  • Type of movement may change (more jabs, fewer big kicks), the number of movements should remain consistent. Hiccups DON'T count.

• Baby movement slows during labor.

  • You should feel your baby move throughout labor, too. Pay attention after your water breaks as well.

• A dramatic increase in movement is normal.

  • Any dramatic changes in movement warrants a check-in with your provider.

• Eat/Drink something sugary, drink a cold glass of water, or lay down flat for a while to get baby moving.

  • NO. NO. NO. Please go see your provider. This is outdated information. When in doubt, go be seen.

• If I have a fetal doppler, I'll be fine.

  • A change in baby's movement can sometimes detect problems before changes in heart rate can.

*What I recommend*:

Count the Kicks app

• It’s free.

• You can rate the strength of the movements on a scale of 1-5.

• You get to know what’s normal for YOUR baby.

• The app has a contraction timer, notes function, dark mode, and you can share your kick sessions with your provider!

In health and doula love,

Brooke

Eating & Drinking During Labor

You may have heard it said that labor is a marathon, not a sprint. This is not only because your body expends a lot of energy while giving birth (even if you have a precipitous labor), but because the average labor is between 12-18 hours for a first-time mom (ACOG). It’s not unusual for labor to last 24 hours, with the longest phase being early labor (before 4cm dilated). The average active labor phase (5cm and beyond) for a first-time mom is around 8 hours. If you’ve given birth before, an average TOTAL time of labor may be 8-10 hours (ACOG). Of course, these are just estimates, and every labor is different!

So if labor could last so many hours, and we know it’s already some of the hardest work of your life, then why are some not permitted to eat (or even drink) once admitted to the hospital?

Great question! Let’s explore this policy.
The concern with eating and drinking during labor comes from the risk of aspirating during a cesarean when under general anesthesia (when mom is put completely to sleep). Aspiration is when one vomits stomach contents into the lungs. This policy started in the 1940s, when aspiration was more common since we now have made advances to make anesthesia safer. There has also been a decline in general anesthesia births (less than 6%).
According to this study, a serious anesthesia-related complication occurs in approximately 1 in 3,000 births, or 0.03%. Another large study of 45 million births reported 33 maternal deaths from aspiration during a cesarean with general anesthesia from 1979-1990. That’s 1 death for every 1.4 million births.
The American Society of Anesthesiologists say. “Without adequate nutrition, women’s bodies will begin to use fat as an energy source, increasing acidity of the blood in the mother and infant, potentially reducing uterine contractions and leading to longer labor and lower health scores in newborns. Additionally, the studies suggest that fasting can cause emotional stress, potentially moving blood away from the uterus and placenta, lengthening labor and contributing to distress of the fetus.”

What are some good snacks to eat?
In early labor, whatever you feel like! A good balance of protein and carbohydrates (pasta, brown rice, sweet potatoes) are ideal. If you’re being induced, please consider eating a good meal on your way to the hospital.

Snack ideas:

• Toast with avocado or peanut butter

• Nut butter with banana

• Fruit or dried fruit

• Veggie sticks

• Trail mix / nuts

• Crackers

• Protein smoothies

• Soups

• Popsicles or other cold things (especially during hot months)

• Anything that makes you happy (think oxytocin!)

• Honey sticks are great for a boost of energy once you don’t feel like eating anymore.

Honey sticks - great way to get a quick sugar boost when you’re tired during hard labor

Should you eat or drink during labor? That is up to you!
Some research has shown labor to be an average of 16 minutes shorter in women who were able to eat and drink. And since labor is just that, hard work, we’ll take every minute we can get! If you are low-risk, and unmedicated, a supportive provider is likely to have no qualms about food. If they do, you can present them with the supportive evidence. At some point during labor, it’s likely you won’t feel like eating anymore. But it is important to remain hydrated with water or electrolytes of some kind (coconut water is great!).
If you have a high-risk factor such as preeclampsia, eclampsia, are using IV opioids, etc. then you may want to reconsider eating during labor.
Gestational Diabetes is another factor to consider. Since the labor process lowers glucose levels, if you’re on insulin, the American Association of Endocrinology recommends the insulin to be put on hold, and glucose infusions, during labor if you’re also fasting. This is so your blood sugar levels aren’t lowered to a dangerous level (ketosis), which can also affect your newborn.

You can find more information about eating and drinking during labor, how Diabetes plays a role, and the risks here.

Ultimately, you must weigh the benefits and risks of your labor choices.