Do Kick Counts Count?

A kick count is something some OBs and midwives like pregnant ladies to do during their third trimester. There are a few different ways to do it but the most typical is to pick a time of day when your baby is usually active, sit or lie down and relax, and then time how long it takes to feel 10 fetal movements. Sometimes these movements are real, swift Rockette-style kicks to your rib cage (thanks, son) or sometimes they feel like sweeps or rolls as baby shifts around. All these movements count. It could take as long as two hours to feel 10 movements but it’s usually less than that. Babies develop clear patterns of movement starting around 28 weeks, and any deviations from that pattern can be an indication of distress.  Of course at the end they have less space, so the movements might feel different, but the frequency and timing should remain the same. Your care provider may want you to keep a journal or log each day of the time so you can see if it changes drastically one day from the next.

So what’s the purpose of doing the kick count anyway? Some care providers feel it is safe and simple way to monitor the well-being of your baby everyday. The idea is that a significant change in your baby’s day-to-day movement may be a clear signal of a potential problem with your pregnancy. It’s an easy way to detect if your baby is in any major danger because healthy fetuses move around a lot. However, a recent clinical, randomized study of 68,654 pregnant women found that monitoring fetal kicks did not decrease the rate of stillbirth in average-risk pregnancies. In this study, maternal perception of decreased movement was not statistically linked to fetal outcome. I should note that the validity of this study has been called into question because the participants were told what they were studying (hardly blind) and some feel that skewed the results.

So where does that leave you? Well, the American College of Obstetricians and Gynecologists does not recommend for or against daily kick counting in normal, healthy pregnancies. If your OB or midwife suggests you do this, you can ask why he/she feels it’s necessary for you, especially if you think collecting this data will drive you batshit crazy with worry. But hey, at the end of the day, it might be nice to have reason to put your feet up. You can be all, “Sorry honey, I can’t cook dinner/feed the dog/discuss our taxes right now. I have to do my kick count!” And then hoist yourself onto the couch and bond with that little babe of your for an hour or so. 


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Scary Shit Series - Stillbirth

Not that long ago, stillbirth was an easier topic to talk about. At the turn of the century infant mortality was so high that if you lost a baby at birth (or shortly thereafter) you weren’t the odd man out. Everyone knew someone who lost a child, heck, some parents didn’t even name their children until they hit a year because odds were they wouldn’t make it that long.

So clearly that has changed and stillbirth is less common. That’s great, but the downside is we are less comfortable with it because it’s less commonplace now. It also doesn’t help that it’s shitty, and sad, and scary and devastating so we just keep it on the down low because there’s no point in scaring expectant parents. Hey, I’m all for keeping it upbeat but if it does happen we’ve now added a layer of taboo to that loss and pain.

While stillbirth rates have plummeted in recent decades, approximately 1% of babies in the U.S. are born still which is still pretty up there. It’s actually 10 times the number of babies that tragically die of SIDS.

So let’s just get this shit done and lift the tarp on this scary topic.

When a baby dies after 20 weeks of pregnancy, it is called stillbirth. Anything before that is considered a miscarriage. (Note: it looks like the U.K. considers the 24-week mark the change in definition).

In most cases, stillbirth occurs before delivery and less often during labour. The cause of stillbirth is often linked to placenta issues, infections, chromosomal disorders, blood clots, umbilical cord accidents or chronic heath issues in mom – like diabetes, high blood pressure, kidney disease, etc. – but sometimes they just don’t know why a baby is born still.

It’s usually picked up at an ultrasound appointment or by mom with a sudden drop in fetal movement.

There’s really no way to prevent stillbirths, which is probably another reason why there isn’t much “awareness” around it – there’s no point in printing pamphlets if you can’t do anything about it. If you are having a high risk pregnancy some doctors will suggest you doing a daily kick count, but even that is debatable on how well it works considering you have to notice the decreased movement, get to a healthcare provider, have them agree that something’s wrong, then take action. That’s a lot of steps to happen in a really short window.

If you are told that your baby is no longer viable, you will more than likely be advised to give birth vaginally through an induction. As heartbreaking as it sounds, it is still safer to give birth vaginally than a c-section regardless of the birth outcome.

Most hospitals and healthcare providers have a protocol when dealing with a stillbirth, however, it’s still your birth, so you certainly have a say in how things play out.

This cheat sheet that Samantha Durante put together after she lost her daughter, Alana, at 39.5 weeks is truly incredible and a fantastic resource if you or someone you know is going through a loss.


Baby’s Delivery

What to bring:

  • A good camera (seriously!  You’ll regret it later if you don’t have one!)
  • At least one nice outfit for baby


Who to invite:

  • Anyone particularly close to the baby (e.g., grandparents) who might want a chance to hold the baby while s/he’s warm (the baby will look and feel just like s/he’s sleeping at first)
  • A professional stillborn photographer from Now I Lay Me Down To Sleep


What to do:

  • Have the birth you were planning to have (i.e., if you were going to birth vaginally, don’t ask for a C-section unless it’s medically necessary.  You will be glad later to have honored your child with the birth you wanted to give her/him, and it won’t be nearly as traumatizing or terrifying as you imagine – most mothers describe their birth experience as unexpectedly beautiful, even knowing that their baby wouldn’t be alive when s/he arrived)
  • Hold your baby and spend at least a few minutes in awe inspecting every inch of his/her wonderful little body
  • Kiss your baby
  • Tell your baby how much you love her/him
  • Call your baby by his/her name (and ask everyone else to do so, too)
  • Take lots and lots of photos – of you and your partner holding the baby, the baby on his/her own dressed and undressed, all the little details like his/her hands/toes/ears/etc.  (You’ll want to be able to see your child in detail later, and may want a posed photo of him/her alone to use on a birth announcement.)
  • Don’t be afraid to ask for (or insist on!) more time with your baby.  You probably need more time than you think – consider bathing your baby, posing him/her for more photos, or just having him/her stay in your room with you for a while so you can talk.
  • If desired, baptize your baby (even a layperson’s baptism may bring you comfort later on) or ask for a priest/pastor from your church to come do a reading/blessing for your baby


Leaving the Hospital

Don’t leave without:

  • Something that touched your baby’s skin (hat, blanket, one of the outfits s/he wore for photos, etc.)
  • Baby’s footprints and handprints
  • The nursery card with baby’s weight, length, time of birth, etc.
  • A lock of baby’s hair
  • The names of the nurses/doctors who witnessed your baby’s birth and cared for you and your baby afterward
  • Clear instructions and a contact person on how to retrieve any photos taken by the hospital (e.g., on the wheel-under photo machine or on their own cameras, etc.)
  • Clear instructions about how and when to get the results of your baby’s autopsy and who to contact with questions or for a status update
  • Clear instructions on who will be handling your baby’s remains (funeral home, crematorium, etc.) and how, and contact person to make arrangements for a memorial service


Memorializing Your Baby

Find ways to remember your baby and incorporate him/her into your life:

  • Hold a memorial service for your baby just like you would any other member of your family (e.g., a Christian might choose to do a traditional wake/funeral mass/burial).  You’d be surprised how much comfort this will bring you and your loved ones, and how eager others will be to see/touch/meet your baby.  It will also feel good to plan a nice event honoring your child.  If someone delivered a eulogy, be sure to save a copy of it
  • Consider choosing a charitable organization that people can send donations to in your baby’s memory in lieu of flowers/gifts
  • Record your birth story while it’s still fresh.  (You’ll go over it a million times in your head and will eventually begin to second-guess yourself, so get all the details down before you forget any of them – the human memory is notoriously unreliable!)
  • Build or purchase a nice keepsake box to put all your mementos from the hospital in, along with ultrasound printouts, photos, cards, flowers, etc.
  • Purchase and wear a piece of jewelry with your baby’s birthstone/name to remind you of him/her every day
  • Fill out your baby book
  • Print your baby’s photos and pictures from your pregnancy and create a scrapbook or timeline poster detailing all the time you spent together during your baby’s life in the womb and after his/her birth.  (Note: there are organizations like that will retouch your baby’s photos for free – see HeartprintsAngelPics)
  • Get birth announcements printed and send them to your loved ones, or post a digital version online along with your birth story
  • Plant a tree/bush in your baby’s honor.  If possible, choose one that will flower/bloom around your baby’s birthday
  • Hire a portrait artist to paint/draw a portrait of your baby, perhaps smiling and looking up at you
  • Write your baby a letter and tell him/her about all the dreams you had for the future and how much s/he will be missed
  • Order a Molly Bear teddy bear weighted the same as your baby
  • Don’t rush to put away (or give away!) all your baby’s things or have other people do this for you before you go home.  Take your time and put/give them away only if and when you decide you want to
  • Create rituals/traditions to remember your baby on certain dates or at holidays.  Some ideas: celebrate his/her birthday, hang a stocking or ornament for your baby at Christmas, light a candle for your baby on October 15th Pregnancy & Infant Loss Remembrance Day, etc.
  • Ask your friends and loved ones to refer to your baby by name and tell them it’s okay to bring him/her up in conversation
  • Read stories from other parents who lost babies to remind yourself you’re not alone (Glow In the Woods is a good place to start)
  • Use a scanner/camera to create electronic copies/photos of all your keepsakes and store them on multiple computers (or better yet, in the cloud) to make sure they can never be lost, even if something happens to the originals
  • Whatever else works for you!  There’s no right or wrong way to remember your baby


I obviously found Samantha’s story heartbreaking but I also found it incredibly insightful, honest and beautiful:

 “The problem is that for most people (my husband and myself included), you can’t trust your instincts when your baby dies.  What you’ll want to do is withdraw, hide behind your shock and your terror, do whatever you can to escape from the nightmare facing you.  But what you’ll need to do is be present – be there for your baby, feel your grief, live this experience, and remember it – as hard as it may be.”

You can find the post in its entirety here.

Some other great resources are:

And please let me know of any other resources, book lists, groups, etc. and I’ll add them to the list.

Listen, your odds of having a stillbirth lie somewhere between unintentionally poisoning yourself and being be eaten by a shark (I’m serious), so this isn’t something that needs to be at the forefront of your mind. But we do need to be more aware of stillbirth (all of us) because it makes us better at helping, listening and empathizing with people going through one.

If you’re reading this because someone you know lost a baby, one of the best things you can do is simply be there. Suffering a loss like this is not only devastating, but it can be really isolating too. No one wants to say the wrong thing or ‘intrude’, but for the people suffering the loss, that kind of abandonment just makes their journey that much harder. Listen to them closely (none of their feelings are wrong), try not to fix it (because you can’t) and follow their lead. Here’s what one of my readers told me:

“I would say the best way to approach someone, is to simply do just that. Approach me. Cards have been nice, Facebook, text message, a phone call (a little harder cause you actually have to talk back,) a simple hug and “I don't know what to say”. I cannot stand when people just ignore what happened. It happened, it totally sucks, but don't ignore me. Don't be "afraid" I don't have a disease and I won't bite. If you make me cry, well, I will. If you cry, well, you will. The hardest is when people just stare and don't say a thing.”

A special thanks goes out to Samantha and Alana, Jaime and Little Nipper, and Kathleen and Henry for all their help and guidance.




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What do FDA Pregnancy Ratings Mean?

So you guys know about the Food and Drug Administration, right? It’s the American agency that’s responsible for protecting and promoting public health and one of their main jobs is to oversee the production and safety of drugs and medications. They are the folks who slap those handy warnings on cigarettes and alcohol.

You knocked up gals get your own, special FDA rating system for your over-the-counter and prescription drugs. This rating system has five categories that indicate the potential a drug may have to cause fetal birth defects if taken while pregnant.

These categories do not apply to breastmilk and nursing moms, just FYI.


The categories are:


Category A

Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters). Example: Folic Acid


Category B

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. Examples: Acetaminophen (Tylenol), Amoxicillin


Category C

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Examples: Coedine, Zoloft,


Category D

There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Example: Valium, Xanax


Category X

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits. Examples: Accutane, Lipitor


Category N

FDA has not classified the drug.


If you read through these descriptions you can see that the FDA is carefully weighing the pros and cons of the potential for fetal birth defects against the potential harm to the mother if she doesn’t get her needed medication.

As far as I can tell there are two clear categories here. Category A translates to: ‘Go take your pills! You and baby both get to be happy!’ And Category X seems to indicate ‘The risk of birth defects with his drug is so high, it is totally not worth it. Just don’t take it.’ I can only assume they chose ‘X’ (instead of 'E') for this category to illustrate a significant separation from the other categories, and because ‘Fuck No’ would be too long.

The tricky part seems to be all the categories in the middle. Some of these drugs caused birth defects in animals but can’t ethically be tested on pregnant women – "could you swallow this pillow case of Zoloft in your third trimester and tell us what happens?". Some of these drugs are risky in the first trimester and seem to have less risk of being harmful later in the pregnancy. Some of these drugs didn’t cause much harm if taken infrequently but risk increased with added exposure.

If you want to track down any medication you’re currently or thinking about taking you can try here, here and here. I’ll warn you though, these pages are designed like a basement bingo hall and category listings aren’t always easy to find. In all fairness, they are most likely trying to make your doctor or pharmacist your go-to so a medication isn’t getting a thumbs up without the whole picture – what may be safe for you may not be safe for someone else.

You get the gist. Bottom line is: talk to your doctor about the safety of any drugs you have to take while pregnant – you never know what will make rats glow this month.

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