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What kick counts communicate about fetal health
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What kick counts communicate about fetal health

Fetal movement counts are an indicator of a fetus’s health and can help in timely identification of distress in the baby
Fetal movements can be felt around 20–24 weeks of pregnancy
Dr Sandhya Rani explains the kick count chart to an expectant mother. (Photo by Anantha Subramanyam K/Happiest Health)

Deepa Hegde, a 36-year-old software professional from Bengaluru, recounts that she was over the moon the first time she felt her baby move in her tummy. “I initially mistook the movement to be bloating. It was my first pregnancy — I had no clue what it felt like. My  doctor informed me that it was my baby kicking, and went on to enlighten me about fetal movement count.”

Deepa who gave birth to her son in 2021, reminisces looking forward to her baby kicking and excitedly discussing it with her husband. “It is a priceless feeling, a moment where you truly connect with your baby,” shares Deepa.

What is fetal movement count?

“Fetal movement pattern, earlier called kick count, is an indicator of fetal health on a day-to-day basis,” informs Dr Sandhya Rani, senior consultant, obstetrics & gynecology, Aster Women & Children Hospital, Bangalore. It is gauged by counting the number of times a fetus’ movements are felt over a period of two hours. “Ideally, the baby should move at least ten times in two hours, which implies that the baby is comfortable and not under any stress,” explains Dr Sandhya.

Doctors advise pregnant women to maintain a kick count chart to track fetal movement. Deepa, too, maintained this chart and recorded her baby’s activities after every meal. “The types of movements would vary. Sometimes there would be kicking, while at other times, it would just be a flutter,” she recalls. “Initially, I’d get worried if the kick counts didn’t reach the exact mark. I would wait another 30 minutes and try again, to find it to be more-or-less hitting the mark.” 

What do fetal movements feel like?

Fetal movement includes kicks, flutters, swishes or rolls. The sensation of the baby’s activities can vary depending on the stage of pregnancy. 

“Initially, around 20 weeks, it may feel like a vibration or jerk. Some describe it as bubbles in the tummy. Others confuse it with bloating,” says Dr Sandhya. She adds that as the fetus grows bigger, around 32-34 weeks, one can feel the head and feet of the baby as they start observing the fetal movement pattern.

When do you start feeling the baby move?

Dr Anita Soni, consultant, obstetrics and gynecology, L H Hiranandani Hospital, Mumbai, says that the fetus begins moving from the time of conception, throughout the gestational period. However, the movements are only felt by the pregnant person when the baby grows in size and strength. The perception of movement differs depending on the size of the baby, and the space available in the womb to move.

The stage of pregnancy at which one begins to perceive their baby’s movements may vary from person to person. “In the first pregnancy, people begin to notice fetal activity around 20–24 weeks of gestation,” shares Dr Soni. “In subsequent pregnancies, they may notice the movements earlier, around 16 to 18 weeks. After around 8 months of pregnancy, the perception of movement decreases, as the baby increases in size, leaving less room for the baby to move in the womb,” she adds.

How to track fetal movement count?

Several kick count charts are available for recording the daily movements of the baby.

“The Cardiff count-to-ten method is one such chart where fetal movement is tracked over a 12-hour period. If the movements are felt at least 10 times within the 12-hour period, all is thought to be well,” explains Dr Soni.

Another method involves counting for an hour after each meal — breakfast, lunch and dinner. “Three to four movements in an hour are considered sufficient,” points out Dr Soni.

A 2008 study published in Medical Journal Armed Forces India found that tracking the fetal movements using a daily fetal movement count chart (DFMC) in the ninth month of pregnancy helped in identifying ‘at risk fetuses’ in low-risk pregnancies in the absence of any other adverse factors necessitating early delivery.

What if the baby doesn’t move enough?

While it can be daunting when the baby doesn’t kick enough, it doesn’t always mean something is amiss. Dr Sandhya shares, “The baby isn’t awake throughout the day. If you do a kick count when the baby is asleep, which may last between 20 – 90 minutes, you may not get the expected results.” 

If the fetal movement count is less than 10 times in two hours, the person can try stimulating the baby by consuming sugary beverages, patting the tummy gently, lying down on the left side, listening to music or talking to the baby. 

“Despite these attempts, if the movements are not perceived for two more hours, one must seek medical attention,” stresses Dr Sandhya. A test called cardiotocography (CTG), also known as a nonstress test (NST) is performed, where a machine is connected to the mother’s tummy to record the baby’s heart rate graph. “This shows if the baby is under some stress. If there are any markers of stress, it is acted upon immediately. If CTG doesn’t show any obvious signs of distress, we perform an ultrasound,” explains Dr Sandhya.

An ultrasound gauges parameters like amniotic fluid levels, blood flow to the uterus and fetal weight.

“If the amniotic fluid is too low, the baby’s movements can reduce due to less space. And in case of excess amniotic fluid, the person may not be able to perceive the baby’s movements,” says Dr Sandhya Rani.

She further adds that if the person has health conditions like diabetes, blood pressure or liver-related issues, the blood flow to the baby may not be appropriate, slowing down the baby’s movements.

Takeaways

  • Fetal movement counts are an indicator of a fetus’s health.
  • Fetal movements can be felt around 20–24 weeks of pregnancy.
  • The fetus should move at least 10 times in two hours.
  • There are several charts available to track fetal movement patterns.

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