Danny's Story in the Des Moines Register

Expectant moms urged to tally prenatal jabs
By DAWN SAGARIO PAULS • dsagario@dmreg.com • June 17, 2009

Jennifer McCune was 37weeks pregnant in December 2007 when she noticed that her baby had moved only once in an hour-long period - significantly less than usual. The South Sioux City, Neb., woman regularly had been counting her baby's kicks after reading a magazine article recommending the practice.

"It said that many moms who have experienced a stillbirth noted that there had been reduced fetal activity in the days before the loss of a child," said McCune, 30.


McCune called her doctor and was told to immediately go to the hospital. Her son, Danny, was born via emergency Caesarean section, and doctors found the umbilical cord wrapped around his neck four times.

"I feel very lucky because I had the knowledge when it counted," said McCune, whose son was born healthy and has had no lasting side effects.

McCune's experience is being highlighted in a new, statewide public health campaign called Count the Kicks, which was developed to help prevent late-term birth complications and stillbirths.

Annually, there are 200 stillbirths in Iowa and 26,000 in the United States, with a large percentage of them happening late-term, said Tiffan Yamen of Waukee. Yamen and four other Des Moines-area mothers created the Count the Kicks campaign. All have had a stillbirth or an infant death.

The campaign teaches expectant parents to use a kick count chart to track their baby's movement patterns daily during the third trimester. Women log how long it takes to feel 10 movements within two hours.

Decreased movement can be a sign of a potential problem. The campaign urges parents to call their health care provider immediately if they notice significant changes in their baby's movements.

The group began working on Count the Kicks after learning of a study from Norway that showed the stillbirth rate was cut in half following a public health campaign on kick counting, Yamen said. They also used kick-counting recommendations from the American College of Obstetricians and Gynecologists.

Rep. Janet Petersen, a Des Moines Democrat and a member of the Count the Kicks group, said doctors' discussions with expectant mothers about monitoring their baby's movements are too general. The group hopes that health care providers will incorporate Count the Kicks materials as part of their prenatal care.

Dr. Neil Mandsager, a perinatologist with the Perinatal Center of Iowa, said many babies tend to move less during the third trimester of pregnancy. By counting kicks, women have an objective measure of what is normal activity for their babies, he said.

"The genius behind this campaign is that it provides a very simple and yet effective way for every woman ... to self-monitor the well-being of her baby without adding any cost to the care," said Mandsager, who reviewed the Count the Kicks campaign material for the group. "I really think that this campaign is one of those that truly has the capacity to save lives."

Dr. Dwight Rouse, who helped write recommendations on fetal surveillance before birth for the American College of Obstetricians and Gynecologists, said evidence is "mixed."

"In my mind, fetal-movement counting is stuck in that netherworld where it might be beneficial, but we can't really say that definitely," said Rouse, a professor of obstetrics and gynecology at the University of Alabama at Birmingham School of Medicine. "I think ... it would be imprudent to ignore a complaint of reduced fetal movement."

Moms such as Jessica Boltnar, 26, of West Des Moines continue to keep track of their baby's progress, one move at a time.

"She's recently become really regular," said Boltnar, whose second child is due July 8. "I know when she's most active."