Let's Talk Kick Counts

By: Gloria Miles

The author's daughter, in utero. 

The author's daughter, in utero. 

A fetus has sleeping and waking cycles.  One of the most exciting parts of pregnancy (for most), is feeling those little tiny movements and kicks.  They are very reassuring for the expectant mother and elicit a range of emotions for both those expecting and those allowed to feel the movements.  

I know that for my husband and children, it's a bit of bonding that occurs before the birth.  My sons love to hold their hand on my growing abdomen and feel the little rolls, elbows, and kicks. "I felt the baby!" they'll squeal. And, for myself, I'm always reassured to feel this little life growing and moving about. 

Okay, so what are kick counts? 

Kick counts are sort of what they sound like: counting baby's kicks.  Though, of course, it's not exclusive to kicks. Rolls, stretches, punches, and any type of movement counts as a "kick." 

I'm not feeling movement yet. When do I start? 

For most people, movement is felt starting between 18 to 26 weeks.  It really depends what number pregnancy it is, the lie of the baby, and where the placenta is located.  If the placenta is anterior (meaning against the uterine wall that is against the abdomen), movement may not be felt until later in pregnancy and with less frequency.  

Most providers advise to begin kick counts around 28 weeks.  However, ask yours for specific timelines and guidelines. 

How are the kicks counted? 

Choose a time a day that you know baby is most active.  Lie down on your left side and start counting movements.  You're hoping to feel ten movements within two hours.  Most likely, you'll feel that long before the two hour mark.  

Keep a journal or log.  You can write it down on a paper, use an app, or simply mark it on the calendar.  This also helps you see a pattern in fetal movement.

I didn't get ten kicks/I don't feel movement/I feel decreased movement.

First, don't panic.  Try eating a snack or drinking juice (though, ask for advice from your provider if your diet has restrictions in place) and try again. 

If you still do not get ten movements within two hours, if you think there's a significant decrease in movement, or if you have any concerns regarding fetal movement, call your provider for advice.  

 

Chime in! Did you or are you counting kick counts?  Did your provider recommend this practice?  How did you fit it into your routine? 

Note: This blog post is purely informational and not meant to be a substitute for medical advice or attention.  Please direct any questions or concerns to your own medical provider.  Whenever there is a question about fetal movement, a licensed health care professional should be consulted.  

Gloria Miles is a Navy veteran and mother of 3, soon-to-be 4. She wears many hats as a doula, Certified Aromatherapist, and student. She is currently working towards obtaining a Bachelor's in Healthcare Management, with an end goal of becoming a Certified Nurse-Midwife. When she is not blogging or hanging out with her family, she enjoys reading, knitting, hiking, and mud runs. 

A Birth Story

The Third Degree

This is the story of my natural birth in a hospital setting that turned into a medical birth.  My goal is to educate and encourage women to birth on their terms.  Please consider your provider and the location of your birth!

A note from Richmond Doulas...such a huge thank you to Cori for sharing both of her birth stories and the inspirations and wisdom she drew from both her births. It's our dream that women could enter any hospital, be treated by any care provider and receive compassionate care, but until birth culture changes in the U.S., choosing your care provider, as Cori puts it, is time well spent. Here is some more information about choosing a care provider.

Delivery Day

I woke up with contractions around 7 a.m.  They did not subside after an hour like they had the few days before.  I kept busy all day to distract myself but knew it would be the day to meet our baby! 

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I felt a gushing sensation around 2:30 p.m. - My water broke!  I called my OB and let Donna Westcott, my doula know. I wanted to labor at home as long as possible to make sure I received as few interventions at the hospital as possible. 

Finally at 4:45 we decided to drive to the hospital.  Contractions were much more intense and getting closer.  I continued to breathe through each contraction visualizing the pain going through my body and out my toes.

Contractions were painful but purposeful. And things seemed to be happening so much quicker than I thought they would.

At the Hospital:

My first nurse was a bitch… She wanted to hook me to the monitor immediately; she did not want to undo it so I could go pee. She did not care that I felt nauseous, and she said it was still hospital policy to check me to see if my water actually broke because so many people mistaken it for pee leaking!

Finally, the hospital OB came in but seemed annoyed.  He looked over the birth plan and scoffed at a few things: He said we would only delay cord clamping about a minute and reassured me there would be no episiotomy.  His biggest concern was the possibility that my baby was close to 9 pounds.

He left the room for a while and when he returned he was determined to check my cervix. He was impressed with how far along I had gotten. Again he made me feel unimportant and even though I was determined to birth naturally he seemed like he would rather do C-section to get it over with.  He did not offer pain medication, which I appreciated.  But he did insist on checking me more often than I felt necessary.  The last time he checked me, I peed on him. (he deserved it.)  They also would not let me out of the bed to walk around or unhook me from the monitor.

I remember transition…It was painful.  I also remember that being the only point at which I said: "I can't do this."  Donna, said you can and you are!  Donna’s soothing and calm encouragement was so nice to have throughout the birth!

Before I knew it was time to push… My biggest regret is not waiting for my body to tell me when to push. 

This is the point it became a medical birth and my nurse and doctor were screaming at me to push for ten seconds!  The nurse held my leg and I was lying on my back… They did not know when my body was contracting. I was pushing when they told me to.

I remember a sense of relief during stage two; like my body was doing all the work, there didn’t have to be any actual pushing.

Where it all went wrong:

I should not have been on my back and I should not have pushed for a count of ten, my body was not ready for that! I should have used the positions I practiced.  I should have spoken up and birth the way I had planned.  I should have breathed my baby out.

In a medical birth, the doctor does not listen to the woman… (*A woman’s body is amazing and knows what to do. Let your body do its job!)

Time really escapes you in labor. Pushing didn’t seem to last long.  I remember a burning sensation when the baby was crowning, Donna told me that was normal.  The doctor did not talk me through the birth.  I am so grateful for Donna being there and coaching me through. The OB was more into making sure I pushed hard enough.

After an additional push baby slid out onto the table. (A baby girl was here!)

The doctor was not seated, did not catch my baby, and did not have adequate towels underneath me.

I was numb from that point on.  I suffered a third-degree laceration and had postpartum hemorrhaging (maybe my body was being nice and didn’t want me to remember the pain and it was my body’s adrenaline reaction to go numb.)

But this is where I question if counter pressure on my vagina and perineum and assisting the head and shoulders through would have helped.  I really should have been more determined to ask for different positions during pushing.

The OB tried to partially repair me in the delivery room with no success.  I had a hard time staying still and he continually yelled at me to stop moving.  I only held my baby girl for a couple minutes on my chest before the doctor had packed me with gauze and took me out of the room on the way to the OR. 

The doctor did not explain what had happened. He did not use the word tear or hemorrhage. He just said I had no choice but to get a spinal block and come to the OR.

My husband was left in the room with Donna and a baby who was a few minutes old.  No information was shared with them except that I had to be taken out of the room and they could not be in the OR with me.

In the OR:

The anesthesiologist was pretentious.  He actually said “see this isn’t so bad” when putting in the spinal tap, “you could have done this in the first place.”

In the OR, there was still no explanation of what happened. Dr. G, the OB I had been seeing in the office for prenatal visits, arrived to help repair me.  She did not acknowledge me.  I was awake and aware during the repair and continued to ask them questions: How is it, is it bad, what does it look like, what are you doing?  They ignored me and did not speak to me directly. 

A nurse assistant held my hand and talked with me the whole time (she was so sweet).  Another nurse brought me a phone so I could tell my husband I was still alive and that everything would be okay.

After what felt like an eternity, I finally made it back to the room, with a catheter and no feeling in my legs.  The OB informed me he ‘lost’ a sponge (gauze) that he packed me with when I was hemorrhaging and to make sure it wasn’t still inside me he ordered an x-ray. 

After the x-ray, I finally got to hold my baby and try to nurse her!  She did not have a good latch.  It had been three hours since she was born and hunger had set in. 

Breastfeeding was uncomfortable and I could not feel my legs.  I also still did not really know what had happened… I was disappointed Dr. G. never came in to check on me after I made it back to the room. (So much for being her patient.)

I held my baby all night.  I continued to try and nurse her with little luck.  Instead of sending in a lactation consultant or a nurse who could help me get a latch, one nurse gave me a nipple shield.  (Hindsight is 20/20, the nipple shield may have saved my breastfeeding journey! But it led to many weeks of stress and anxiety that I could not feed my baby without it- Why couldn’t I be coached on getting a better latch instead of using an artificial nipple?) 

In the morning, two nurses came in to help me out of bed and into the bathroom where I passed out and they had to use smelling salts to wake me!  I returned to the bed weak, helpless, and groggy. 

Eventually, I moved to a postpartum room.  Those nurses barely came into check on us.  One did come in to give the baby a bath but did not welcome my help with my child…

Discharge Day:

A well respected and favorite OB discharged me.  She told me three things: 1 Here are your prescriptions for Oxycodone and ibuprofen, 2 you can sit in a bathtub or sitz bath a few times a day for swelling and pain relief, and 3 you need to make an appointment to see this specialist in a week.  (At this point I still have not been told what actually happened, she had the perfect opportunity to show some sympathy and do her job, yet nothing, she didn’t want to be bothered either, I was not her patient….she lost my respect.)

I was so scared to leave the hospital! I cried, a lot. I did finally take a shower but still felt numb, weak, and terrified.

The First Days Home:

I don’t remember much except that I was helpless.  (A feeling I do not do well with!) I did not take the oxy but did take ibuprofen for pain and swelling.  I was uncomfortable and spent a lot of time in bed trying to nurse.  I would cry every time she nursed.  I would look down at this perfect little human and knew that I loved her but could not express that love with words.  I continued feeding her and holding her. But all I really wanted to do was leave.  

The Specialist:

A week later I went to see Dr. S., an urogynecologist.  She was wonderful! Smart, direct, and caring.  Finally, someone explained what had happened, she even had an illustration.

She informed me I had an infection in the laceration and listed what we would try to do to fix it.  Surgery was a last resort. My instructions were to sit in a sitz bath at least three times a day, take a whole concoction of antibiotics and drink Miralax to make sure all my stools were super soft! (gross, I know)

I had follow-up appointments weekly.  The only time I left the house was to go to the doctor.  I continued to be devastated and uncomfortable. I blamed myself for the tear and the infection.  I continually thought about what I should have done differently. Not pushing the way I did, not laying on my back, also what did I do to get this infection? Did I deserve it somehow?

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The Last Resort:

Finally, at five weeks, post-partum, Dr. S. said we needed to go in and surgically remove the infection and repair the tear.  I lost it.  I was so nervous.  I was hoping to go my whole life without any major surgery…

I had two options for hospitals.  I will not go back to the hospital I delivered my daughter in for as much as a hangnail. So I chose a different location.  The surgery was scheduled for the next day. 

I was not prepared to leave a five week old at home without me.  I had no bottles or formula.  No milk pumped.  I barely had the hang of breastfeeding (I was still using the nipple shield).

I had total faith in Dr. S. to get me repaired and keep me safe.  But major surgery is still frightening. 

The surgery was successful and Dr. S. informed me it wasn’t as bad as she thought it was going to be, the infection also was localized and not systemic and she repaired the other trauma to my vagina.

My recovery nurses at this hospital were so sweet and compassionate.  They helped me set up the breast pump and kept all my milk frozen for me.   

I continued to see Dr. S every other week until I got the all clear to resume all normal activity two and a half months postpartum!

The New Normal:

It took me months to feel completely comfortable in my skin (squatting scared me, I felt like I would just rip into a million pieces). At about eight weeks postpartum, I had breastfeeding down!  I nursed my baby lying down, standing up, one handed, with a pillow, without one! 

I continued to have feelings of anger and grief.  I still blamed myself but was mad at the hospital OB.  I didn’t know who to blame.  

I changed to a more positive outlook shortly after.  I realized it could have been worse (I could have died; it could have been a 4th degree tear going through my rectum completely)

The whole experience made me stronger and I couldn’t love my daughter any more than I do! 

Baby #2

I had a lot of anxiety after finding out we were pregnant with baby #2.  I feared that I would tear again, get an infection, and not be able to take care of a two and a half year old and a newborn. 

I told Donna we were expecting as soon as we found out because I knew I wanted her to be there.  She was an amazing resource and coach the first time around!  One of the first things we discussed was what provider I should use.  It didn’t take much convincing to know I should switch to a practice with Midwives. 

I broke down in tears at each Midwife appointment. I was so nervous to birth again.  They comforted me and really encouraged me to be positive. (I read positive birth affirmations daily and those positive thoughts made me believe and trust my body going into my second birth)

The pregnancy was uneventful and healthy and I enjoyed spending quality time with my oldest while she was the only one.

I thought labor was fast the first time…

On the way to the hospital my water broke in the car.   Upon entering the hospital we were met by Donna and my midwife.  Both were so happy to see us.  They were both encouraging and calm and no one was annoyed to be caring for us.  It was a positive experience from the moment we got there!

I birthed my son about twenty minutes after getting to our room.  I was coached and talked through the whole birth.  The nurses were welcoming to both Donna and the midwife.  Everyone respected each other’s position in the room. 

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I labored in positions that were comfortable to me and I was not yelled at to push harder.

My son’s entrance into the world was calm. 

My vagina was in one piece. 

I felt empowered because my body did what it was supposed to do. His birth was a completely different experience because of my caregivers and I am grateful for that.    

My advice to any soon to be mom, veteran or not, is to choose your provider wisely, research birth positions and use them, but also be ready for anything!

XOXO,

Cori

 

An Exercise: Being Strong in Labor

This exercise was created by Virginia Bobro, formerly of Birthing From Within and Pam England. Check out Pam England's new book: Ancient Map for Modern Birth, or a local Birthing From Within class for more juicy exercises. This exercise was adapted by Cat Ennis Sears, BFW mentor, for the RD Blog.

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When you're pregnant, a lot of things can alert your worry muscle. Maybe you've heard birth stories from others, things you'd like to avoid, and you are thinking of how you would want things to go differently. Maybe you're worried about your support options, logistics, or needing medical support that you were hoping to avoid. 

Sometimes, we get into a state of avoidance. We put our fingers in our ears (positive birth stories only, please!) with the hope that blocking out the thought of unwished for events will prevent these things from occurring. While it's true that fear is not helpful in labor and birth, and adrenaline can decrease natural birth hormones that make labor safer and more efficient, the act of total avoidance (trying to avoid fear at all costs) paradoxically arises from a place of fear. And completely avoiding the thought of unwished for events does not decrease the likelihood of those events occurring, but does increase the likelihood that you will be unprepared for those events, should they occur.

A positive visualization of how you would like your birth experience to go, without qualifiers and without "if's" and "but's" is the first step toward trusting birth. It's important to know what your ideal birth would look like, what you are hoping for, what your dreams and goals are. Visualization is a powerful tool that evidence suggests actually changes our brains, and can in fact change outcomes.

So go ahead and visualize your ideal birth, without qualifiers, without "if's" and "but's."

Next, I invite you to go one step further in your preparation for birth, and visualize not only your perfect birth, but visualize something unexpected happening. And (this is the important step) don't stop there: visualize how you and your support people will cope with that unexpected event. Visualize yourself being strong and present, giving birth in awareness, being there for the moment, no matter what happens. What, specifically, would help you cope with something you were hoping to avoid? Is it a prayer, is it holding your partner's hand, is it closing your eyes, playing a specific song, or just focusing on your breathing? Close your eyes and see yourself doing that thing.

Birth is unpredictable. Our bodies are fallible. And if something unwished for does occur, it does not mean you did something wrong, or weren't prepared enough, or should have done this or that differently. You can truly trust birth and postpartum when you know that you have coping resources you can pull on, should an unwished for event occur. This is a deeper kind of trust.

Being Strong in Labor

With your partner or support person...

Each of you fold your paper in half twice (once horizontally, once vertically) so the fold-lines make four quadrants. 

In the first quarter: Draw the first image that comes to mind when you think of being strong in labor.

The second drawing: Draw being strong in a long, prolonged labor.

The third drawing: Being strong in a cesarean birth.

The fourth: Being strong in... [choose a situation that is personally powerful to you, something that you are working to avoid]. 

Share your images with your partner.

Did anything surprise you? Was there anything you hesitated to draw? Did not want to draw? The takeaway is that we are often much stronger than we realize. And, in my mind, all of this is already within us. In some ways, this is an exercise in intention.

 

Guest Post: Why Moms Make the Worst Clients, and Why I’ll Never Stop Training Them.

Guest Post: Why Moms Make the Worst Clients, and Why I’ll Never Stop Training Them.

I’ve been a Personal Trainer at a gym for over 8 years. After having my first child 4 years ago, I saw how different my body was and took a course in Pre and Post-Natal Fitness with the goal to help other moms through those changes. Little did I know Moms would become some of my favorite yet worst clients. See, Personal Trainers only get paid after they train a session with a client, and I soon saw my paycheck take a hit. Here’s why…

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Guest Post: Music Therapy and Birth

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by: Megan Martin, MA, MT-BC
Music Therapy Assisted Childbirth Clinician
megan@healingsoundsrva.com
(804) 244-0193
Healing Sounds RVA

Imagine this: you're pregnant and you're nervous. Maybe you're nervous about labor and delivery. Maybe you're nervous about bonding with your baby. Maybe, you've heard stories about birth and newborn babies that have made you afraid. Pregnancy. Birth. Newborns. These are all words that bring enormous amounts of excitement and an enormous amount of fear to women. There are a lot of resources and strategies available for women these days to help you have a healthy pregnancy, a low-intervention birth, and support in those first months post-partum. One resource is not as well known- music therapy.

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Forget Self Love and the Truth about the Superwoman You Already Are

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Mothers and women, this one is for you!

No sleep, weary to the point of tears, stained shirt, messy bun, piles of dishes and laundry. The kids calling you every time you go to sit or eat. In fact, when was the last time you ate? Showered? What on earth happened to your other sock?

People like to talk about motherhood as beautiful, angelic, where you look amazing in leggings, messy bun, and still find time to put on a smidge of makeup. Not everyone will talk about the time you realize you only shaved one leg in the shower, and forgot the knee cap on the other leg. Or how your oldest child mentions the dark circles under your eyes.

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