State senator educates woman about fetal health

DES MOINES, Iowa (AP) — In the 10 years since she delivered a stillborn baby girl, state Sen. Janet Petersen has been on a mission to help other mothers try to avoid the same tragedy.

A public health campaign that she started with four other moms who suffered similar losses is now reaching women in Iowa and branching out around the country. Called Count the Kicks, the campaign educates women about how to monitor their babies’ activity during the final stages of pregnancy in the hope that they may notice any potentially problematic changes. Since the 2009 launch, the campaign has been adopted by more than 75 percent of Iowa OB/GYN clinic and birthing hospitals.

A new Count the Kicks web application was launched last month and efforts to create similar programs are underway in seven more states. Peterson said she is thrilled to see the grassroots project grow into a larger movement.

“I really can’t think of anything worse than losing a child,” said Petersen, a mother of three who represents part of northwest Des Moines. Petersen said her daughter Grace died after a knot developed in her umbilical cord, depriving the baby of oxygen. She thinks if she had known more about monitoring her movements, they might have been able to intervene.

“Our end goal is for every expectant mom to know about the importance of counting the kicks,” Petersen said. “Basically we’d like it to become as easy for people to remember as taking a prenatal vitamin.”

Based on a similar effort in Norway, the Count the Kicks campaign — which has attracted more than $200,000 in donations and grant funding — advises women in the late stages of pregnancy to keep track of their baby’s movements each day. Using colorful posters and pamphlets, they suggest picking a similar time each day and counting 10 movements within a two-hour period. According to the campaign, if women consistently do that, they should get a sense of the baby’s patterns and will notice a decline in movement, which should prompt a call to a health care provider.

Just how effective kick counting is as a way to prevent stillbirth is hard to say. In their official guideline on fetal surveillance, the American College of Obstetricians and Gynecologists states that it is not clear if fetal movement assessment can actually reduce stillbirth, noting a limited amount of research on the topic. But Dr. Stephen Hunter, a professor of obstetrics and gynecology at the University of Iowa, said kick counting is helpful, because a decrease in movement often precedes a stillbirth.

“A lot of it is just patient education,” said Hunter, the director of the Division of Maternal-Fetal Medicine and an associate director of the Iowa Statewide Perinatal Care Program, which visits all Iowa hospitals that deliver babies to review the care offered and to educate physicians and other providers.

“The nurse and I review every stillbirth in the state of Iowa. It’s sad how many of them we see where patients had decreased fetal movement for days before they came in,” Hunter said.

Stillbirths in Iowa have declined from 231 in 2008 to 174 in 2012. There is no way to know if the campaign is a direct cause, though Hunter said he has a “strong suspicion” that it may be among the contributing factors.

Petersen and her group have also pursued legislative ways to address stillbirth, successfully passing a stillbirth registry law in 2004, which has helped fund research on stillbirths in Iowa. Petersen said she continues to review legislation to protect maternal health, but has no definite plans for the 2014 legislative session.

Amanda Brezina, 32, a stay-at-home mother of four in Des Moines, recently delivered a healthy baby girl and said that closely tracking the baby’s activity was important to the successful birth. Brezina went into labor at 35 weeks and noticed that the baby seemed to go limp when she stood up. She rushed to the hospital and it was later discovered that she had a hemorrhage in the base of the umbilical cord and standing was apparently having a negative impact on the baby.

“I was grateful that I knew her well enough in utero to know what she usually did,” said Brezina, who became a volunteer for Count the Kicks after her second pregnancy in 2008, when she went to the hospital after noticing her son had stopped moving. It turned out he had had a stroke and his heart wasn’t beating after delivery. But he was revived and Brezina said his development has been normal.

“There’s so much to learn about pregnancy and parenthood, this isn’t something that should be skipped over,” Brezina said of counting kicks. “It’s easy to do. It’s not invasive. Kids and parents can participate.”

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