The 3rd trimester: What to expect with baby movements

Feeling your baby move while you’re pregnant is special and reassuring. It’s one of the best ways to bond with your baby before he or she is born. And those little kicks are a subtle – or sometimes, not-so-subtle – way for baby to let you know all’s well.

“Kick counting” is the practice of counting the number of times you feel your baby move during a specific period. Counting fetal kicks is a no-cost, low-tech way you can help monitor your baby’s health.

Counting kicks, also referred to as fetal movement counting, is how an expectant mom can track her fetus’ movements in late pregnancy. Most doctors recommend you do it daily during your third trimester. Knowing your fetus’ movement pattern can help you gauge if the pattern changes – which can be a possible warning sign your fetus is distressed.

Kick counting is so simple and low-tech, it may seem like the kind of wisdom that’s been passed down, mother to daughter, through the ages. But the “Count the Kicks” movement is a mom-led initiative that began in Iowa in 2008. According to an Oct. 15, 2018 story in The Washington Post, it “teaches pregnant women to track the movements of their unborn babies in the last trimester … so they can quickly detect in utero distress. The campaign has corresponded to a nearly 28% drop in stillbirths in Iowa.”

There are three ways to count kicks:

• Use an app on your Smartphone. (Forbes’ health editorial team recommends Nurture Pregnancy Week by Week (Glow), BabyCenter Pregnancy Tracker and amma-Pregnancy and Baby Tracker. All are free to download.)
• Go old-school and use a kitchen timer or clock and piece of paper to count the number of kicks you feel in an hour.
• Track the amount of time – again with a clock or watch and piece of paper – it takes for the fetus to kick 10 times.

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When to expect the first kicks and when to start counting.

Most pregnant women feel those first kicks or flutters when they’re between 18 and 25 weeks pregnant. For women experiencing their first pregnancy, it may be later than that. If you’ve been pregnant previously, you might feel it sooner.

But the movements won’t likely have any regularity to them yet. It’s too early to pick up on a pattern.

Kicks may not be obvious at first. At 20 weeks, your fetus weighs about 10 ounces and is about 6 1/2 inches long. Its movements can be hard to detect. (And there’s also the chance that what you’re feeling is gas!)

Some women say kicks feel like flutters, tiny jabs or something akin to butterflies in the stomach. Fetal movements will grow stronger during your third trimester.

By then (28 weeks and onward), fetal activity picks way up. This is when your baby’s movements become more regular and somewhat predictable. And it’s when the American Congress of Obstetricians and Gynecologists (ACOG) recommends expectant moms begin counting kicks. (If you’re having a high-risk pregnancy, counting should start at 26 weeks.)

During your third trimester, you should be feeling at least 10 movements every two hours. You can monitor them yourself to be sure they’re happening as often as they should be.

Ready, set, count.

Counting kicks is easy, but it does require a little preparation:

• Pick a time when you’re pretty sure your fetus is likely to be active – and when you’re feeling relaxed.
• Lie on your left side or sit with your feet propped up on a stool, pillows or a cushion. (Lying on your left side allows for the best circulation, which could prompt baby to move.)
• Put your hands on your baby bump.
• Set a timer or make note of the start time on your watch or a clock. You may even want to start a notebook to keep track of baby’s movements each day. That notebook will be a good thing to take with you to all your OB-GYN appointments.
• Count each kick. Write them down as single tick marks or “X’s” so you don’t lose track. Keep counting until you’ve reached 10 kicks.
• Once you get to 10, make a note of how long it took to get there.

Another way to do it: Set a timer for one hour and have paper (or your kick-counting notebook) and pen handy. Once the timer starts, make a mark on the paper every time you feel a kick. When the hour’s up, total the number of marks you made.

Baby not cooperating? If the fetus just isn’t budging after you’ve gotten set up to count kicks, try getting up and moving around, drinking fruit juice or eating something. Even turning up the volume on your music might nudge baby out of a deep sleep.

The value of counting.

Kick counting helps you get to know your baby and its movement patterns. Once you’ve discovered your baby’s typical patterns – which you’ll do after a week or so of kick counting – you’re more likely to be aware if something is amiss.

You should aim to do your kick-counting exercise at about the same time each day (or night). Once you know what the baseline number of movements is for your baby, you’ll know if your baby veers from the standard pattern. And if that happens, call your OB provider.

When is your baby most active?

It depends. Some of us are early birds and others are night owls. It’s the same inside the womb.

Some pregnant women report more fetal movement after they’ve eaten a meal. That’s due to the increase in sugar in their blood. Others say movement is heavier at night. Just when they’re trying to go to sleep, baby’s ready for a party. (It’s true: They do tend to be more active at night.) Baby’s also more likely to be active after you’ve been physically active.

Reduced kicking.

If you haven’t felt your baby move for a couple of hours, don’t panic. It may just be nap time.

If you don’t feel movement during the day, it could be that you’re focused on your work or that you’re busy caring for a child, or children, and are less likely to notice kicking. That’s why it’s important to find some time to be still so you can focus on counting.

If you’ve been using an hour as your unit of measurement, try increasing it to two hours. If you don’t feel 10 kicks within a two-hour period, try doing another round of kick counting. If you still don’t feel the number of kicks you’ve come to expect, let your doctor or midwife know.

Notice a change in movement patterns?

Contact your care team immediately if your baby’s kick pattern changes suddenly, decreases or stops entirely. Keep in mind: Decreased fetal movement isn’t typically cause for concern. But your doctor will probably want you to come to the office to confirm everything’s OK. If your doctor does want to see you, you’ll likely be placed on a fetal monitor to check your baby’s heart rate.

Does fetal movement change throughout pregnancy?

Not typically. It should remain steady at 10 kicks or movements every hour or two. By 39 weeks – when your baby is full-term – you may feel fewer sharp jabs but a greater number of gentle, rolling movements.

Your baby has grown and doesn’t have as much room to wind up for a kick. So, shoulder rolls have to suffice. Whether it’s a kick, flutter or roll, you should feel the same number of movements per day near the end of your pregnancy as you did at about 28 weeks.