The MSNBC article “Autopsies Urged to Unravel Tragedy of Stillbirth” (Associated Press, March 2, 2009) struck a painful chord. The worst experience any obstetrician wants to go through is admitting a pregnant woman into the hospital to deliver a dead baby. Stillborn deliveries are the ultimate dread in obstetrics and they affect twenty-six thousand women in our country each year.
While the article focuses on autopsies of stillborn babies as a means of diagnosis, we also need to seek a means of prevention. Although one-third of stillbirths occur for unknown reasons, a heightened sense of awareness of fetal movement is priceless. Live babies move. The most important question that I ask every patient during each prenatal visit is, do you feel your baby move? After twenty-three weeks, a patient should feel her baby move at least ten times within a four-hour period and once every ninety minutes during the third trimester. If the baby does not move within these periods, than the provider should be contacted immediately. If a provider is not available, the patient should go to the hospital as fast as she can. Fetal movement is extremely critical, yet as obstetricians, we don’t emphasize this point enough.
Watch, watch, watch is the key to a successful pregnancy, and there are tools that can assist along the way. A kick chart is a tool that helps monitor a baby’s movement and can usually be obtained from a healthcare provider’s office. This chart helps patients focus on baby’s movements. Pregnant women also need to be aware of tests such as non-stress tests and biophysical profiles that monitor the baby’s heartbeat, movements and breathing on an ultrasound for approximately thirty minutes.
Fetal movement is always a beautiful thing and reassures you that your baby is alive.