Count the Kicks Research

BJOG: An International Journal of Obstetrics and Gynaecology published research that shows a more than 30% reduction in Iowa’s stillbirth rate in the first 10 years of the Count the Kicks stillbirth prevention program at a time when America’s stillbirth rate remained stagnant. The results have led researchers to call for urgent action to address the stillbirth crisis in the U.S. and to study Count the Kicks on a national level.

Dr. Alexander Heazell, global stillbirth researcher at the Tommy’s Research Centre at the University of Manchester, England, and his team of statisticians looked at Iowa’s stillbirth rate from 2005 (before the introduction of Count the Kicks) through 2018 (the end of the first decade of implementation) and compared it to three neighboring states that did not have a comprehensive stillbirth prevention program during the same time period.

The report, “Information about fetal movements and stillbirth trends: analysis of time series data,” that was published in February 2023, found the stillbirth rate in Iowa went down 1% every three months for a decade (2008-2018) while stillbirth rates in neighboring Illinois, Minnesota, and Missouri, remained relatively stagnant during that time frame. The research also shows that the stillbirth rate in Iowa went down sharply despite confounding factors like obesity, maternal age, high blood pressure and diabetes all increasing during the same timeframe. 

Dr. Heazell Shares His Findings

“To be able to demonstrate that we have a rate going down at 1% every three months in Iowa, which is much faster than the U.S. population average, that tells us that something is happening in Iowa that is not happening in the rest of the United States.” -Dr. Alexander Heazell, global stillbirth researcher at the Tommy’s Research Centre at the University of Manchester, England

Stillbirth in the U.S.

Every year in the U.S. more than 21,000 babies are born still, according to the CDC. The U.S. has one of the highest rates of stillbirth of high-income countries, and also one of the lowest rates of improvement. For U.S. parents, 1 in every 175 pregnancies ends in stillbirth. Stillbirth data broken down by state can be found here. Racial disparities persist, and expectant parents in racial or ethnic minorities have a greater risk of enduring a stillbirth. According to the CDC: 

“The U.S. ranked 27th out of 49 high income countries in 2015 with a low annual rate of reduction in stillbirth. Thus, identification of effective strategies to reduce stillbirth are urgently needed,” Dr. Heazell said.

In addition to Heazell’s research, data from the Iowa Barriers to Prenatal Care survey shows that 78% of Iowa moms learn about how to monitor changes in their baby’s activity during pregnancy from their provider. Systemic change is happening throughout the state and kick counting has become more commonplace in Iowa than in the rest of the country. In June of 2018, toward the end of the study period, the state of Missouri adopted Count the Kicks.

About Count the Kicks

Count the Kicks, which started in Iowa in 2008, was developed by Healthy Birth Day, Inc. as an empowering stillbirth prevention program for expectant parents to get to know their baby’s normal movement patterns in the third trimester and to speak up if they notice a change. Decades of research, including this study out of Norway, shows paying attention to movement is a non-invasive way for expectant parents to monitor their baby’s health and that babies can in fact be saved when parents speak up and providers act on their concerns.

The program teaches expectant parents the method for tracking fetal movement during the third trimester of pregnancy through a network of providers, birthing hospitals and maternal health champions using printed educational materials, a free mobile app, health worker training and mom-to-mom outreach. 

Count the Kicks

Educational Tools and Resources

The Count the Kicks program has printed educational materials available to order in all 50 states. The Count the Kicks App, which launched in 2015, is FREE and available in 20+ languages in the iOS and Google Play app stores.

Since its initial launch in 2008, the Count the Kicks program has expanded to additional states. Thanks to the generous support of our state partners, Count the Kicks educational materials are currently available for free to providers in more than 25 states.

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Resources for Providers
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Resources for Expectant Parents
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Our organization is leading the charge of stillbirth prevention and awareness in the United States, and our vision is to replicate the success of Count the Kicks in all 50 states. If we can reduce America’s stillbirth rate by 32% as we have done in Iowa, we would be saving 7,500 babies from preventable stillbirth each year.

Pregnant woman holding phone with CTK App on Screen
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How to Count the Kicks

Count the Kicks can help you get to know your baby's normal movements starting in the third trimester of pregnancy. Learn how to Count the Kicks.

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