Count the Kicks campaign to fight stillbirths expands to Arizona

Kaila Mellos

Cronkite News

While pregnant with her second child 12 years ago, Shawn Soumilas started having labor and thought she was giving birth. But the pain was excruciating and she knew something was wrong.

“I called my doctor and she was like, ‘Let’s go and head to the OB-GYN triage unit. “”

It was the day before the 4th of July and Scottsdale Hospital was busy. Then a shift change happened. A new nurse was supposed to perform a biophysical profile on the baby, checking heart rate, breathing and movement, but, Soumilas said, she neglected to do so.

“I was a pebble under his shoe,” recalls Soumilas. “She kept telling me I was dehydrated because it’s July in Scottsdale.”

Things quickly deteriorated. Hospital staff sent Soumilas for an ultrasound, but the technician then told her they needed her for triage, without saying why. While waiting to be transported, Soumilas is seized with nausea.

“My husband told me later, that’s when he felt like I was starting to die.”

Back at triage, Soumilas was greeted by a wall of doctors shouting, “Is that her? Is it her?”

They rushed her to an operating room and inserted an IV. Before sinking completely, Soumilas remembers shouting: “Please take care of my baby.

When she woke up the next day, she asked her nurse, “Where’s my baby?” But she didn’t have to wait for an answer to realize the worst had happened.

“I could tell in his eyes that he was gone.”

Made with Flourish

Count kicks, help moms

Soumilas later learned that she had suffered a rare complication called placental abruption, in which the placenta separates from the uterine wall before birth – sometimes depriving an unborn child of oxygen and causing internal bleeding in the mother.

“I lost three times my blood volume,” she recalls, “and needed blood, plasma and platelet transfusions. They told my husband that I had about a 30% chance of having the operation.

By the time doctors got to the baby, he had gone too long without oxygen. Soumilas lost his son, Zachary, at 38 weeks.

As she recovered, Soumilas began researching everything she could about stillbirth, and one thing struck her. A symptom of placental abruption is decreased fetal movement, and two days before losing her baby she had reported to doctors that she hadn’t felt much movement.

“I was told to lie on my side, drink some juice, see if he straightens up. So I did that,” she said. “I was told, ‘Her due date is almost up; he is probably settling in for the birth. And that doesn’t happen. They don’t stop moving.

“If I had… followed his patterns, I would have known something had changed.” If I had been there two days earlier, he would have been alive.

Soumilas eventually discovered a campaign called Count the Kicks, dedicated to teaching pregnant women about fetal movement and tracking the health of their unborn children. The effort grew out of the nonprofit Healthy Birth Day, started in 2008 in Iowa by five mothers who all lost their daughters to stillbirth or infant death.

Working with state health agencies, the organization is providing a free app or flipchart to help expectant mothers track their baby’s movements during the third trimester so that if they detect any unexpected changes, they’ll can seek help immediately.

The campaign, already in 14 states, is expanding to Arizona this month. The Arizona Department of Health Services partners with Count the Kicks to provide educational materials in multiple languages ​​to healthcare providers, birthing centers and others on the journey of a future. mom.

“Too many people believe that stillbirth cannot be prevented. We strongly disagree,” said Emily Price, executive director of Count the Kicks. In 2010, Price noticed her baby’s movements had slowed, but because she tracked them, she alerted her doctor and her son, Hayden, was born healthy.

Stillbirth is the death of a fetus at 20 weeks or older during pregnancy. Causes can include infections, birth defects, lifestyle, or problems with the umbilical cord or placenta, as Soumilas experienced.

Stillbirths have declined in the United States over the past 15 years. Still, nearly 22,000 were recorded in 2019, according to data from the Centers for Disease Control and Prevention.

The most at-risk mothers are black women, those 35 and older, women who smoke during pregnancy, and those with health conditions like diabetes and obesity. But they are not alone.

“Hispanic women are at higher risk,” Price said. “Indigenous women are more at risk. And it is totally unacceptable that in 2022 we are losing babies to stillbirth at the rate we are.

New research also shows that women with COVID-19 at the time of childbirth are at greater risk of stillbirth. A CDC study found that among 1,249,634 deliveries from March 2020 to September 2021, stillbirths occurred in 0.65% of deliveries. But among those who had COVID-19 at the time of delivery, the stillbirth rate was 1.26%.

Arizona recorded nearly 500 stillbirths in 2019, the latest data available, with stark disparities among women of color.

“It’s a much bigger problem in Native American communities, as well as African American communities,” said Angie Lorenzo, who directs the office of women’s health at the state Department of Health Services. “Those are the two most affected by this.”

Experts examining these disparities note that in many cases the cause of death is not even documented, but they point to aggravating factors, including access to good health care, institutional biases and differences in health care. health before and during pregnancy.

“Racial disparities definitely persist,” said Stephaney Moody, health equity coordinator at Count the Kicks. “We don’t have conversations. It’s not easy to get, but it’s something I’m not afraid to do.

Warning signs – and solutions

Although lack of fetal movement is a warning sign of potential problems, experts disagree on whether kick counting is directly correlated with fewer stillbirths.

A 2009 study in the journal BMC Pregnancy Childbirth that reviewed previous research on fetal movement monitoring found evidence of an impact on stillbirths in high-risk pregnancies, but recommended that more studies be conducted to determine the effect of universal fetal movement monitoring.

Another review in 2021 agreed that further studies are needed to assess the effectiveness of various methods of monitoring fetal movements, but noted that “monitoring fetal movement counts is a low-cost, low-tech method that has the potential to prevent worsening of problems with unborn babies and deserves the attention of providers and pregnant women.

Count the Kicks also undertakes its own research. Researchers from Des Moines University and the Harkin Institute for Public Policy & Citizen Engagement surveyed 809 women who used the Count the Kicks app and determined that users increased their knowledge of movement patterns and were more likely to be seen by a physician for decreased fetal movement.

The app developed by Count the Kicks works with moms-to-be to track how long it takes to feel 10 movements, including kicks and rolls. Count the Kicks has also developed a paper form to track moves and average them out.

“Every baby and every pregnancy is different,” Moody said. “Maybe it would take my baby 10 minutes to get the 10 kicks…but it takes your baby 45 minutes. The key is knowing what’s ‘normal’.”

In Arizona, the health department and Count the Kicks are working to specifically target underserved communities and women of color. Materials are available in English and Spanish, and Moody and Lorenzo said the goal is to provide Navajo brochures, posters and enforcement reminder cards as well.

The Department of Health Services is partnering with Diné College of the Navajo Nation and South Phoenix Healthy Start, a provider for women of color, to help raise awareness of the effort.

Moody said she hopes to see a decline in stillbirths in the state by introducing the program “not only to expectant parents, but also to maternal health workers and providers who are in the state.”

Tribute to Zach

After volunteering with Count the Kicks, Soumilas now represents Arizona as an ambassador for the organization – to share her story and raise awareness of the campaign. She connects with groups and hospitals that treat pregnant women, and is encouraged that the partnership with AZDHS will bring additional attention.

Today, Soumilas, 48, lives in Prescott with her husband, Theo, and 13-year-old son, Ian. But Zach is still in his heart.

“It will always be hard to know that Zach is meant to be by Ian’s side during all of our memorable family moments,” she said. “When I was pregnant with Zach, I felt a sense of peace that they would always be together in life.”

And every day she works to honor her son through her work with Count the Kicks.

“If you see a change, you need to talk about it…Don’t wait until tomorrow,” she said. “Having this conversation is extremely important for women to know that you are the one who is empowered to do this for you.”

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