Key quotes

“in the early 2000s. We were founded by five Iowa moms who all lost daughters to stillbirth or infant death in that timeframe. Oh, wow. Yeah. And so they were told that stillbirth isn't very common, that it doesn't happen a lot anymore. And they came together, you know, through friends and, you know, connections within the community and, you know, in their grief realized, you know, we've heard that this isn't very common, but it happened to all five of us in the short amount of time within, you know, a year or so. And they really wanted to”

“conference, they saw a presentation on some research in Norway that showed a 30% reduction when moms were educated on paying attention to their babies movements and getting to know their movement patterns in the third trimester. 30% reduction? 30% reduction. Wow. Yeah.”

“But what we have seen is that within that 32% reduction, we saw a 39% reduction among stillbirths in African-American families. So as with many other maternal health and birth outcomes, Black women face an increased risk of experiencing stillbirth, almost two times that of their white counterparts. That's a huge number. And so you're saying that in that population, there was a greater decrease in stillbirth when they adhere to the count the”

“that we get is when families reach out to us and they say, your program helped my baby get here safely. So we have heard from more than 130 families since our program began. And these families are in six different countries now as well.”

“what our app users actually tell us is that 77% of them said it helps to reduce their anxiety about the wellbeing of their baby. And more than 80% of them said that it helped to increase”

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Transcript

AI-generated transcript with speaker labels — may contain errors, especially names and medical terms. Dr. Elliot Berlin, DC appears in blue; Kimberly Isburg in orange.

Dr. Elliot Berlin, DC [0:12] Welcome to the Informed Pregnancy and Parenting podcast. I am your host, Pregnancy Focus Car Director, Dr. Elliot Perlin. My guest today is the Communications Manager for Stillbirth Prevention Program, Count the Kicks. She's here to talk about the Count the Kicks app, her own experience with pregnancy and motherhood, and common myths surrounding movement monitoring in the third trimester. Kimberly Eisberg, welcome to the podcast.

Kimberly Isburg [1:02] Hello. Thank you so much for having me. I'm excited to be here.

Dr. Elliot Berlin, DC [1:05] I'm so glad that you're here. And I think the topic is really important and relevant for pretty much everyone who listens to our podcast. And I have a lot of questions about it too. So this is going to be an informative episode. Why don't we jump right in? From the beginning, where are you from originally?

Kimberly Isburg [1:21] I am from a small town in northwest Iowa of about 4,000 people called Emmitsburg. Oh, Emmitsburg. What's it near?

Dr. Elliot Berlin, DC [1:30] It's near kind of the Iowa Great Lakes. So you might've heard of Okoboji or Spirit Lake.

Kimberly Isburg [1:34] So it's about 45 minutes from there. Wow, that sounds peaceful. Is it peaceful?

Dr. Elliot Berlin, DC [1:39] Yeah, it was very nice. You know, small town life.

Kimberly Isburg [1:42] Small town life. And now, as I mentioned at the beginning, you're the Communications Manager for Count the Kicks. How did you get into that?

Dr. Elliot Berlin, DC [1:51] So I studied journalism in college and always enjoyed, you know, communicating. And after having kids, I just became really passionate about helping to support other parents to help educate them, kind of share some of the things that I didn't know. So when I found this particular position, it combined my experience in journalism and my interest in maternal health and pregnancy. And so it was just a really great fit.

Kimberly Isburg [2:19] If you came from a town of 4,000 people, what was college like?

Dr. Elliot Berlin, DC [2:24] Well, college was not that different, honestly, because I chose a small college. So I went from a town of about 4,000 to a college of about 4,000 to 5,000. So if I stayed in my little, you know, college bubble, it was about the same, fewer variations in age, I guess, but roughly the same amount of people. But it was in the capital city of Iowa. So the city itself was quite a bit bigger.

Kimberly Isburg [2:51] Ah, you know, I was like the home of chiropractic.

Dr. Elliot Berlin, DC [2:55] Yes. So I feel connected. Good. You'll have to come visit sometime.

Kimberly Isburg [3:01] I would love to. We lived in Nebraska for a year. So we're in the general neighborhood.

Dr. Elliot Berlin, DC [3:05] Yeah, very close.

Kimberly Isburg [3:07] Okay. So your count the kicks is very specific.

Dr. Elliot Berlin, DC [3:10] Did you have sort of a vision when you studied journalism of what you wanted to do? I thought I wanted to work in magazines, but I think the underlying thing that always drew me to journalism was wanting to do work that mattered, that helped people, that made an impact. And so I think that's absolutely what drew me to this work with Count the Kicks.

Kimberly Isburg [3:30] How long have you been doing it?

Dr. Elliot Berlin, DC [3:32] I've been with Count the Kicks for about four and a half years now. Oh, wow. That's a lot of kicks. Yeah.

Kimberly Isburg [3:38] And talk to me about your own personal journey, motherhood.

Dr. Elliot Berlin, DC [3:42] Yeah. So I have two kids, boys. They are 10 and 7. That's a lot of energy. It is a lot of energy, but a little bit more independent than those young toddler and baby years. So I am enjoying that. Always knew that I wanted to have kids. It was a bit of a journey for us to be able to have kids. So I think that kind of framed my parenting, but also found that-

Kimberly Isburg [4:07] Like a fertility journey?

Dr. Elliot Berlin, DC [4:09] Yes. We tried for two and a half years or so before we got pregnant with our first child and then similarly like more than a year to have our second.

Kimberly Isburg [4:19] Oh, wow. They kept you waiting. That's a tough journey.

Dr. Elliot Berlin, DC [4:22] They did. We had to earn it.

Kimberly Isburg [4:24] Yeah. So when you said that framed your parenting style,

Dr. Elliot Berlin, DC [4:27] because we also had a fertility struggle, my wife and I, do you mean like just a different approach to sort of being excited when they scream at two o'clock in the morning, just because they're there? I mean, is that what you mean by that? Yeah, a little bit. Yeah. I think it definitely made me appreciate parenting more and also gave us a couple more years to be older and wiser, I guess, so to speak. So, we really, really enjoyed once we had kids and appreciated that they were in our lives. I never thought about that, but yeah, I guess the fact that we had to wait a few years made me older. I don't know about wiser, but. And in your pregnancies, did you know about

[5:13] third trimester fetal movement monitoring? So I did. Our program started here in Iowa. And so

Kimberly Isburg [5:21] you see count the kicks materials in a lot of places, posters hanging on the wall at the doctor's office. Your provider will say like, is your baby moving or how's your baby moving? That kind of thing. So it's definitely familiar with it. Got the brochures with my first pregnancy. I kind of followed all the rules, you know, being a first time mom. And so every night at bedtime, I'd sit down and pay attention to his movement and see how long it took him to move. He was always really active again at that bedtime time. When I would lay down to go to sleep, that was when he was just doing somersaults in my belly. And then with my second baby, I think I felt more comfortable, more knowledgeable,

[6:02] and I wasn't quite as dedicated to counting kicks, but I definitely was still aware of his movement patterns and his active times. And he was just a less active baby during pregnancy than my first, but still, you know, lots of movement, just kind of a little more mellow. Well, all this talk about movements and the counting and sort of monitoring what's

Dr. Elliot Berlin, DC [6:24] normal versus abnormal is definitely stirring up a lot of questions. I want to take a quick break and when we come back, we'll get into the whole idea and what count the kicks is and what we can learn from you guys. We'll be right back. from Count the Kicks. Okay, let's just jump into Count the Kicks. What is Count the Kicks? So Count the Kicks is an evidence-based stillbirth prevention program. It teaches expectant parents how to get to know their baby's normal movement patterns in the third trimester and helps empower them to speak up if they notice a change in their baby's normal.

Kimberly Isburg [8:40] Okay, why third trimester specifically? So the third trimester of pregnancy generally is

Dr. Elliot Berlin, DC [8:46] that time when your baby is bigger, you can feel them moving in your belly consistently, and they tend to get into a recognizable pattern kind of close to the beginning of the third trimester, which is 26 to 28 weeks. Okay, so at that time you start to keep an eye on looking for that pattern? Yeah, so Count the Kicks has a free app, but we also have paper charts, we have a web counter. So kind of any of these methods that you want to use,

Kimberly Isburg [9:16] you're going to pick a time every day around the same time, a time when your baby is active. So earlier, you know, I was talking about how my first baby was always active when I went to bed, that kind of evening time when I was winding down. So that would be a good time to Count Kicks. So kind of just getting familiar with when your baby is normally active and counting around that same time every day. Is it, I don't know, never had one and never really thought about it, never had a baby inside me. But is it not like activity all day long? It isn't activity all day long. They have sleep wake cycles, similar to newborns. And so you may find that they're, you know, always active

[9:56] in the morning after you eat breakfast, or maybe it's that bedtime, you know, or maybe it's after you eat dinner. So just kind of being familiar with those patterns can help you. And then when you're counting the kicks, you're going to time how long it takes your baby to

Dr. Elliot Berlin, DC [10:11] move 10 times. Okay. So even if they're not moving all day long, but it still sounds like there are multiple times throughout the day where they might move. I mean, if they're sleeping, not so much movement, but then wake patterns, or you're saying that there's generally a time of day for each baby where that is their active time. There are multiple times a day that a baby would be active in your pregnancy. But with

Kimberly Isburg [10:36] count the kicks, it's really just about picking that one time a day to kind of tune in, count how long it takes your baby to move 10 times, pay attention to the strength of that movement. And then by doing that every day around the same time, you're going to get to notice that pattern that normal amount of time it takes your baby to move 10 times. And if that ever changes, either a decrease or an increase, or the kicks aren't as strong in that time that you normally count, that's an indication that you need to contact your

Dr. Elliot Berlin, DC [11:08] provider. Okay. Is there a sort of a normal amount of time it should take for them to

Kimberly Isburg [11:13] do the 10 or does each baby have their normal? Yeah, each baby has their normal. So that's really the key. Every baby, every pregnancy are different. So what you're wanting to do is really get to know what's normal for your baby. So that may be 10 minutes for my baby and it may be 20 or 30 minutes for somebody else's baby. I know myself,

Dr. Elliot Berlin, DC [11:36] like I would definitely be there thinking, was that a kick? Was that a kick? Is there a way to reassure somebody that they're doing it right? Yeah. So I would say once you get to

Kimberly Isburg [11:47] the third trimester, the kicks are pretty recognizable or the movements. And again, you're not counting just kicks, but you can count kicks, pokes, jabs, rolls, swishes, pushes, any type of movement where your baby is intentionally moving. The only thing that doesn't count are hiccups. And the difference between like a kick and a hiccup would be those hiccups are going to feel a little bit less strong and they're going to be very rhythmic. So if you think about when you have hiccups, it's a recognizable pattern, pretty close together too. I can see the TikTok video now. Hic or kick you decide.

Dr. Elliot Berlin, DC [12:25] Well, this is quite interesting. So I'm going to get into the app shortly because that I think will help a lot of people to have a system for doing it and some tools, but this is really

Kimberly Isburg [12:35] interesting. How did the organization begin to count the kicks? Yeah. So our organization began

Dr. Elliot Berlin, DC [12:42] in the early 2000s. We were founded by five Iowa moms who all lost daughters to stillbirth or infant death in that timeframe. Oh, wow. Yeah. And so they were told that stillbirth

Kimberly Isburg [12:55] isn't very common, that it doesn't happen a lot anymore. And they came together, you know, through friends and, you know, connections within the community and, you know, in their grief realized, you know, we've heard that this isn't very common, but it happened to all five of us in the short amount of time within, you know, a year or so. And they really wanted to do something to prevent it from happening to other people. Wow. I mean, it's so tragic.

Dr. Elliot Berlin, DC [13:24] And I think that also sometimes, I don't know if I'm that person that when I get kicked hard like that, if I have the strength to pick myself up to dust myself off, let alone sort of rise up and use my experience to help others not have a similar type of experience. That's really powerful. But still, how do you go about creating a program, finding the information, getting it out to people? Yeah. So these moms started by creating a stillbirth registry here

Kimberly Isburg [13:58] in the state of Iowa so that we could gather more information on what was happening in our state, how often it was happening, why it was happening. And they attended a conference and at that conference, they saw a presentation on some research in Norway that showed a 30% reduction when moms were educated on paying attention to their babies movements and getting to know

Dr. Elliot Berlin, DC [14:21] their movement patterns in the third trimester. 30% reduction? 30% reduction. Wow. Yeah. It is. And they saw that and they said, hey, if they can do that there, we can do it here.

Kimberly Isburg [14:34] So they worked with the Iowa Department of Health and Human Services and a local marketing company and they created this mom-focused empowering educational campaign that was focused

Dr. Elliot Berlin, DC [14:46] on stillbirth prevention. Wow. Has there been a way to sort of track its effectiveness here?

Kimberly Isburg [14:54] Yes. So in the state of Iowa, we saw a 32% reduction in the stillbirth rate in the first

Dr. Elliot Berlin, DC [15:01] 10 years of the campaign. Wow. And then have you learned? I mean, it seems like the longer it goes on, the more data you get, the more you can fine tune and learn. Have you been able to learn other things like to further reduce? I mean, you can't save them all. Right. Right. Yeah. Every stillbirth is not preventable. That is definitely true. But what we have seen is that within that 32% reduction, we saw a 39% reduction

Kimberly Isburg [15:32] among stillbirths in African-American families. So as with many other maternal health and birth outcomes, Black women face an increased risk of experiencing stillbirth,

Dr. Elliot Berlin, DC [15:44] almost two times that of their white counterparts. That's a huge number. And so you're saying that in that population, there was a greater decrease in stillbirth when they adhere to the count the

Kimberly Isburg [15:58] kicks protocols. Yes. So in the state of Iowa, in the first five years of the program,

Dr. Elliot Berlin, DC [16:05] the stillbirth rate among African-American women decreased by 39%. Wow. Okay. And then

Kimberly Isburg [16:12] are there other things that you're able to learn over time? It just seems like you must be

Dr. Elliot Berlin, DC [16:17] collecting a lot of data. Yes, we are. And one of the most amazing pieces of data or information that we get is when families reach out to us and they say, your program helped my baby get here safely. So we have heard from more than 130 families since our program began. And these families are in six different countries now as well.

Kimberly Isburg [16:41] Meaning they'll count the kicks, notice something is not adding up and then go get help and realize

Dr. Elliot Berlin, DC [16:47] there's an issue that they can take care of before it's too late. Yes. Wow. That's incredible work. I mean, how will you ever leave this company? I don't know. I don't know if I will. It's hearing these stories from families that say, you know, count the kicks, help my baby count the kicks, save my baby. Like those stories are incredible and they make me cry every single time. Yeah. All right. We are going

Kimberly Isburg [17:13] to take another little break and when we come back, I want to jump into two things with you.

Dr. Elliot Berlin, DC [17:18] Number one, more about how the app works on the other count the kicks tools and also just fine tuning a little bit more about some of the myths and clearing up back versus fiction when it comes to monitoring fetal movements. Let's take a little break. We'll be right back.

Kimberly Isburg [17:46] Welcome back. We're talking to Kimberly Iceberg from count the kicks. All right. The tools,

Dr. Elliot Berlin, DC [17:52] let's talk about the app. First of all, where can someone get the app and what does it do? Yeah. So the app is available in either the iOS, Apple app store, or the Google app store. It is in 20 different languages. So it's really, you know, widely available to anyone. The count the kicks app is really easy to use. You just open it, click on start counting, and it will time how long it takes your baby to move 10 times. And then once you reach that 10th movement and then timer stops, it will let you rate the strength of your baby's movements because research also shows that the strength of your baby's movements is an important sign of their wellbeing. And then you can take any notes that you want to take, whether it's what

[18:37] you ate that day or maybe where you were at or question for your doctor, and then finish your session. And again, if you count every day, kind of around the same time, it's going to show you a graph of how long it takes your baby to move 10 times each day. And you'll begin to see that history over time. Does it indicate to you if there's a change? So no, again, every baby and every pregnancy are different. So a change for one mom might not be a change for another mom. And again, there's no threshold of what's normal for every single baby. So it's really just you looking at the data that's in your app and being able to say, okay, it has consistently

[19:18] taken my baby 10 to 15 minutes to move 10 times. And today it's taking 45 or 60. And that is not normal for your baby. And that's when you really want to contact your provider and say, Hey, I noticed a change in my baby's movements. Can I come in and get checked?

Kimberly Isburg [19:37] Yeah, that's right. I was just thinking that once you establish a baseline for your baby,

Dr. Elliot Berlin, DC [19:42] then, you know, does the app say, wait a second, you're off base here. And it sounds like it doesn't yet. It doesn't suggestion from Dr. B. But still, you could see the data clearly laid out. And if you're taking the time to count the kicks and use the apps, you'll notice that there's been a change. Yeah, I wondered. I mean, I just see patients in my office every day where we do a lot of pregnancy all day long. And some people just not really connected at all, like just going about life outside the womb. You know, they're just moving slower, but otherwise nothing's changing. And, you know, strong, fine, healthy, just not all that connected to the baby. And other people

[20:19] that seem so connected, they're like, is that normal? Is that normal? So I just wonder if the app and it could be different for different people, but does the app

Kimberly Isburg [20:27] make people less anxious or more focused? Yes, absolutely. The app is a great way to

Dr. Elliot Berlin, DC [20:35] bond with your baby. It's really taking that time to slow down, to enjoy your pregnancy, to bond with your baby, to get to know their personality a little bit. It's a great way to involve your partner or your baby's older siblings. And we have actually found that while you might hear that kick counting could increase anxiety, what our app users actually tell us is that 77% of them said it helps to reduce their anxiety about the wellbeing of their baby. And more than 80% of them said that it helped to increase their feelings of bonding with their baby. Oh, wow. I didn't even think of it from

Kimberly Isburg [21:11] bringing other family members into the bonding process. Yeah. It's a neat way.

Dr. Elliot Berlin, DC [21:17] So I'm trying to picture like a little toddler with the hand on the belly and,

Kimberly Isburg [21:21] you know, there's a kick. Yeah. And that's the great thing about the app too. It's so easy to use. Like when you pull it up, it's got a big teal footprint on the screen in a circle and you just tap the footprint. So really anybody can do it. That's very cute. All right. So there's some misunderstandings about movement monitoring

Dr. Elliot Berlin, DC [21:43] and lightness. Yes. There are a lot of misconceptions out there. One that I already talked about was that increase in anxiety. I think another one is that if your baby is always active, you don't need to take time to count the kicks. But like I said, what's important is really getting to know what's normal for your baby. Even active babies can experience distress. And so that can sometimes happen quickly and there may not be other warning signs. So that's the reason that this is important for everyone to do, not just people who are high risk or, you know, people who have a baby that maybe doesn't seem as active.

Kimberly Isburg [22:20] Yeah, right. I think that if you get the sense that there's movement generally, then

Dr. Elliot Berlin, DC [22:25] you feel secure in that perhaps. But like you're saying, it's going to be hard to notice a change in pattern, a change in nuance if you're not deliberately monitoring. And then I do hear, and I wonder, like who would know, like as the baby gets bigger in the third trimester, let's say 34 weeks, 36 weeks, and most people's space is running out. There's this vision, this idea that the baby doesn't have much room anymore. So does the movement pattern change? So the movement pattern should not change. The types of movement that you feel may change. You may feel more jabs, more swishes. You're not going to feel maybe those big kicks or rolls that you might've felt earlier in pregnancy. But again, if you're counting around

[23:12] the same time every day, you should take the same amount of time for your baby to move 10 times. And the same, because you're rating it right on a scale of one to five, how strong the movements are. So the movements will still be similar strength?

Kimberly Isburg [23:26] Yes, they should still be similar strengths. So you might not feel a kick, but you might

Dr. Elliot Berlin, DC [23:30] feel a big, you know, nudge or a push. Yeah. And they should still be similar in strength. Yeah. Roughly the same. Wow. Okay. I guess the concern, I don't know if it goes up or goes down as you get closer to the end, but I guess my question is, do these movements change even a couple of days before labor? Like, is there a time where we would expect to see a change and that's like, oh, that's normal or no, always report the change.

Kimberly Isburg [23:58] Always report the change. Your baby should move up to and even during labor. So if you notice

Dr. Elliot Berlin, DC [24:03] that your baby isn't moving or isn't moving as much, that is a red flag and a reason that you should call your provider. Okay. Good to know. I've learned a lot and I hope that our audience is learning a lot too. I know they are.

Kimberly Isburg [24:16] And it's interesting. You have like a clear passion for the work that you're doing

Dr. Elliot Berlin, DC [24:21] and who wouldn't again, how they ever leave that company. But you also have some videos, Count the Kicks videos and other educational materials. I know that some of them are available to informed pregnancy listeners through informed pregnancy plus under Count the Kicks. And there's how-to videos. There's powerful stories on there. Where else could people find information or tools from Count the Kicks? Yeah. So we have a website where you can find a lot of information on how to Count the Kicks. We have printed educational materials that can be ordered for anyone who works with expectant parents, whether they're providers or community

Kimberly Isburg [25:05] based organizations. Are those things that you hand out or like posters that you put up?

Dr. Elliot Berlin, DC [25:10] Yeah, there are brochures that you could hand out. We have app cards, just a little, business card sized card with the QR code on there that goes directly to the app to download it and posters to put on the wall. So really anyone who works with expectant parents can order those materials on our website and share them with the families that they work with.

Kimberly Isburg [25:30] Amazing. I asked all the questions I can think of immediately. Did I leave something

Dr. Elliot Berlin, DC [25:34] out that you want to share? I think just would encourage everyone to learn more and visit us at countthekicks.org and also follow us on our social media platforms. Are they also at Count the Kicks? Yeah. So we are at Count the Kicks on Instagram,

Kimberly Isburg [25:53] at Facebook, and TikTok. Oh wow. TikTok. For real? Yeah. Yes.

Dr. Elliot Berlin, DC [25:59] Thank you again, Kimberly. Thank you so, so much. This seems like not only one of those topics that it's important to educate ourselves about, but also important to share. The more people that know, the more people that learn, the more people that do the self-monitoring, seemingly the more babies will be saved, will realize early enough that there's an issue and be able to intervene. And in all the areas of medicine, to me, we have so many medical marvels in modern medical history, but I think some of the greatest are NICU. And once we able to get those babies access to the babies, there's so much we can do now to keep them

Kimberly Isburg [26:39] healthy and keep them strong. Yeah, you're absolutely right. And it's really just something

Dr. Elliot Berlin, DC [26:44] that we're working towards making sure that all expectant parents know this, that it is common as taking a prenatal vitamin in pregnancy or taking your baby home in an infant car seat. We want every expectant parent to know that when you get to the third trimester,

Kimberly Isburg [26:59] you count the kicks. Tough, but important topic to speak about. Thank you for joining

Dr. Elliot Berlin, DC [27:03] me and for sharing, and we will visit you online at Count the Kicks. And at home, thanks for listening to our podcast. For more pregnancy and parenting information, visit us online at informedpregnancy.com.

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