How a Maternal Health Campaign Aims to Save 100 Stillborn Babies a Year in Massachusetts

Samantha LaCroix loved being pregnant for the first time.

During her 40-week appointment, LaCroix suspected she might be induced, as her unborn son – Xavier Brian LaCroix – had seemed to slow kicking and moving in the womb. LaCroix’s care team, affiliated with a major Boston hospital, assured her that everything looked healthy, including the baby’s heartbeat, and told her to come back three days later for an ultrasound.

But by then it was too late. As LaCroix stared at the ceiling during that subsequent appointment, with cold jelly smeared across her stomach, the ultrasound technician struggled to share the news: the baby had lost a heartbeat.

“This is the first time I’ve heard and learned that a baby can die in utero these days,” LaCroix, 43, said of her stillbirth experience more than a decade ago. “I really thought it was something relegated to history and to the wives of King Henry VIII. And I didn’t know what I had done – I didn’t know if it was my fault.

In Massachusetts, just over 300 babies on average are stillborn, according to data from the Centers for Disease Control and Prevention. This translates to a stillbirth rate of 4.34 per 1,000 live births.

LaCroix, from Northborough, is a Massachusetts-based ambassador for Count the Kicks, a maternal health awareness campaign that has been shown to reduce stillbirth rates by around 30% in the Commonwealth. This would parallel the success Count the Kicks has already had in Iowa over a 10-year period.

Using the free Count the Kicks app, pregnant women will choose a particular time each day – ideally when the baby is active – and log the time it takes to reach 10 kicks. By tracking fetal movement data, mothers-to-be will generate a clear pattern of their baby’s behavior and can alert their providers if kicking begins to noticeably decrease within a given time frame.

“At the time, I wasn’t really educated on what fetal movement monitoring is, what kick counting is, or how to do it. I just knew that in general I should be more attentive, and if I noticed anything to call,” LaCroix said of her pregnancy with Xavier, which involved several hospital visits in the middle of the night.

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Nneka Hall, a full-spectrum doula and the other Massachusetts ambassador for Count the Kicks, is trying to secure $160,000 from state lawmakers in this year’s budget cycle to officially launch the campaign across the Commonwealth, filled with a public awareness blitz with billboards at-risk communities, digital ads and emails, brochures in doctors’ offices and other printed materials in six different languages.

How a Maternal Health Campaign Aims to Save 100 Stillborn Babies in Mass.

Samantha LaCroix from Northborough with children Oliver, 9, and Lillian, 6, on their return from school on Wednesday April 5, 2023.Christine Peterson

While the Count the Kicks app is free — and about 2,000 expectant parents in Massachusetts have downloaded it so far — the goal is to connect as many expectant mothers and providers as possible with the tool through this massive public awareness campaign, Hall and LaCroix said. On a smaller scale, more than 40 Massachusetts-based vendors and organizations already distribute Count the Kicks materials, stylized with bright Dr. Seuss-style imagery, a campaign spokeswoman said.

The funding would also cover in-person training, webinars and a health survey integrated into the Count the Kicks app, said Hall, commissioner of the state’s Ellen Story Commission on Postpartum Depression. Hall, of Boston, plans to build support from lawmakers on the committee — including Sen. Liz Miranda, who introduced an omnibus birth justice bill this session — to ensure Count the Kicks can ultimately receive a budget allocation from the Ministry of Health.

Hall, who founded the Quietly United in Loss Together awareness campaign to recognize pregnancy and infant loss, said her daughter was stillborn at 39 weeks. But looking back, Hall called the tragedy of her third pregnancy “avoidable.”

“If I had the app when I was pregnant with the daughter I lost, it would still be there,” said Hall, who is also seeking government funding for a community-based maternal health training initiative. “I would have had the words and the data to take to my doctor, plus something is wrong, she is slowing down, what is going on with those hiccups, etc.”

LaCroix, who has a 9-year-old son and a 6-year-old daughter, joined the Count the Kicks campaign to honor the 10th anniversary of Xavier’s death.

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When she first came across the campaign’s website, LaCroix felt “sucked in” as she absorbed the sheer volume of information that was now readily available on stillbirths. But she was also grateful to know that Count the Kicks existed.

LaCroix said she now regularly shares brochures and information cards with expectant mothers, whether on a train or at her children’s swimming lessons – or through more structured webinars.

“I sincerely believe that if I had this data, there would have been a chance to save my son,” LaCroix said. “I don’t know what caused it, so I can’t say it would have been saved. But my God, this (the Count the Kicks app) could have changed that outcome drastically.

LaCroix had brought her duffel bag to the appointment during which she discovered that Xavier’s heart had stopped beating.

LaCroix thought her doctor would tell her she was ready to give birth. She felt excited, even though she had woken up that morning and hadn’t felt Xavier move. LaCroix assumed he was sleeping or resting.

“If someone like me, with no pre-existing health conditions, considered a perfectly healthy pregnancy, amazing care at Longwood Medical (area) – like phenomenal hospitals and doctors; we have some of the best in the world – if it can happen to me in the state of Massachusetts … then it can happen to anyone,” LaCroix said. “Stillbirth does not discriminate. It doesn’t matter who you are.

Count the Kicks’ mission is to save 7,500 babies nationwide each year and reduce racial disparities. While 1 in 173 pregnancies overall in the United States results in stillbirth, this rate is 1 in 97 for black pregnancies, 1 in 205 for Hispanic pregnancies, 1 in 211 for white pregnancies, and 1 in 254 for Asian pregnancies, according to the CDC and Count Kicks.

Within five years of its full launch in Iowa, Hall said Count the Kicks was successful in reducing the white stillbirth rate by 32% and the black stillbirth rate by 39%.

In Massachusetts, LaCroix said Count the Kicks has the potential to save about 100 “innocent and beautiful” babies and curb rising rates of maternal morbidity, especially among women of color.

“What an incredible impact we could have here in this state if implemented,” LaCroix said. “Anyone who has lost someone they love – be it a stillborn baby, parent or grandparent – that life is so precious and priceless.”

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