Kick Counting and Anxiety: What Studies Found
If your baby's movements change, call your care team at once, whether or not you count kicks. Studies that compared groups of women mostly found less anxiety with counting or no clear difference, and none found a statistically significant increase, though two trials found slightly more women anxious or insecure. The RCOG's 2026 guideline says most evidence shows monitoring is not linked to more anxiety. If counting worries you, tell your midwife or doctor.
Written by the Bumpi Kicks team at Speed AI Labs LLP. Last updated . General information, not reviewed by a clinician, and not medical advice. How we write and check these pages.
If your baby's movements change, contact your care team now
Call your midwife, doctor or maternity unit immediately if your baby moves less than usual, you cannot feel movement, or the usual pattern changes. Do not wait until the next day, and do not let worry about counting stop you calling. If counting itself is making you anxious, tell your midwife or doctor.
If you cannot reach them, or you are worried about your own health, call your local emergency number.
What the research on anxiety found
Cochrane review, 2015: less anxiety in one study
One study of 1,013 women, the Norwegian trial of 1,076 women, found lower anxiety on the Cambridge Worry Scale among women who counted routinely. The review calls the difference statistically significant but not clinically important. It was the only study of anxiety in that comparison; two other trials reported nervousness or insecurity in other comparisons, with no statistically significant difference. The review also notes that counting tests can cause considerable anxiety for some women.
Trial in Iran, 2016: lower anxiety at 37 weeks
In a randomized trial of 208 first-time mothers, women asked to count daily from 28 weeks had lower state and trait anxiety scores at 37 weeks than women given standard care. The groups did not differ at 28 weeks. The trial was in one country's care system, and we read the abstract only.
Review of nine studies, 2022: no clear difference
A systematic review of nine studies (70,824 women in all, 68,654 of them in the 1989 trial) reported anxiety in four and did not pool them. Its summary was no differences in maternal anxiety or worry. One trial found lower anxiety with counting, and the 1989 trial found slightly more women anxious, which was not statistically significant. The authors say a Hawthorne effect could potentially over-estimate the positive effects they found, such as higher attachment with counting.
Small study after birth, 2022: no difference
Of 50 mother-infant pairs, 25 counted kicks daily for two weeks in the third trimester. Depression and anxiety symptoms reported one to four months after birth did not differ significantly. It was small and groups were set by when women enrolled. It does not say counting raised anxiety.
App users, 2025: lower anxiety among frequent counters
In a study of 1,147 users of the Count the Kicks app, more frequent counting was associated with lower pregnancy-related anxiety and more bonding with the baby. It describes people who chose to count and answered a survey, so it cannot show that counting lowered anxiety.
The RCOG replaced its 2011 caution in 2026
The RCOG's 2026 guideline says the majority of evidence indicates that asking women to monitor movements is not associated with increased maternal anxiety and increases maternal-fetal attachment, graded B. Its 2011 edition had told clinicians to be aware that instructing women to monitor is potentially associated with increased anxiety, citing a small cohort in which 23% of women reported anxiety.
One guideline still cautions, citing a 1986 study
The 2023 guideline of the Sri Lanka College of Obstetricians and Gynaecologists says instructing women to monitor movements may cause increased anxiety. It cites a 1986 study, the same one the RCOG cited in 2011.
What we did not find
We did not search for studies of women who stopped counting because it worried them. The NHS says you do not need to count the number of kicks or movements each day, and Tommy's says you do not need to count a specific number of kicks. That is not advice to stop, which is a question for your own provider.
Common questions
Can counting kicks make me more anxious?
For some women it may. The Cochrane review notes that counting tests can cause considerable anxiety for some women. The studies we read that compared groups mostly found less anxiety with counting or no clear difference, and none found a statistically significant increase, and the RCOG's 2026 guideline says most evidence shows monitoring is not linked to more anxiety. Averages do not tell you how counting will feel for you.
Does counting reduce anxiety?
In one study in the Cochrane review (1,013 women) and one trial in Iran (208 first-time mothers), anxiety scores were lower with counting. A 2022 review of nine studies found no difference between groups, and a small 2022 study found no difference in symptoms after birth. The Cochrane review calls its difference statistically significant but not clinically important. Two trials found slightly more women anxious or insecure with counting, which was not statistically significant: the 1989 cluster trial and a 1990 trial against hormone tests. None of this tells you whether to count, which is a decision for you and your midwife or doctor.
Should I stop counting if it worries me?
Follow the method your midwife or doctor gave you, and tell them how counting makes you feel. They may have asked you to count for a reason that applies to your pregnancy. The NHS says you do not need to count the number of kicks or movements each day, and Tommy's says you do not need to count a specific number of kicks.
What if I feel anxious about movements even without counting?
Tommy's, on its page about an anterior placenta, says you may feel anxious about your baby's movements, especially after difficult experiences in other pregnancies, and that your midwife can arrange support with your mental health. If your baby's movements feel different, contact your maternity unit immediately and do not wait to see whether the worry passes.
Is a count that looks fine a reason not to call?
No. The advice does not depend on a count. The NHS and the RCOG say to contact your midwife or maternity unit immediately if your baby moves less than usual or the pattern changes. The RCOG says that over 28 weeks you must not wait until the next day.
Sources
These are the sources behind the statements on this page. We opened each one and checked it on the date shown.
- Mangesi L, Hofmeyr GJ, Smith V, Smyth RMD. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database of Systematic Reviews, 15 October 2015 (summary of findings)
A 2015 Cochrane review found a statistically significant but not clinically important reduction in anxiety with routine counting in one study of 1,013 women.
Limits: It was the only study of anxiety in the main comparison (Cambridge Worry Scale, moderate-quality evidence), so nothing was pooled. Two other trials in the review reported nervousness or insecurity in other comparisons. In a 1990 trial of counting against hormone tests, more women said counting made them insecure (relative risk 3.55, 95% interval 0.98 to 12.82 at 35 weeks), which was not statistically significant.
Checked . Read directly from the source.
- Mangesi L, Hofmeyr GJ, Smith V, Smyth RMD. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database of Systematic Reviews, 15 October 2015
A 2015 Cochrane review of five studies (71,458 women), too few and too weak to be sure, found no difference in stillbirth between routine and mixed or undefined counting.
Limits: Two of the five studies compared routine counting with standard care or mixed or undefined counting; the other three compared counting methods, or counting with hormone tests, so most results come from single studies. One study of 1,013 women found less anxiety with counting. In another, antenatal admissions after women reported decreased movements rose with counting (relative risk 2.72, 95% interval 1.34 to 5.52; 123 women). The review is about ten years old, calls for more research, and notes that counting tests can cause considerable anxiety for some women.
Checked . Read directly from the source.
- Delaram M, Shams S. The effect of foetal movement counting on maternal anxiety: a randomised, controlled trial. Journal of Obstetrics and Gynaecology, 2016;36(1):39-43
A 2016 randomized trial of 208 first-time mothers in Iran found lower anxiety scores at 37 weeks among women asked to count movements daily from 28 weeks than among women given standard care.
Limits: Anxiety was measured with the Spielberger State-Trait Anxiety Inventory, and the groups did not differ at 28 weeks. At 37 weeks the mean state anxiety score was 35.34 with counting and 38.25 with standard care. The women were all first-time mothers expecting one baby, in one country's care system. We read the abstract only.
Checked . Abstract read at the source.
- AlAmri N, Smith V. The effect of formal fetal movement counting on maternal psychological outcomes: a systematic review and meta-analysis. European Journal of Midwifery, 2022;6:10
A 2022 systematic review of nine studies (70,824 women, 68,654 in one trial) reported no differences in maternal anxiety or worry with formal counting; four studies reported anxiety, not pooled.
Limits: Within it, one trial found lower anxiety with counting and the 1989 trial found slightly more women anxious with counting (2.0 per 100, not statistically significant). It reported higher maternal-fetal attachment with counting across five studies (1,565 women), with very high heterogeneity. The authors say a Hawthorne effect could potentially over-estimate the positive effects, and that contamination between groups may have influenced the results.
Checked . Read directly from the source.
- Owens B, Libertus K. Are there postnatal benefits to prenatal kick counting? A quasi-experimental longitudinal study. Frontiers in Psychology, 26 January 2022
A 2022 study of 50 mother-infant pairs found that depression and anxiety symptoms after birth did not differ significantly between women who had counted kicks and women who had not.
Limits: A small study. Women were grouped by when they enrolled: 25 completed a daily kick count for two weeks in the third trimester and a second group enrolled after birth. Symptoms were self-reported after birth only. It does not say counting increased anxiety.
Checked . Read directly from the source.
- Huang H, Ceavers O, Pinzón-Iregui MC, Howard MM. Connecting with fetus: the use of app-based fetal movement counting and experiences during pregnancy and birth. Midwifery, 2025;140:104214
A 2025 study of 1,147 users of the Count the Kicks app found that more frequent counting was associated with lower pregnancy-related anxiety and more bonding with the baby.
Limits: Observational: it describes people who chose to use the app and answered an end-of-pregnancy survey, so it cannot show that counting lowered anxiety. The authors report inadequate compliance with daily counting. We read the abstract only.
Checked . Abstract read at the source.
- Whitworth M, Fisher M, Heazell A, Royal College of Obstetricians and Gynaecologists. Reduced Fetal Movements, Green-top Guideline No. 57, second edition. BJOG 2026;133(8):e70-e92, first published 27 April 2026 (section 7)
The RCOG's 2026 guideline says most evidence indicates that asking women to monitor fetal movements is not associated with more maternal anxiety, and that it increases maternal-fetal attachment.
Limits: Graded B. This replaces the 2011 edition's caution that monitoring is potentially associated with increased anxiety, though the guideline still says clinicians must take account of potentially negative effects of maternal stress and anxiety. The section still notes a small cohort in which 23% of women reported anxiety, and says perceiving reduced movements is itself associated with anxiety.
Checked . Read directly from the source.
- Royal College of Obstetricians and Gynaecologists, Reduced Fetal Movements, Green-top Guideline No. 57, first edition, February 2011 (section 7)
The RCOG's 2011 guideline said instructing women to monitor fetal movements is potentially associated with increased maternal anxiety, and that clinicians should be aware of this.
Limits: Graded B. The text cites a small 1986 retrospective cohort in which 23% of women reported anxiety. The same section said two studies, one of them randomized, reported no adverse effects. The 2026 second edition replaces it: most evidence indicates asking women to monitor movements is not associated with increased anxiety (grade B).
Checked . Read directly from the source.
- Sri Lanka College of Obstetricians and Gynaecologists, Managing reduced fetal movements (SLCOG guideline), Sri Lanka Journal of Obstetrics and Gynaecology, September 2023, reference 18: Draper J, Field S, Thomas H, Hare MJ, British Journal of Obstetrics and Gynaecology, 1986
The Sri Lanka College of Obstetricians and Gynaecologists' 2023 guideline says instructing women to monitor movements may cause increased anxiety, citing a 1986 study.
Limits: The 1986 study (Draper and colleagues) is the same one the RCOG's 2011 guideline cited. The guideline gives the statement as a caution and adds that kick-charts are helpful for high-risk pregnancies. We did not read the 1986 study. The trials of anxiety in the Cochrane review and later studies are newer.
Checked . Read directly from the source.
- NHS, Your baby's movements, page last reviewed 8 July 2024
The NHS says there is no set number of movements you should feel each day, that you do not need to count your baby's kicks, and that you should get to know your baby's usual pattern.
Limits: NHS advice is written for the UK. Advice elsewhere differs, and your own midwife or doctor comes first.
Checked . Read directly from the source.
- Tommy's, Baby movements in pregnancy, last reviewed 30 January 2026
Tommy's says there is no set number of normal movements, that you do not need to count a specific number of kicks, and that you should get to know your baby's usual movements from day to day.
Limits: Tommy's is a UK charity. The page lists the clinicians who reviewed it for clinical accuracy and says it is certified under the PIF TICK for health information. It also says that with an anterior placenta you should still feel regular movement, and what is normal for your baby will just be different.
Checked . Read directly from the source.
- Tommy's, Anterior placenta, last reviewed 6 March 2026
Tommy's says you may feel anxious about your baby's movements, especially after difficult experiences in other pregnancies, and that your midwife can arrange support with your mental health.
Limits: UK charity advice. The sentence sits in the page's section on movements, and it points to your midwife for mental health support.
Checked . Read directly from the source.
- Royal College of Obstetricians and Gynaecologists, Your baby's movements in pregnancy (patient information based on Green-top Guideline No. 57, February 2011)
The RCOG says that if your baby moves less than usual or the pattern changes, it is essential to contact your midwife or maternity unit immediately, and that over 28 weeks you must not wait until the next day.
Limits: UK patient information published February 2019 and based on the 2011 guideline; the RCOG still had it online on 17 October 2026. The guideline's second edition (April 2026) says to report any decrease or stopping of movements and finds insufficient evidence for counting to set numbers. Advice elsewhere differs, and your own midwife or doctor comes first.
Checked . Read directly from the source.
- NHS, Your baby's movements, page last reviewed 8 July 2024
The NHS says to call your midwife or maternity unit immediately if your baby moves less than usual, you cannot feel movement, or the usual pattern changes, and not to wait until the next day.
Limits: NHS advice is written for the UK. Advice elsewhere differs, and your own midwife or doctor comes first.
Checked . Read directly from the source.