Knowing what to do about reduced fetal movement
Your baby will be moving in your womb from as early as seven weeks. She will be bending and startling, then flexing, rolling and turning. As your baby continues to grow and develop during your pregnancy she will also start to move her limbs and even suck her thumb. Your baby can be quite acrobatic.
You might get a glimpse of this at your early scan but around 18 to 20 weeks you should start to feel the fetal movement for yourself. These first tiny movements give mothers-to-be comfort and reassurance that their baby is active and well. As the ‘kicks’ get stronger it’s also a great way for your partner to feel the baby in your tummy and begin to make a physical bond.
Why it’s good to know your baby’s movements
Pregnant mums are strongly encouraged to be aware of their baby’s movements because it can also be a vital indicator if something is wrong.
If fetal movements stop suddenly it could just be a sign that your baby is unwell and conserving energy by moving less. And, if this symptom is reported quickly, it can provide an opportunity for health care professionals to take action and perhaps even save your baby’s life.
In the UK, 55% of women who experienced a stillbirth had noticed a marked decrease, or halt, in their baby’s movements but did not report it in time.
What your baby’s movements feel like
The most common feelings a pregnant mum will have when her baby moves are discrete kicks, flutters, swishing and rolling.
As a first time mum-to-be it you might not feel fetal movement until around weeks 24 to 28 weeks. Some women feel it much earlier, especially second-time mums. At first it just feel like butterflies or a ‘quickening’ in your tummy. Some pregnant women describe a tickling sensation and others report that it can feel more like gas or indigestion.
You might also feel rhythmic and small jerking movements. This could be a case of hiccups for your baby. These are not considered movements and you should try to recognise the difference.
As your baby’s activity and movements increase and get stronger during weeks 28 to 32, they might become more jab-like from your baby’s arms and legs. Some mothers-to-be may also feel kicking to the ribs, which can sometimes be uncomfortable.
By the time you reach 32 weeks your baby’s movements will have become established and regular. There may be less room for your baby to be quite so acrobatic in your womb, but it’s important to know that the pattern of your baby’s movements will not change.
Get familiar with you baby’s movement patterns
The best person to know and understand your baby’s movements is you. As mother-to-be, your baby’s physical presence in your womb gives you a direct experience.
Each baby’s routine is unique to them. Try not to worry if what your baby’s routine and level of movement is different to other pregnant women around you. The important thing is what is normal for you and your baby. Getting to know this can help you to be prepared to recognise any change and take action if necessary.
Some things you might want to be familiar with are:
- the time of day when activity is increased – morning, lunchtime or evening
- if your baby’s activity increases after you eat
- if your baby responds to certain outside sounds, noises or music
- a sleep will be a period of between 20 to 40 minutes but no longer than 90 minutes
Sometimes, if your placenta is in front of your uterus it may not be as easy to feel your baby’s movements but it is still possible to detect them.
How your partner can help monitor fetal movements
Your partner may also be able to share some responsibility for helping you to monitor your baby’s movements. When you are less active, sitting on the sofa perhaps, you may start to notice your baby’s activity more clearly. Sometimes, the busier and more active you are the more the baby is lulled to sleep. Your partner could help you monitor your baby in these quieter moments.
If you suspect a problem
Trust your instincts and don’t delay. If you are concerned and have noticed that your baby’s movements have slowed or stopped altogether, you need to get in touch immediately with your midwife or hospital.
Some pregnant mums use hand held monitors, dopplers and phone apps at home to check baby’s heartbeat. However, these should not be relied upon in place of expert, medical support.
Getting medical attention if movement reduces
In most cases, your midwife or GP will be the first to assess you and if required you may need to go to hospital to be monitored. The checks they will need to perform include:
- monitoring your baby’s heartbeat
- measure the size of your baby
- check your blood pressure
- take a urine sample to check for protein
If the baby is considered smaller than expected then an ultrasound will be necessary. If you need an ultrasound, this will look at the growth and development of the baby, risk factors associated with stillbirth and amniotic fluid levels.
If reduced fetal movement occurs after 28 weeks it is likely that your baby’s heart will be monitored for a 20 minute period. If a problem is identified then an ultrasound will take place within 24 hours and possibly referral to a specialist.
Some reasons why slow fetal movement is detected
It is not clear why fetal movement slows sometimes, but there are some links with certain conditions or contributing environmental factors:
- smoking and drinking alcohol – when smoke or alcohol pass across the placenta it can distress the baby
- stress – if you are anxious and stressed this will release hormones causing baby to move less
- dehydration and fasting – can cause the baby to conserve energy and move less
- membrane rupture – if your membrane ruptures (waters breaking) it could cause leaking of the amniotic fluid which reduces the space the baby has to move in
- placental abruption – where the placenta separates from the uterine wall. Minor cases will heal but in severe cases it will restrict flow of oxygen and blood to your baby
- fetal hypoxia – when the umbilical cord fails to deliver enough oxygenated blood to the baby
- intrahepatic cholestasis – a disorder that affects the liver and reduces oxygen and blood flow to the babySome of the above may mean your baby is in grave danger, so it is important to get yourself checked out if you are at all worried that your baby is not kicking and moving in its usual pattern.