Using Movement to Determine a Child's Health Before Birth

When the lack of movement could be a sign of trouble

Black pregnant woman holding her stomach at window
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From the moment that you first start to feel your baby move, which doctors refer to as quickening or flutters, you will likely begin to use those movements as a means to check in on your baby's health.

For first-time mothers especially, any changes in the frequency or quality of movement can be a source of significant stress. And while people will often tell you that this is perfectly normal the closer you get to delivery, is there a line where a mother should start worrying?

The Quality of the Baby's Movements

Typically speaking, the fetus will begin to flutter at around week 18 to 24 of gestation. At first, it may be hard to distinguish whether it is your baby you're feeling or gas. But, over time, those movements will become more characteristic and robust. They are something we look forward to, reassurances that the child is developing normally and will be healthy and strong upon birth.

Most doctors, in fact, will tell you that fetal kicks after week 28 are one of the better predictors of the baby's well-being.

But the quality of those movements can sometimes change as you move beyond week 30. No longer will your baby be able to flip around as readily as the uterus become increasingly cramped. Soon enough, rather than feeling acrobatic-like twists and turns, you may experience little tickles and squirming motions instead. There may also be a sudden jab or kick that can feel downright uncomfortable.

At the same time, the baby may move less frequently simply because there is less room to navigate. And, while you may be told not to worry, that the baby is just settling into the birth position, there are times when these changes do warrant medical investigation.

How to Know When to Call for Help

Generally speaking, it is natural to go from feeling big movements during early pregnancy to experiencing smaller squirms and jabs in later pregnancy.

It is also common to feel less motion as the baby begins to takes a vertex (head down) position in the womb.

However, if you believe these changes are abnormal, doctors and midwives will usually ask you to keep a journal of the the fetal kick count.This allows you to track, hour by hour, how often you often you feel distinct movement from your baby. There is no hard-and-fixed rule as to how much is too little, but most doctors will suggest that ten distinct movements over two continuous hours is a sign that everything is A-okay.

Keeping a journal also allows you to be more aware of the subtle movements that are sometimes easily missed. Certainly, as parents make preparations for everything from the trip to the hospital to painting the nursery, there can be a lot of stress. It's not unusual for a mother to become less aware of a little tickle when stress levels are high.

However, if the journal tells you that fetal kick count is low, you will want to report this to your doctor or midwife immediately. In such case, you will be asked to undergo series of tests to assess the well-being of your baby.

Chief among them is the non-stress test (or NST) to evaluate your baby's heart rate in association with uterine activity.

If the baby is inactive during the exam, the mother may be asked to drink something with sugar or bubbles to perk it up. If this doesn't work, a loud noise may be used to startle the baby.

More often that not, the baby will react normally and be just fine. If not, additional tests will be performed to determine whether there are any abnormalities that need urgent care. In the end, early diagnosis allows for early intervention.

A Word From Verywell

The bottom line is this: trust your instincts if something doesn't feel right with your pregnancy. Yes, you could be wrong, but never let the fear of being wrong stop you from seeking care

Ultimately, when it comes to pregnancy, there is no such thing as being too concerned. Never let anyone suggest that it's your "hormones talking" or that you're just being neurotic. As cliché as it may sound, it's always better to be safe than sorry.

Source

  • American Congress of Obstetricians and Gynecologists (ACOG) " ACOG Practice Bulletin Number 145: Antepartum Fetal Surveillance." Obstet Gynecol. 2014; 124:182-192.

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